urinalysis

Question 1

what are the indications of a cystocentesis?

Answer 1

• Avoid contamination from the lower urogenital tract
• Minimize iatrogenic urinary tract infection caused by catheterization
• Aid in localization of hematuria, pyuria, and bacteriuria
• Therapeutic cystocentesisin blocked cats –early as part of management

Question 2

what are contraindications of a cysocentesis

Answer 2

• Local pyoderma, coagulopathy, neoplasia (risk of seeding)
• Insufficient volume of urine in the urinary bladder
• Patient resists restraint and abdominal palpation
• No redirecting the needle! If you don’t get urine on the first stick –get a new needle!

Question 3

Grigio’s peepee is yellow orange?

Answer 3

bilirubin

Question 4

Grigio’s peepee is yellow-green/ yellow brown

Answer 4

Bilirubin and biliverdin dwell within.

Question 5

grigio’s peepee is red

Answer 5

RBCs or HgB or Mgb…or every single one

Question 6

Grigio’s peepee is red-brown

Answer 6

RBCs, HB, Hgb, MetHgB (makes the brown)—seek medical attention

Question 7

is it true that horses hate you? and their pee will turn an angry red in storage or pure unadulterated snow? and that there is natural mild turbidity?

Answer 7

yes, its true

Question 8

Human medicine is convoluted…thats why MDs are dumb (and so are their dipsticks)what info should you go ahead and ignore?

Answer 8

leukocytes (you are more thorough and will make a slide yourself)

USG (once again, more thorough…use a refractometer)

nitrate

urobilinogen

Question 9

why is cold bad for urine?

Answer 9

it falsely messes with the (increases) USG and creates a false decrease in Urine glucose

Question 10

will puppies have glucose?

Answer 10

maybe. yes they might…yes?

Question 11

renal threshold for glucose?

Answer 11

–Dog180 mg/dL
–Cat280 mg/dL
–Horse180 mg/dL
–Cattle100 mg/dL

Question 12

hyperglycemic glucoseuria is seen in these cases

Answer 12

• Diabetes mellitus –glucose
• Hyperadrenocorticism –cortisol
• Drugs –dextrose, glucocorticoids, progesterone
• Postprandial
• Acute pancreatitis
• Extreme stress
• Pheochromocytoma
• Glucagonoma
• Head trauma

Question 13

cases of normoglycemic glucosuria

Answer 13

• Transient stress
• Reversible tubular damage: drugs, hypoxia, infection, toxins
• Cats with urethral obstruction (unknown mechanism)
• Fanconi’s syndrome: inherited tubular transport protein defects
• Primary renal glucosuria: inherited glucosuria w/o hyperglycemia

Question 14

you see a little bit of bilirubin in a dog, should you be concerned?

Answer 14

nah…only in other species
Conjugated bilirubin:
•Dog:
–Has low renal threshold
–Canine PCT can conjugate Hgb & excrete bilirubin
–More than 20% normal dogs 1+ bilirubinuria
–Expect bilirubinuria beforebilirubinemia
•2+ bilirubin & USG 1.020 –more concerned
•2+ bilirubin & USG 1.040 –less concerned

Question 15

in anyother species bilirubinuria is abnormal and can be seen in cases of

Answer 15

–Liver disease
–Bile duct obstruction
–Starvation
–Hemolysis
–Pyrexia
–Horses off feed

Question 16

what might cause a false negative of bilirubin?

Answer 16

• Old sample
• Light exposure
• Nitrites
• Ascorbic acid

Question 17

what are the three most important ketones? and which ones are true ketones

Answer 17

–β-hydroxybuterate~78%
–Acetoacetic acid~20%
–Acetone~2%
•Only acetoacetic acid and acetoneare TRUEKETONES;
only true ketones are detected on the dipstick

Question 18

which ketone will the dipstick not detect

Answer 18

β-hydroxybuterate

Question 19

where is β-hydroxybuterate found?

Answer 19

–Predominant form in ruminants

–Expect β-OHB in bovine ketosis & pregnancy toxemia in ewes

Question 20

when you do see ketouria, what are you expecting?

Answer 20

•Excessive/ defective lipid or carbohydrate metabolism
•Ketonuria detected prior to ketonemia
Ketonuria
•Negative energy balance
•DKA
•Insulinoma

Question 21

your dipstick sees blood, what might you expect?

Answer 21

HgB, MgB or RBCs; watch out because bleach can cause a false positive reaction.

Question 22

how can you tell the difference between everything that might make the dipstick test positive for blood?

Answer 22

if there was blood, it will clear with centrifugation (Trauma, infection, inflammation, infarction, calculi, neoplasia, coagulopathy)

if there was hemoglobin in there it will stay red after being centrifuged. urine will also be red brown; usually caused by IV hemolysis

if there was myoglobinuria, the supernatant will stay red and you will need to look for increased AST and CK

Question 23

what is the normal pH for dogs and cats? horses and cows?

Answer 23

Dogs and Cats: 6.4-7.5

horses and cows: 7.5- 8.5

be aware that pigment can hinder interpretation and renal tubular dysfunction can lead to an paradoxically alkaline urine which can lead to a falsely high protein

Question 24

you have an alkaline pH, what are you thinking

Answer 24

UTI (proteus, pseudomonas, staphylococcus)

low protein diet (herbivores and pathologic crystalluria)

respiratory alkalosis, metabolic alkalosis

alkalinizing drugs

Question 25

you see an acidic pH, what are you thinking

Answer 25

high protein diet if its a carnivore or an herbivore that is on milk and drugs

respiratory and metabolic acidosis

hypochloremic metabolic alkalosis and severe dehydration

hypokalemia

furosemide

Question 26

how does hypokalemia lead to an acidic pH or urine?

Answer 26

–Body is K+ deficient, so the kidney resorbs K+;

–K+ is exchanged for H+ to maintain electroneutrality

Question 27

how does furosemide lead to an acidic pH of urine

Answer 27

–Blocks Na+K+2Cl-pump in Loop of Henle;

–Causes inc. Na+& H+excretion

Question 28

dipstick protein detects

Answer 28

albumin and not Bence Jones proteins or globulins

Question 29

should you see proteinuria, what should you be thinking

Answer 29

‒Pre-renal: Fever, hypertension, seizures, IV
‒Renal: Glomerulonephritis, renal tubular injury
‒Post-renal:Hemorrhage, infection

Question 30

what are all the occasions that you can see a positive reaction on a urine dipstick

Answer 30

–r/oHemorrhage
•Positive blood reaction
•Will see RBCs in sediment
–r/oUTI / Cystitis
•Will see bacteria & WBCs on sediment
–r/oIntravascular hemolysis –hemoglobinuria
•Hgb is a protein
•Animal will be anemic

Question 31

proteinuria caused by renal disease will look like

Answer 31

1. Blood reaction will be negative (usually)

2. Sediment will likely have casts

Question 32

T/F Proteinuria with nothing in the sediment is most often indicative of glomerular disease

Answer 32

true

Question 33

sulphosalicylic acid test is used when?

Answer 33

can react with globulins and Bence Jones proteins