urinalysis Flashcards
what are the indications of a cystocentesis?
- 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
what are contraindications of a cysocentesis
- 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!
Grigio’s peepee is yellow orange?
bilirubin
Grigio’s peepee is yellow-green/ yellow brown
Bilirubin and biliverdin dwell within.
grigio’s peepee is red
RBCs or HgB or Mgb…or every single one
Grigio’s peepee is red-brown
RBCs, HB, Hgb, MetHgB (makes the brown)—seek medical attention
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?
yes, its true
Human medicine is convoluted…thats why MDs are dumb (and so are their dipsticks)what info should you go ahead and ignore?
leukocytes (you are more thorough and will make a slide yourself)
USG (once again, more thorough…use a refractometer)
nitrate
urobilinogen
why is cold bad for urine?
it falsely messes with the (increases) USG and creates a false decrease in Urine glucose
will puppies have glucose?
maybe. yes they might…yes?
renal threshold for glucose?
–Dog180 mg/dL
–Cat280 mg/dL
–Horse180 mg/dL
–Cattle100 mg/dL
hyperglycemic glucoseuria is seen in these cases
- Diabetes mellitus –glucose
- Hyperadrenocorticism –cortisol
- Drugs –dextrose, glucocorticoids, progesterone
- Postprandial
- Acute pancreatitis
- Extreme stress
- Pheochromocytoma
- Glucagonoma
- Head trauma
cases of normoglycemic glucosuria
- 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
you see a little bit of bilirubin in a dog, should you be concerned?
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
in anyother species bilirubinuria is abnormal and can be seen in cases of
–Liver disease –Bile duct obstruction –Starvation –Hemolysis –Pyrexia –Horses off feed
what might cause a false negative of bilirubin?
- Old sample
- Light exposure
- Nitrites
- Ascorbic acid
what are the three most important ketones? and which ones are true ketones
–β-hydroxybuterate~78%
–Acetoacetic acid~20%
–Acetone~2%
•Only acetoacetic acid and acetoneare TRUEKETONES;
only true ketones are detected on the dipstick
which ketone will the dipstick not detect
β-hydroxybuterate
where is β-hydroxybuterate found?
–Predominant form in ruminants
–Expect β-OHB in bovine ketosis & pregnancy toxemia in ewes
when you do see ketouria, what are you expecting?
•Excessive/ defective lipid or carbohydrate metabolism •Ketonuria detected prior to ketonemia Ketonuria •Negative energy balance •DKA •Insulinoma
your dipstick sees blood, what might you expect?
HgB, MgB or RBCs; watch out because bleach can cause a false positive reaction.
how can you tell the difference between everything that might make the dipstick test positive for blood?
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
what is the normal pH for dogs and cats? horses and cows?
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
you have an alkaline pH, what are you thinking
UTI (proteus, pseudomonas, staphylococcus)
low protein diet (herbivores and pathologic crystalluria)
respiratory alkalosis, metabolic alkalosis
alkalinizing drugs
you see an acidic pH, what are you thinking
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
how does hypokalemia lead to an acidic pH or urine?
–Body is K+ deficient, so the kidney resorbs K+;
–K+ is exchanged for H+ to maintain electroneutrality
how does furosemide lead to an acidic pH of urine
–Blocks Na+K+2Cl-pump in Loop of Henle;
–Causes inc. Na+& H+excretion
dipstick protein detects
albumin and not Bence Jones proteins or globulins
should you see proteinuria, what should you be thinking
‒Pre-renal: Fever, hypertension, seizures, IV
‒Renal: Glomerulonephritis, renal tubular injury
‒Post-renal:Hemorrhage, infection
what are all the occasions that you can see a positive reaction on a urine dipstick
–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
proteinuria caused by renal disease will look like
- Blood reaction will be negative (usually)
2. Sediment will likely have casts
T/F Proteinuria with nothing in the sediment is most often indicative of glomerular disease
true
sulphosalicylic acid test is used when?
can react with globulins and Bence Jones proteins
