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Lab D > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

Sampling procedures

A
  • Free catch sample
  • Catheterisation
  • Cystocentesis
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2
Q

Free catch sample - advantage and disadvantage

A 
Adv:
no restraint or sedation
no special equipment
done by owner
Disadv:
easily contaminated
not to be used for microbiological culturing
animal will not urinate if disturbed
impossible to do with cat using a litter box
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3
Q

Catheterisation - advantage and disadvantage

A

Adv:
less contaminated (not to be used for microbiological culturing)
additional info for diagnosing urethra obstruction
sample even in bladder is empty
can measure volume over a period of time
Disadv:
special equipment needed
small animal females & large animal males are difficult
danger of transferring bacteria
risk of traumatic injury
small bleeding = false + for blood in urine
sedation needed sometimes

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4
Q

Cystocentesis - advantage and disadvantage

A 
Adv:
sterile samples
not influenced by urethral or genital problems
safe, no sedation
Disadv:
rare but trauma can occur
minor bleeding
cats have vagal stimulation = transient SX
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5
Q

Why must urine samples from horses be filtered before analysis?

A

They contain mucous and crystals that can disturb the analysis

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6
Q

Urine is yellow because of?

A

Urobilins. Specifically d-/i-/l- urobilin.
Normally, should be clear and yellow to straw coloured.
Horses may have turbid urine.

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7
Q

Very light yellow or pale straw colour urine indicates?

A 
Low SG (specific gravity)
Polyuria/ Polydipsia in diabetes mellitus or chronic kidney failure
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8
Q

Deep yellow / orange urine indicates?

A 
Very concentrated
Oliguria, dehydrated, acute kidney failure
Jaundice = increased bilirubin content
Drug effects
Food sources
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9
Q

Dark yellow - greenish urine indicates?

A

Biliverdin
Stasis of urine due to blockage
Long storage

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10
Q

Red, yellow - reddish urine indicates?

A

Haemoglobinuria / haematuria

Food sources

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11
Q

Dark red brown, chocolate urine indicates?

A

Oxidized haemoglobin
Methaemoglobin present (babesiosis, paracetamol toxicosis)
Myoglobinuria (burns)

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12
Q

Blue urine indicates?

A 
Methylene blue (drugs, vitamins, food dyes)
Pyuria due to Pseudomonas spp. infection
Genetic disease in humans
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13
Q

Green urine indicates?

A 
Fod sources
Drug sources (propafol IV)
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14
Q

Cloudy or opaque urine indicates?

A 
Mucous
Proteinuria ( kidney failure, exercise)
Lipiduria
Pyruria
Crystals
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15
Q

Odour of urine

A

Varies among spp.
Stronger in male animals
In case of UTIs or retention = ammoniacal smell
Ketoacidosis = sweet, fruity, acetone like smell

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16
Q

Transparency of urine

A

Transparent in healthy animals (except Horses)

Opacity due to UTI, lipiduria or contamination from vaginal/preputial discharge

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17
Q

Specific Gravity of urine

A

Indicator of concentrating ability (tubular function) of kidneys

  • Ratio of the weight of the liquid to an equal volume of distilled water
  • Increases with increasing cc. of dissolved ions, glucose, proteins, lipids and contrast material
  • Measured by urinometer, refractometer or test strip
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18
Q

Urinometer measurement - adv. and disadv.

A 
Calibrated at room temp.
Adv:
most accurate
not influenced by opacity
Disadv: 
high amount of urine is needed (5-10ml / 30-50ml)
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19
Q

Refractometer measurement - adv. and disadv.

A 
Calibrated with distilled water.
Adv:
One droplet of urine
Disadv:
not reliable if sample is not transparent
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20
Q

Test strip measurement - adv. and disadv.

A

Not useful in animals, unreliable

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21
Q

Physiological range of SG

A

Dogs: 1.015 - 1.040
Cats: 1.035 - 1.060
Can vary due to water intake and hydration status
Measurement essential if there is polydipsia and polyuria

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22
Q

Hyposthenuria (evaluation of SG)

A 
SG < 1.008 (if persistent = pathologic)
Hyper-/hypoadrenocorticism
CDI - central diabetes insipidus
NDI - nephrogenic diabetes insipidus
Renal tubular damage
PP - psychogenic polydipsia
Decrease in urea synthesis
Prolonged fluid therapy = medullary washout
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23
Q

Isosthenuria (evaluation of SG)

A

SG 1.008 - 1.012 (if persistent = pathologic)
Tubules cannot concentrate or dilute primary glomerular filtrate
Indicator of severe tubular damage
Medullary washout
CDI
NDI
PP
(A water deprivation test may be necessary)

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24
Q

Hypersthenuria (evaluation of SG)

A 
SG > 1.012 (normal urine)
Pathologic when:
Decreased water intake
Water loss (vomit, panting, sweating, diarrhoea)
Acute kidney failure
25
Q

Water deprivation test (WDT) goal

A

Assess concentrating ability of tubules, to differentiate between CDI, NDI and PP

26
Q

WDT indications

A

Persistent PU / PD, more than 1 SG measurement classified as hyposthenuria

27
Q

WDT contraindications

A 
Severe endocrine disturbance (DM, Cushings, Addisons)
Dehydration
Uraemia
Pregnancy
UTI
28
Q

WDT interpretation in case of PP, CDI and NDI

A

PP = SG > 1.025
CDI / NDI = SG < 1.010

1.010 - 1.020 values = equivocal / partial CDI

29
Q

How to differentiate between CDI and NDI

A

Perform the DESMOPRESSIN TEST
SG > 1.015 = CDI
SG < 1.010 = NDI

In between = medullary washout

30
Q

Urine pH in herbivores, carnivores and in renal compensation

A

Herbivores pH 7 - 8.5
Carnivores pH 5.5 - 7.5

Renal compensation pH 4 -8.5

31
Q

What affects urine pH?

A

Diet
Recent feeding
Bacterial infection
Storage time

32
Q

False low pH occurs when?

A

Due to contamination by acid from protein region of the test strip

33
Q

False high pH occurs when?

A

Contamination due to detergents, bleach, disinfectants

34
Q

Causes that DECREASE pH ( 7 POINTS )

A 
Metabolic and Respiratory acidosis
Vomiting
Hypokalaemia
Acidifying drugs
Distal renal tubular acidosis
Abomasal displacement
Toxicosis of acidifying substances
35
Q

Causes that INCREASE pH ( 6 POINTS )

A

Feeding in carnivores = slight metabolic alkalosis
UTI
Metabolic and respiratory alkalosis
Proximal renal tubular alkalosis
Overload of HCO3- or lactate containing infusion
Long storage time

36
Q

Measuring methods of Proteinuria (8 methods)

A

1) Test strips = colour change, blue to green
2) Sulphosalicylic acid test = coagulates proteins, high sensitivity, not specific and does not differentiate types and causes
3) Heller test = Gmelin test, shows protein content as an opaque zone above biliverdin and urine
4) Spectrophotometric
5) UPC , info on severity, normal < 0.5, proteinuria > 1
6) Evaluate albumin / globulins
7) Determine Bence-Jones proteins = monoclonal immunoglobulins
8) Microalbuniuria

37
Q

Pre-renal Proteinuria causes

A 
Benign proteinuria:
Occurs in neonates <40 hours of age
Exercise
Hypo-/hyperthermia
Stress 
Pathologic proteinuria:
Increased protein catabolism
Fever
Seizures
Increased BP
Haemoglobinuria
38
Q

Real Proteinuria (nephrogenic)

A

Plasma proteins leak into the urine
When albumin is excreted = selective proteinuria
When IgG appear in urine = non-selective proteinuria

39
Q

Difference in protein content in Acute and Chronic renal failure

A 
Acute = high (inflammation, cc. urine)
Chronic = low (polyuria, diluted urine)
40
Q

Pseudo Proteinuria

A

Proteins detected originate from lower urinary or genital tract
Physiological after parturition
Normal in horses
Pathological in UTI, inflammation of testes/prostate, prostate/vaginal tumour

41
Q

Pus in urine

A

Accumulation of neutrophil granulocytes, tissue cells and microbes
Called PYURIA when in urine

42
Q

How to evaluate pus in urine

A

Donne test

43
Q

Causes of Pyuria (pus)

A

Normal in Eq = positive result
Kidney pelvis inflammation
Cystitis
Inflammation of genital tract

44
Q

Haematuria

A

Presence of blood

Intact RBCs in the urine

45
Q

Hamoglobinuria and myoglobinuria

A

Presence of dissolved haemoglobin and myoglobin in urine

46
Q

Benzidine test

A

Shows the presence of blood, haemoglobin or myoglobin
High sensitivity
Low specificity

47
Q

Urine test strip

A

Speckled appearance = haematuria

Diffused colour = haemoglobinuria / myoglobinuria

48
Q

Causes of haematuria (6)

A

UTI
Trauma
Genital tract injury, tumour or inflammation
Infectious / non infectious inflame. process of UT
Renal infarction
Thrombocytopenia, coagulopathy

49
Q

Causes of Haemoglobinuria (2)

A

Intravascular haemolysis

Long term stasis of blood in bladder

50
Q

Causes of Myoglobinuria (5)

A 
Muscle trauma
Exercise
Ischaemia
Myositis
Burns
51
Q

Renal threshold of Glucose

A

Dogs - 10 mmol/l

Cats - 14-17 mmol/l

52
Q

When can Glycosuria be detected?

A

Hyperglycaemia (duh)
Renal tubular defects = decreased reabsorption capacity
Tested with urine test strips

53
Q

Ketonuria

A

Ketone bodies not present in urine normally
Ruminants - screen for 1st and 2ndary ketosis
Small animals - seen in DKA and starvation
Use urine test strips

54
Q

Nitrite

A

Urine test strips
UTIs
UNRELIABLE IN CARNIVORES, their urine contains no nitrates

55
Q

Bilirubin and UBG

A

Conjugated bilirubin in healthy dog urine
Other spp only appears during jaundice
Urinary test strips or Gmelin test

56
Q

Organic sediments found in Urine

A

1) Blood cells: normal < 5 / hpf, abnormal = haematuria
2) Cells from lower Urogenital tract : norm 0-2/hpf
- Urothelium cells
- Renal tubular cells
- Squamous cells from penis or vagina
3) Viral inclusion bodies
4) Microbes
5) Mucin : fat droplets normal in cats
6) Casts

57
Q

Inorganic sediment found in Urine

A

Struvite crystals

Calcium crystals

58
Q

Different types of crystalluria (alkaline urine)

A
  • Struvite: UTIs
  • Ca carbonate: hypercalcuria
  • Ca phosphate: hypercalcuria
  • Amorphous phosphate: meat and grain diet, cc urine
  • Ammonium ureate/biurate: hepatic function f**d, for eg. dalmatians
59
Q

Different types of crystalluria (acidic urine)

A
  • Ca oxalate: toxic plants consumption in cates
  • Uric acid: dalmatians
  • Cystine: liver failure
  • Bilirubin crystals: pre-/hepatic jaundice
  • Sulphonamiddes: therapy

Lab D (2 decks)

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