urinalysis (done) Flashcards
define micurate
(1 mark)
to urinate
define polyuria
(1 mark)
excessive production of urine
define oliguria
(1 mark)
reduced urine output
define anuria
(1 mark)
complete suppression of urine production
define dysuria / stranguria
(1 mark)
painful / difficult urination
define proteinuria
(1 mark)
protein in the urine
define urolithiasis
(1 mark)
uroliths / urinary crystals present
define haematuria
(1 mark)
blood in the urine
define glucosuria
(1 mark)
glucose in the urine
why might a urine exam be performed?
(1 mark)
assess kidney function, behaviour changes in the animal
what diseases can urinalysis help diagnose?
(5 marks)
- kidney disease
- liver disease
- FLV
- uroliths
- diabetes insipidus / mellitus
patient prep for urine sample?
(5 marks)
- ask owner to obtain morning sample as more conc
- obtain sample without meds if poss
- ask when last had meds
- obtain sample before IVFT
- prep owner for transportation + storgae - give them container
sample collection methods?
(4 marks)
- natural urination (free catch / litter tray)
- manual expression
- catheterisation
- cytocentesis
equipment needed for natural urination collection?
(5 marks)
- gloves
- commercial, sterile urine collection kit
- clean, sterilised litter pan
- commercial, sterile, non-absorbale cat litter
- steril universal container
advanatges of free catch?
(5 marks)
- non-traumatic
- quick + easy
- cheap
- non-invasice
- client can obtain sample if given correct instructions
disadvantages of free catch?
(5 marks)
- poor patient compliance
- mid stream sample different in female dogs
- sample contamination (non-sterile)
- only small amount urine passed may result in insufficent sample obtained (male)
- cat litter may become contaminated if cat defecates
equipment for manual expression?
(4 marks)
- gloves
- patient restraint
- commercial, sterile urine collection kit
- sterile universal container
how to perform manual expression?
(3 marks)
- isolate bladder
- gentle pressure (with one / both hands)
- squeeze cranial to caudal
advantages of manual expression?
(4 marks)
- relativey simple method of urine collection in unconcious patient
- minimal trauma if patient relax
- non-invasive
- cheap if no sedation required
disadvantages of manual expression?
(5 marks)
- non-sterile sample will be obtained
- can be difficult to isolate bladder id insufficient urine / large abdo
- strong resistance in some concious patients
- risk of bladder rupture if undue pressure exerted / urethral blockage present
- can be distressing for patient
equipment needed for urinary catheterisation?
(8 marks)
- sterile gloves
- assistant to restrain patient
- sterile 10-20ml syringe
- sterile water soluble lubricant
- adequately sized urinary catheter
- sedative may be required
- sterile container
- speculum for female dogs
how to perform urinary catheterisation in male dog?
(6 marks)
- clip + prep prepuce
- assistant pull back sheath + restrain dog
- cut packaging to keep catheter steile when advancing
- needs lubricant
- check for urine flush back
- collect sample / flush bladder if needed
how to perform urinary catheterisation in male cat
(7 marks)
- sedation / GA required
- clip + prep prepuce
- assistant pull back sheath
- cut packaging to keep catheter steile when advancing
- needs lubricant
- check for urine flush back
- collect sample / flush bladder if needed
advantages of urinary catheterisation?
(3 marks)
- bladder doesnt have to be distended to sample
- quick + easy in males
- other tests may be carried out on bladder at same time (e.g. radiograph contrast study)
disadvantages of urinary catheterisation?
(5 marks)
- causes discomfort to patient - commonly GA patient
- skilled technique more difficult in female
- risk of urological infection
- risk of urethral / bladder wall damage
- contamination of sample still occur even with aspectic prep of external genital area
what is cytocentesis?
(2 marks)
- gold standard for sterile sampling
- aseptic introduction of needle through abdomen wall into bladder
equipment needed for cytocentesis?
(7 marks)
- electric clippers
- detergant scrub
- surgical spirit
- sterile gloves
- sterile hypodermic needle
- sterile 10ml syringe
- sterile container
advantages of cystocentesis?
(6 marks)
- quick
- inexpensive, if no sedation
- sterile sample
- no urethral contamination
- infection uncommon
- preffered method for bacterial culture
disadvantages of cysocentesis?
(5 marks)
- stressful + painful for patient
- sedation / GA may be required
- skilled technique, training required
- risk of internal damage of bladder / other organs
- can result in false positive for haematuria
urine collection + storage?
(4 marks)
- avoid collection without secure lid
- ensure sterile container
- refridgerate 4-8 degrees for 6h
- can freeze but damages cells - still okay for chemical testing
what are the urine preservatives?
(and what urinalysis test it is used for?)
(8 marks)
- boric acid - culture (freezes bacteria)
- tolulene - chemistry
- formaline 10% - cytology
- thymol - chemistry - tablet that maintains chemistry base
how soon after collection should urine be tested?
(2 marks)
40-60 mins
if left grows bacteria not present in urine + can form struvite crystals
which methods of examination can be done once sample obtained?
(3 marks)
- physcial properties
- chemical properties
- microscopic properties
what are the physcial properties of urine?
(5 marks)
- colour
- odour
- turbitidy
- pH
- specific gravity
normal colour of healthy cat / dog / rabbit / hamsters?
(5 marks)
- dog - pale yellow
- cat - pale yellow
- (dictated by sex + diet - males have more conc than female and dry diet more conc)
- rabbits - red due to beta-carotene in diet
- hamsters - cloudy
what pink / red / reddish brown urine colour indicates?
(1 mark)
prescence of intact RBCs / haemoglobin / myoglobin (uncommon)
what orange urine colour indicates?
(1 mark)
bile pigmenets / bilirubin present
what dark brown - black urine colour indicates?
(1 mark)
conversion of haemoglobin to methamoglobin in acidic urine myoglobinuria - paracetamol toxicity
what yellow / brown - green / brown urine colour indicates ?
(1 mark)
concentrated sample, pseudomonas infection
what green / green-blue urine colour indicates?
(1 mark)
methylene blue treatment
define turbitidy
(1 mark)
urine contaminated with ‘stuff’ - causes cloudy appearance
what may cause normal urine to become turbid?
(1 mark)
due to phosphate precipitates
what may a turbid sample indicate?
(5 marks)
the presence of:
* crystals
* pus
* mucus threads
* excessive WBCs / RBCs
* prostatic / vaginal secretions
odour of normal urine?
(1 mark)
slightly sour, ammonia-like odour
what odour of urine may indicate?
(3 marks)
- male - stronger smelling
- pungent ammonia in fresh urine - bacteria
- uncontrolled diabetes mellitus - sweet + fruity urine - prescence of ketones
define specific gravity
(1 mark)
density / weight of water of a fluid compared to an equal vol of distilled water
SG reference ranges for dogs and cats?
(2 marks)
- dog = 1.050-1.045
- cat = 1.020-1.050
what non clinical factors may cause an animal to have a higher / lower SG?
(2 marks)
- dry diet - slightly higher than wet
- IVFT / high water intake - low SG
what does urine dipstisk test for?
(10 marks)
- glucose
- bilirubin
- ketones
- SG
- blood
- pH
- protein
- urobillinogen
- nitrate
- leukocytes
glucose on dipstick test?
(3 marks)
- small amount present in urine - insufficient to be detected
- usually inidcates overload but can indicate tubular dysfunction
- can see false negatives on cold samples
bilirubin on dipstick test?
(2 marks)
- dogs (usually male) have small amount bilirubin present
- info on liver - particularly cholestasis
ketones on dipstick test?
(4 marks)
- indicated production of excess ketones as result of negative energy balance
- false negatives with delayed testing, interference by other chemicals / drugs
- not usually seen in urine
- positives associated with uncontrolled diabetes mellitus, hyperthyroidism etc
SG on dipstick test?
(2 marks)
- measures conc abilities of kidneys
- can be incorrect check with refractometer
blood on dipstick test?
(2 marks)
- false negatives if RBCs settles out
- positives can result from haematuria, haemoglobinuria, yoglobinuria - prescence of these is abnormal
pH on dipstick test?
(3 marks)
- not very accurate
- tells us how kidneys respond to acid-base disturbances / dealing with the normal acid load produced from amino acid metabolism
- avoid contamination of this pad from protein pad
protein on dipstick test?
(3 marks)
- not usually present in urine
- false positives not uncommon - can be due to alkaline urine
- better test is creatine ratio test
urobilinogen on dipstick test?
(3 marks)
- metabolite of bilirubin
- not useful in small animals as often false negatives + positives freq occur
- abscence of it cannot be detected on dry reagent strip
nitrate on dipstick test?
(3 marks)
- not found in urine
- can also be produced by some bacteria
- not useful in small animals
leukocytes on dipstick test?
(4 marks)
- can see false negatives in dogs
- false positives in cats
- shows pyuria but doesnt measure conc of leukocytes in sample
- primarily detects neutrophils
microscopic components of urine?
(8 marks)
- crystals
- cells
- spermatazoa
- bacteria, fungi + yeast
- casts
- parasites
- fat droplets
- artefacts
clinical conditions that can influence crystal production?
(5 marks)
- genertic predisposition
- bacterial infection
- diet
- concurrent illnesses
- medication
what are casts?
(6 marks)
- = short, cylindrical structures with parallel sides and tapered ends
- predominantely composed of protein secreted by epithelial cells lining the renal tubules
- cells naturally shed over course of animal life
- apperance of one / two per low power field considered normal
- excessive no. may indicate renal disease process
- waxy or granual - depend where is shed
info of fat droplets (lypurea)?
(4 marks)
- commonly seen _ vary in size
- fat cells float up under cover slip to different plane of focus to other cells
- can occur as artefact due to catheter lubrication.
- prescence may indicate diabetes mellitus, obesity and hypothyroidism
when may an artefact contaminate the urine?
(1 mark)
during collection, transportation or examination of the sample
what could appear as an artefact?
(5 marks)
- hair
- bubble
- crystals
- dirt
- grass
