Urinanalysis Flashcards
Normal pH for carnivores
5.5-7.5
Normal pH for herbivores
7-8.5
Where in the renal tubule is glucose normally resorbed?
Proximal renal tubules
T/F: Glucose is normal in urine
True
Three types of ketones
Acetone*
Acetoacetate**
B-hydroxybutyrate
What effect does sperm have on urine protein?
Positive protein reaction
Positive blood reaction
Normal canine specific gravity
> 1.030
Normal feline specific gravity
> 1.040
Normal large animal specific gravity
> 1.025
Hyposthenuria
Kidney can DILUTE but cannot concentrate
*Unresponsive to ADH
What part of the nephron still is functional with hyposthenuria?
Proximal renal tubule and loop of henle
Isosthenuria
Kidney cannot concentrate OR dilute urine
USG 1.008-1.012
Types of epithelial cells seen in urine
Squamous
Transitional
Caudate
Renal tubular epithelium
Where do squamous epithelial cells originate from?
Distal urethra
Vagina/prepuce
Where do transitional epithelial cells originate from?
Urinary bladder
Proximal urethra
Where do caudate epithelial cells originate from?
Renal pelvis
**Not normal to see in urine
(Looks like tadpoles)
Where do renal tubular epithelial cells originate from?
Renal parenchyma
What does it indicate if renal tubular epithelial cells are seen?
Renal damage or inflammation
What types of casts are normal in low numbers?
Granular
Hyaline
Epithelial (cellular) casts
Nephritis
Granular casts
Renal tubular damage
Waxy casts
Chronic tubular lesion/disease
Order of cast formation
Cellular
Coarsely granular
Finely granular
Waxy
Fatty casts
Fatty degeneration of epithelial cells
Cats
Hyperlipidemia
Hemoglobin casts
Intravascular hemolysis
What type of crystal is normal to be seen in horse, rabbit, guinea pig, elephant?
Calcium carbonate
What type of crystal can be an artifact formed with refrigerated samples?
Magnesium ammonium phosphate (MAP, struvite)
Urates seen in what predisposed breeds?
Dalmation
English bulldog
Uric acid
Avian urine
Two forms of Calcium oxalate
Dihydrate
Monohydrate
Calcium oxalate dihydrate seen in urine means what?
Normal
Calcium oxalate monohydrate seen in urine means what?
Ethylene glycol posioning
Ammonium biurate
Sever hepatic disease (shunt, sago palm)
Bilirubin crystals
Normal in low numbers
Always significant in cats
Extavascular hemolysis
Liver disease
Cystine crystals
Look for urolith!
I cant C U - cystine, urate
Sulfa crystals
Patients administered sulfa-containing drugs
Other things that can be seen in urine
Bacteria
Blood
Lipid droplets
Fungal organisms (Aspergillosis)
Yeast (Candida, indwelling catheters)
Parasites (Trichuris, Pearsonema, Dioctophyma)
Neoplasia (Atypical transitional epithelium)
Clinical signs of renal disease
Nonspecific signs Vomiting, dehydration Halitosis, oral ulcerations Palpable abnormalities Changes in water intake, urination
When can PU/PD be seen?
Acute/progressive phases of chronic disease
Recovery phase of acute kidney injury
Ways to become PU/PD
Osmotic diuresis/medullary washout Decreased ADH ADH resistance Iatrogenic (diuretics, steriods, anticonvulsant) Psychogenic
Medullary washout
Chronic PU/PD
Liver failure
Causes of osmotic diuresis
Chronic renal disease
Diabetes mellitus
Fanconi syndrome
Post-ostructive disease
Causes of decreased ADH secretion
Central diabetes insipidus
Damage to pituitary
ADH resistance
Common cause of PU/PD
Secondary nephrogenic diabetes insipidus
Anemia with chronic renal disease caused by what?
Decreased EPO production
What are BUN and creatinine markers for?
Glomerular filtration rate
Azotemia
Increased BUN and/or creatinine (due to decreased GFR)
Uremia
Clinical signs of azotemia
What can cause increased BUN?
Decreased GFR
High protein diet
Hemorrhage (GI)
Increased protein catabolism
Types of Azotemia
Pre-renal
Renal
Post renal (Obstruction, extra-renal)
Pre-renal azotemia
Dehydration, shock
Renal azotemia
75% renal mass lost
Post-renal azotemia
Obstruction
Leakage of urine into abdomial cavity
Hypovolemia (endotoxins, decreased medullary hypertonicity, electrolyte abnormalities, endocrine disorders)
Signs of Renal disease without azotemia
Proteinuria
Glucosuria withouth hyperglycemia
Casts
Reduced ability to concentrate in dehydrated animal
Cause of decreased BUN
Hepatic failure/shunt
Increased serum creatinine
Decreased GFR
Same diseases as BUN
Not typically GI or hemorrhage
Severe muscle damage
Decreased serum creatinine
Significant loss of muscle mass
Pregnancy
Creatinine in abdominal fluid
uroabdomen
Urinary biomarkers
SDMA Cystatin C FGF-23 NGAL Immunoglobulins ETC
Hyperkalemia
Anuric or oliguric renal failure (decreased excretion)
Hypokalemia
Polyuric renal failure (loss)
Pre-renal elevation of sodium
Dehydration
Renal decreased sodium
Chronic renal failure
High K, low Na
Uroabdomen
Low K, low Na
Chronic kidney disease
Two types of metabolic acidosis
Loss of bicarb (kidneys conserve Cl)
Build up of acids (kidneys do NOT conserve Cl)
Causes of loss of chloride (without loss of sodium)
GI: loss of chloride rich fluid (vomiting), sequestration (displaced abomasum, GDV)
Renal: renal disease
Cutaneous: sweating (horses)
Causes of hyperphosphatemia
Renal disease (decreased P excretion)
Why is control of hyperphosphatemia important?
Causes secondary hyperparathyroidism -> bone resorption and renal mineralization ( wants to elevate Ca and dump P)
Renal damage
Oral phosphate binders
Hypercalcemia
Usually in horses with renal dz
Cattle in renal failure have elevated _____
fibrinogen
Dogs in renal failure have elevated ____ and ____
amylase, lipase
Animals with chronic kidney disease are usually
anemic and polyuric
Animals with acute kidney injury are
anuric, oliguric
Urine protein : creatinine ratio
Can diagnose PLN
Urine fractional excretion used to determine what?
Renal clearance of various substances
Water deprivation test
Not usually used
Tests ability of kidneys to concentrate urine
