Test 2- Urinalysis

Question 1

What is a cystocentesis?

Answer 1

Invasive procedure used to get a urine sample from the bladder of
an animal w/ a needle and syringe. It avoid contamination from the lower Urinary tract, aids in localizing the are of hematuria, pyuria, and bacteriura and be used therapeutically- in blocked cats.

Question 2

What are contraindications for cystocentesis?

Answer 2

Local pyoderma, coagulopathy, neoplasia, insufficient volume of urine in bladder and patient resists restraint and abdominal palpation. Change needle before transferring to red top Cystos can induce microscopic hematuria on a dipstick esp. in cats. – cysto preferred for culture.

Question 3

What is voided urine?

Answer 3

Free catch- mid stream flow- you can have contamination.
Generally acceptable for urinalysis, sediment exam. Not suitable
or cultures

Question 4

What can catheterization result in?

Answer 4

Blood/epithelial cell contamination, trauma, technique difficulty
(esp. in females), track materials into bladder and cause infection, and perform re check UA to check for UTI after catheterization

Question 5

How do you properly handle urine?

Answer 5

Evaluate w/in 30 mins. Refrigerate. Low USG can lead to cell
lysis so make sure to analyze quickly.
• Refrigerate up to 12 hours in sterile, opaque, airtight container. Warm to room temp for 20 mins, gently swish to remix and resusspend sediment

Question 6

When looking grossly, what can the color of the urine tell you?

Answer 6

If they are hydrated (mostly will be yellow)
• Yellow orange – bilirubin
• Yellowgreen/yellow brown- bilirubin and biliverdin
• Red- RBC, Hgb, Mgb
• Red-brown- RBC, Hb, Mgb, Met Hgb
• Brown to black- MetHgbw/ hemoglobin- serum also red/pink; myoglobin- does not accumulate in serum so serum will not be discolored; metHgb- serum brown/black

Question 7

what can the clarity of the gross inspection tell you?

Answer 7

You have clear, slightly cloudy, cloudy, opaque, flocculent (chunky).
• Can have mild turbidity- equine urine tends to be turbid/cloudy.
• Cloudiness or turbidity caused by formed elements, cells,
crystals, bacteria, casts, and lipid droplets (some lipid
normal in cats)

Question 8

What is USG?

Answer 8

SG created by dissolved ions and molecules. Cells, casts and
crystals are not dissolved. So before reading-s pin the sample,
remove the supernatant- read the USG from the supernatatant.

Question 9

What is specific about USG temperature ?

Answer 9

Measure on room temp only! cold fluids more dense so can falsely increase the USG

Question 10

What do you need to interpret the USG along with?

Answer 10

Serum [UN] and [creatinine], amount of urine, and hydration status.

Question 11

What USG per species demonstrates concentration?

Answer 11

Dog > 1.030, Cat >1.035, Horse > 1.025

Question 12

On a dipstick, what values did we ignore?

Answer 12

• Leukocytes, USG, Nitrate, urobilinogen

Question 13

What is specific about dipstick glucose levels?

Answer 13

Not present in healthy individuals, and cold urine can falsely
decrease urine in glucose.

Question 14

What are the renal tubule thresholds for glucose?

Answer 14

Dog and Horse 180 mg/dl; cat 280 mg/dL ; cattle- 100 md.

Question 15

What does hypeglycemic glucosuria represent?

Answer 15

Diabetes mellitus (glucose), hyperadrenocroticism (cortisol)
drugs (dextrose, glucocorticoids, progesterone),
postprandial, acute pancreatitis,
extreme stresses pheochromocytoma, glucagonoma, head trauma.

Question 16

What does normoglycemic glucosuria represent?

Answer 16

Transient stress, reversible tubular damage (drugs, hypoxia,
infection, toxin), cats w/ urethral obstruction (unknown
reason), fanconi syndrome (inherited tubular defect), and primary renal glucosuira

Question 17

What is specific about dogs and bilirubin concentration in urine?

Answer 17

• Normal to have 1+ bilirubinuria on dipstick for canine (20% normal
dogs). Canine PCT can conjugate and Hgb and excrete bilirubin. IN ANY OTHER SPECIES- bilirubinuria is abnormal
Expect bilirubinuria before bilirubinemia (if you have
2+ bilirubin & USG 1.020- more concerned.
o 2+ bilirubin and USG 1.040- less concerned.

Question 18

What are causes for bilirubinuira?

Answer 18

Liver disease, bile duct obstruction, starvation, hemolysis,

pyrexia, horses off feed

Question 19

What can cause a dipstick to be a false positive for [bilirubin]?

Answer 19

Old sample, light exposure, nitrites, ascorbic acid

Question 20

Are positive ketones normally found on a dipstick test?

Answer 20

No—not present in normal healthy animals.

Question 21

What are three kinds of ketone bodies. What ketones do they pick up?

Answer 21

B-hydroxyburterate (78%), acetoacetic acid (20%), Acetone (2%)
o Acetoacetic acid and acetone are true ketones (only
detected)
o B-hydroxybuterate is predomiant form of ketone in rumiantns
expect an increase in it in bovine ketosis and pregnancy
toxemia in ewes

Question 22

What can cause increase dipstick [ketone]?

Answer 22

Excessive/defective lipid or carbohydrate metabolism. Ketonuria
detected prior to ketonemia.
o Ketonuria shows negative energy balance, DKA,
insulinoma

Question 23

Excessive/defective lipid or carbohydrate metabolism. Ketonuria
detected prior to ketonemia.
o Ketonuria shows negative energy balance, DKA,
insulinoma

Answer 23

Hgb, Mgb, or RBC. RBC lyse and release Hb. Bleach can cause a false positive reaction for blood.

Question 24

w/ a true hematuria, what occurs after centrifugation of the urine?

Answer 24

The supernatant clears w/ centrifugation. (pellet settles at bottom)

Question 25

What are causes of hematuria?

Answer 25

Trauma, infection, inflammation, infarction, calculi, neoplasia, coagulopathy

Question 26

What color does hemoglobinuria present as?

Answer 26

Reddish-brown urine. The urine supernatant is not clear
after centrifugation like you would see w a true hematuria.
No RBC are found in the sediment.

Question 27

What are causes of hemoglobinuria?

Answer 27

Intravascular hemolysis- the serum will be pink/red and the patient will be anemic

Question 28

What is myoglobin?

Answer 28

• Small, not protein bound, readily passes glomerular filtration
barrier, no visible myoglobinaemia
• Myocyte damage leads to released Myoglobin. Increase in AST and
creatinine kinase will also be seen on biochem profile and the urine supernatant will have a red color (But serum will not be stained)

Question 29

What is the normal pH of dog/cat urine!

Answer 29

6.5-7.5

Question 30

What is the normal pH of a horse &cows urine

Answer 30

7.5-8.5

Question 31

Renal tubular dysfuncctio can lead to

Answer 31

Renal tubular dysfuncction can lead to a paradoxically alkaline urine

Question 32

What can an alkaline pH demonstrate?

Answer 32

• UTI (urea splitting bacteria! proteus, pseudomonas,
stphaylococcus)
• Low protein diets (herbivores- diets for chornic cyrstalluria)
• Respiratory alkalosis, metabolic alkalosis (put base out into urine),
• Alkalinizing drugs

Question 33

What can cause an acidic pH?

Answer 33

• High protein diets (- amino ACID), carnivores/omnivores
(herbivores on milk/drugs)
• Respiratory and metabolic acidosis
• hypochloremic metabolic alkalosis +sever dehydration
• Hypokalemia- body is K + deficiency, so kidney resorbs K+ and
exchanges K+ for H+(H+ put into urine)• Furosemide- blocks NaK2Cl- pump and cause increase sodium and H+ excretion

Question 34

What does dipstick [protein] demonstrate?

Answer 34

Detects primarily albumin. insensitive to Bence jones protein,
globulins

Question 35

Protienuria caused by renal dz:

Answer 35

blood reaction will be negative (usually), sediment will have casts. o UPCR- normal .5;
glomerular >1.0 (glomerular has highest proteinuria )
o proteinuria w/ nothing in sediment often indicative of glomerular dz

Question 36

What are causes of pre renal, renal and post renal proteinuria?

Answer 36

Pre renal- fever, hypertension, seizures, IV
• Renal- glomerulonephritis, renal tubular injury
• Post renal- hemorrhage, infection

Question 37

What are causes of a positive protein reaction on a dipstick?

Answer 37

• r/0 hemorrhage- positive blood reaction, will see RBC in sediment.
• r/o UTI/cystisits- will see bacteria and WBC on sediment.
• r/o intravascular hemolysis- hemoglobinuria! Hgb is a protein,
animal will be anemic.

Question 38

What is specific about dogs and positive protein on a dipstick stick?

Answer 38

Trace to 1+ protein= normal finding in concentrated urine. Proteinuria w/ dilute urine can be a problem.

Question 39

What is the sulphosalicycl acid test?

Answer 39

SSA used to confirm dipstick protein results- reacts adequately
w/ albumin, globulins and bence jones proteins.
• Urine supernatant + 5 % SSA! turbidity of sample compared to standards