Urinalysis #2​: Sediment​

Best samples to use for sediment

1. morning samples

2. Samples after hours of water deprivation

Why use these samples for sediment

• sample is more concentrated

• will contain more sediment​

recommended standard volume of urine

3-10ml

Centrifuge the urine at what speed and for how long

1500 rpm for 5 minutes

Why do we centrifuge urine at a low speed

Higher speeds disrupt the cells and cast

Remove the majority of urine from the tube and leave what in the bottom

sediment

what should you do if you have a lot of sediment

get a USG from the centrifuged urine before discarding

On the other end of the slide, add another drop of urine and one drop of what stain

New methylene blue stain

The stain aids in identifying what 3 things in the urine

1. RBC

2. WBC

3. Bacteria

view at lowpower (10x objective: Yellow) with the light intensity:​

down low

which objective are sediment counts done

high power objective (40x objective: blue)

At least how many microscopic fields must be evaluated

10

what things per highpower field (40x hpf) are reported

the average number of various cells

Following wet-mount preparation, what should be done with urine

re-centrifuge

Use a second clean microscope slide to spread the material in a monolayer via what 3 possible options

1. the blood smear

2. line prep

3. compression prep techniques​

Allow the dry mount slide to:

• air-dry

• Heat fixation is not necessary and will alter cell morphology ​

3 types of epithelial cells can be found in urine sediment:

1. Squamous​

2. Transitional​

3. Renal tubular

Each epithelial cell originates from a different area of ____ and helps to diagnosis the damage

urinary tract

Squamous Epithelial Cells​

• large

• angular borders

• a small nuclei

where do Squamous Epithelial Cells​ originate from lining of what 3 places

1. distal urethra

2. vagina

3. prepuce

Is Squamous Epithelial Cells​ indicative of disease

generally not indicative of disease

Transitional Epithelial Cells​

• centrally located nucleus

• spherical, polyhedral, or pear shaped cell

Transitional Epithelial Cells​ lining what 4 structures

1. renal pelvis

2. ureters

3. bladder

4. upper portion of the male urethra

The only abnormal finding would be Transitional Epithelial Cells exhibiting these 2 abnormal morphology with:

1. vacuoles

2. irregular nuclei

vacuoles and irregular nuclei may indicate what 2 things:

malignance or viral infection

Renal tubular epithelial cells​

• Vary in size and shape depending on where they come from

• Nuclei are eccentrically placed and they are not totally round.

More than 2 Renal tubular epithelial cells​ per hpf indicates:

tubular injury

The most clinically significant epithelial cell

Renal tubular epithelial cells​

Renal tubular epithelial cells​ may indicate:

1. renal tubular necrosis.​

2. Heavy metal exposure​

3. Drug induced toxicity ​

4. Hemoglobin and myoglobin toxicity ​

5. Viral infections ​

6. Pyelonephritis ​

7. Allergic reactions ​

8. Malignant infiltrations ​

9. Allogenic transplant rejections ​

10. Glomerular disorders

unstained Red Blood Cells are:​

colorless or yellowish​

Red Blood Cells

• round and slightly refractile

• can see biconcave disk & central pallor​

• Uniform in size

In concentrated urine, rbcs will do 3 things:

1. shrink

2. loose fluid

3. crenated

In dilute urine, rbcs will do 2 things:

1. absorb water

2. swell

Normal values of RBCs in urine

2-4 RBC/hpf​

RBCs in urine indicate what pathological thing

bleeding somewhere in the urinary or genital tract.

RBCs in urine indicate what nonpathological thing

trauma from collection methods

White Blood Cells​ in urine

• round

• granular

• larger than rbcs

The presence of how many WBC/hpf indicate a pathologic condition

more than 5-8WBC/hpf

The presence of more than 5-8WBC/hpf indicate ____ depending on the method of collection

inflammation of the urinary or genital tract

what is pyuria

excessive amount of WBC in the urinary tract

urine samples with increased numbers of Bacteria & WBCs should be:

cultured for bacteria

what cells on left

WBCs

casts are elongated structures composed of what 2 things

1. protein from plasma

2. mucoprotein secreted from the tubules

where do casts form

lumen of the distal and collecting tubules of the kidney

Increased number of casts helps to: ​

localize the renal disease

casts usually have what types of outlines

parallel sides with a definite outline​

5 general types of Casts: ​

1. Hyaline​

2. Granular​

3. Cellular​

4. Waxy​

5. Fatty​

Hyaline Cast​

• Clear, colorless

• somewhat transparent​

• highly refractile and difficult to see

what should you do to view hyaline casts better

reduce light to lowest setting

Hyaline Cast​ indicates:

mild renal irritation

Hyaline Cast​ may increases with what conditions

1. fever

2. poor renal perfusion

3. strenuous exercise

4. general anesthesia

Most common form of casts seen in animals

Granular Cast​

types of Granular Cast​

Coarse or fine granular

Granular Cast is seen with:

acute nephritis

Granular Cast indicates what kidney condition, compared to hyaline casts

more severe kidney damage

Cellular Cast​ contains:

cells embedded in their protein matrix

what cells can be embedded

1. RBC

2. WBC

3. epithelial cells

cellular casts indicates (Depending on type of cells seen):

1. Acute Nephritis​

2. renal inflammation​

3. Pyelonephritis​

4. Renal bleeding

waxy casts

• wider, with square flat ends

• burrito appearance​

• Colorless or gray

• highly refractile

waxy casts indicates:

chronic and severe degeneration of the renal tubules

Fatty Cast​

Contain several small droplets of fat

Fatty Cast​ seen in cats with:

renal disease

why is Fatty Cast​ seen in cats with renal disease

lipid in their renal parenchyma

renal parenchyma

functional, working tissue of the kidney responsible for filtering blood, producing urine, and maintaining bodily balance

Fatty Cast​ seen in dogs with:

diabetes mellitus

Large number of fatty casts suggest:

degeneration of the renal tubules

Mucus Threads​

• do not have the well defined edges of casts

• narrow twisted ribbon

• wispy like

Large amounts of mucus threads is normally present in:

horses

Large amounts of mucus threads in other animals indicates:

1. urethral irritation

2. contamination of the sample

Spermatozoa seen in the urine sediment of:

intact male animals

Spermatozoa seen in the urine sediment May be present in recently bred:

female animals

Large amounts of sperm may produce a false-positive result for:​

protein

Fat Droplets​

Lightly green-tinged, highly refractile, spherical bodies of varying size.

one of the first focal planes, so keep focusing past them to get to the other sediment

Fat Droplets​

Fat Droplets​ can be a contaminate from:

catheter lubricates

Fat in cat urine to some degree is:

normal

Lipuria is also seen in animals with:

1. obesity

2. diabetes mellitus

3. hypothyroidism

4. rarely, after a high-fat meal

Microorganisms reported as:

• few

• moderate

• many

• too numerous tocount (TNTC)

• morphology

Normal urine is free of:

bacteria

normal urine may be contaminated by bacteria residing on the epithelium of:

1. vagina

2. vulva

3. prepuce

4. catheterization

Urine should be examined immediately or refrigerated until able to view it, due to:

bacteria’s proliferate activity

Bacteria under magnification appears to be quivering as a result of:

Brownian movement

A large number of bacteria accompanied by a large number of WBCs suggests:

infection and inflammation of the urinary or genital tract

best method for establishing whether or not an infection is present

culturing urine

Common infectious agents of cystitis include:  ​

1. E. coli ​

2. staphylococci ​

3. Streptococci​

4. Proteus spp.

Yeast & Fungi​

• characteristic budding

• may have double refractile walls​

Yeast & Fungi​ are rarely found in urine sediment, and are usually contaminants as yeast infections of:

urinary tract or voided samples

Parasite ova may be seen in the urine sediment of animals with:

1. urinary parasites

2. fecal contamination

parasites that can occur in urine include:​

1. Pearsonema pilca

2. Dioctophyma renale

3. ova of Stephanurus dentatus

4. Microfilaria

Pearsonema pilca

bladder roundworm of dogs and cats

Dioctophyma renale

kidney roundworm of dogs

Dioctophyma renale intermediate hosts

earthworms

how do dogs get Dioctophyma renale

eating rawfish, crayfish, or earthworms

the ova of Stephanurus dentatus

kidney worm of pigs

Microfilaria

heartworm, dirofilaria immitis

how do dogs get Microfilaria into urine

circulating microfilaria may be seen if hemorrhage into the urine occurs either from disease or as a result of trauma during collection

What kind of problem may cause you to find cellular casts containing white blood cells in the urine sediment of a dog ?

Pyelonephritis (kidney infection)