Clin Path - Urinalysis

Which technique is the least appropriate for culture?

Free catch

Which technique is least likely to introduce epithelial cells?

Cystocentesis (urine picks up epithelial cells from the urethra)

Which technique is least likely to introduce blood?

Free catch

Which technique is least stressful?

Free catch

What is the meaning if the urine color is: light to medium yellow

Normal :)

What is the meaning if the urine color is: colorless/clear

very dilute urine

What is the meaning if the urine color is: very dark urine

Very concentrated

Bilirubinuria

What is the meaning if the urine color is: Red to Brownish-red

Hematuria

Hemoglobinuria

Myoglobinuria

What is the meaning if the urine color is: Reddish-brown to brown

Myoglobinuria

Hemoglobinuria

Methemoglobinemia

What is the meaning if the urine color is: Greenish tint

Bilirubinemia

What components on a dipstick are ignored in veterinary medicine?

Specific gravity, leukocytes, Nitrite, Urobilinogen

Should glucose normally be in the urine?

No - normally very low concentrations in urine

T or F: Glucose in the urine must be interpreted in context with blood glucose levels?

True

If a patient has elevated blood glucose exceeding the renal threshold & they have glucosuria, would this be considered appropriate or inappropriate?

Appropriate

What are ketones used for?

Alternate energy source

What are three ketones that we must consider in a urinalysis?

1. Acetone

2. Acetoacetate

3. Beta-hydroxybutyrate

What diseases are associated with altered carbohydrate metabolism?

Negative energy balance:

• diabetes mellitus —> cannot utilize glucose, body shifts to ketones

• bovine ketosis

• pregnancy

Where do ketones accumulate first: urine, milk, or blood?

Urine and milk BEFORE blood

What is the normal pH of urine for carnivores and suckling herbivores?

5.5-7.5

What is the normal pH of urine for herbivores?

7 - 8.5

T or F: Blood pH adjusts based on urine pH.

F - urine pH adjusts based on blood pH

If your patient has acidemia (acidic blood), would you expect aciduria or alkaluria?

aciduria

What two conditions would you see bilirubin in the urine from?

Hepatobiliary dz and IMHA

Bilirubin in urine may be normal in _____.

Male dogs with concentrated urine

Which would you expect to clear with centrifugation?: hematuria, hemoglobinuria, or myoglobinuria

Hematuria

Label the image from left to right; options = myoglobinuria, hematuria, and hemoglobinuria

From left to right: Hematuria, hemoglobinuria, myoglobinuria

Name four reasons you may see hematuria

1. Cystitis

2. UTI

3. Mild pigmenturia

4. Blood contamination (cystocentesis)

What is concerning for proteinuria?

If renal - glomerular/tubular dz

T or F: Alkalinuria causes false positives of proteinuria, especially common in large animals.

T

Trace to 1+ protein in urine may be normal with (concentrated/dilute) urine

Concentrated

What does a sulfosalicylic acid (SSA) confirm?

Confirmatory test for dipstick positive for protein; graded based on turbidity

What is the protein: creatinine ratio used for?

To quantify proteinuria

T or F: complete urinalysis must be done concurrently to exclude hemorrhage or inflammation

True

How do you interpret urine protein: creatinine ratio?

If UPC > or = to 2: glomerular damage

If UPC < 2: tubular damage: tubular damage

What does Bence Jones Proteinuria tell you?

Free immunoglobin light chains; overload proteinuria from multiple myeloma

These cells line the full urinary tract, are relatively large, evaluated at 10x objective and low numbers of them may be normal.

Epithelial cells

Where do squamous cells come from?

Originate from distal urethra, vagina, or prepuce; yellow in picture

This type of epithelial cells are large, flat cells with angular sides and small nuclei.

Squamous epithelial cells

These cells are present on sediment evaluation. What are they?

Squamous epithelial cells

These cells are present on sediment evaluation. What are they?

Squamous epithelial cells

These cells are present on sediment evaluation. What are they?

Squamous epithelial cells

Where do transitional epithelial (urothelial) cells originate from?

the urinary bladder, ureter, and proximal urethra; green in diagram

These epithelial cells are round in shape, variable size, have a low to moderate N:C ratio (higher than squamous), low numbers are normal

Transitional epithelial (Urothelial) Cells

These cells are present on sediment evaluation. What are they?

Transitional epithelial (Urothelial) Cells

These cells are present on sediment evaluation. What are they?

Transitional epithelial (Urothelial) Cells

These cells are present on sediment evaluation. What are they?

Transitional epithelial (Urothelial) Cells

These cells are present on sediment evaluation. What are they?

Caudate epithelial cells

These cells are present on sediment evaluation. What are they?

Caudate epithelial cells

These cells are present on sediment evaluation. What are they?

Caudate epithelial cells

This epithelial cell is spindle or tadpole-shaped and is not normally seen in sediment

Caudate epithelial cells

Where do caudate epithelial cells orginate from?

Renal pelvis; blue in image

These cells are present on sediment evaluation. What are they?

Renal tubular epithelial cells

These cells are present on sediment evaluation. What are they?

Renal tubular epithelial cells

These cells are present on sediment evaluation. What are they?

Renal tubular epithelial cells

Where do renal tubular epithelial cells originate from?

renal parenchyma; orange in image

This type of epithelial cell is small, round/rectangular (cuboidal/columnar) and may contain vacuoles if from a cat.

Renal tubular epithelial cells

What do renal tubular epithelial cells indicate on a urine sediment?

indicate renal damage or inflammation (tubular nephritis)

What two conditions can caudate epithelial cells indicte?

Pyelonephritis (inflammation of renal pelvis)

Calculi in renal pelvis

What is a typical early indicator of renal tubular disease?

Casts

What type of cast is this?

Hyaline

What type of cast is this?

Hyaline cast

What are hyaline casts?

Tamm-Horsfall mucoprotein precipitates secreted by renal tubular epithelial cells

Are hyaline casts a significant finding on sediment evaulation?

Low numbers are insignificant —> exercise and hyperthermia

What type of cast is this?

Cellular cast (renal tubular epithelial casts)

What type of cast are these?

Cellular cast (renal tubular epithelial casts)

What type of cast are these?

Cellular Casts (renal tubular epithelial casts)

What type of cast are these?

Cellular Casts (renal tubular epithelial casts)

This type of cast consists of round to polygonal epithelial cells in tubular arrangement

Cellular casts (renal tubular epithelial casts)

What do renal tubular casts (cellular casts) indicate?

Renal tubular damage; may be seen with nephritis/pyelonephritis (you would also expect specific gravity to be dilute

What type of cast is pictured?

Granular cast

What type of cast is pictured?

Granular cast

What do granular casts indicate?

Degenerated tubular epithelial cells; slow progression through tubule

Evidence of tubular damage

What type of cast are the arrows pointing to?

Waxy casts

What type of cast is pictured?

Waxy casts

What type of cast is pictured?

Waxy casts

What do waxy casts indicate?

complete breakdown of epithelial cells; very slow progression through tubule; rare

What type of casts are pictured? Are they common or uncommon? What species are they usually seen in?

Fatty casts

Uncommon

Usually seen in cats

What type of cast is pictrued?

Hemoglobin casts

What type of cast is present?

Hemoglobin cast

What does hemoglobin casts indicate?

Intravascular hemolysis (Hemoglobinemia)

What type of cast is pictured?

Pseudo-casts

What type of cast is pictured?

Pseudo-casts

Name the crystal

Calcium carbonate

Name the crystal

Calcium Carbonate

What species are calcium carbonate crystals common in?

Normal in species that excrete calcium in urine: Horse, rabbit, guinea pig, elephant

Are calcium carbonate crystals found in acidic or alkaline urine?

Alkaline urine

Name the crystal

Magnesium ammonium phosphate (MAP, Struvite)

Name the crystal

Magnesium ammonium phosphate (MAP, Struvite)

Are magnesium ammonium phosphate crystals more common in acidic or alkaline urine?

Alkaline urine

What do magnesium ammonium phosphate crystals indicate in dogs? What about cats?

Dogs: secondary to UTI

Cats: sterile cystitis; seen in cats b/c they excrete NH3 via renal tubules

Name the crystal

Calcium oxalate dihydrate

Name the crystal

Calcium oxalate dihydrate

Name the crystal

Calcium oxalate monohydrate

Name the crystal

Calcium oxalate monohydrate

What do calcium oxalate dihydrate crystals indicate?

• can be normal

• ingestion of oxalate containing plants

• Calciuresis from hyperadrenocorticism

• Increase number d/t storage at room temp and refrigeration

What do calcium oxalate monohydrate crystals indicate?

• seen in acute ethylene glycol poisoning, 3-18 hrs after ingestion

• Increase number d/t storage at room temp and refrigeration

Name the crystal

Ammonium biurate

Name the crystal

Ammonium biurate

What does ammonium biurate indicate?

• Liver dz (ammonia not converted to urea)

• portosystemic shunt (vascular malfunction)

  • sago palm toxicity

Name the crystal

Cystine crystal