Urinalysis

Name 5 methods of urine collection

Free catch
cystocentesis
Short term urinary catheterisation
Long term urinary catheterisation
Manual expression

What is normal urine production?

1-2 ml/kg/hour

Why is it important to ensure a free-catch sample is caught mid-flow?

To reduce contamination from the prepuce or residual cells in the urethra

Why is it important to take a urine sample before starting treatment?

Treatment such as antibiotics can change the readings of the sample

Name 3 benefits of free-catch sampling

Cheap and easy
Non-invasive
Anyone can do it

Name 4 disadvantages of free-catch sampling

Easily contaminated
Not suitable for potential lepto
Reliant on the patient urinating
Not suitable for culture

Name 5 items you need for a free-catch urine sample

Kidney dish
Gloves
Syringes
Urine pot
Litter crystals

Name 5 advantages of manual expression

Cheap and easy
Don’t have to wait for the patient to urinate
Less invasive
Good for neurological patients
Can be done conscious

Name 6 disadvantages of manual expression

Requires a full bladder
Uncomfortable for the patient
Should only be done by professionals
Risk of contamination
Not suitable for blocked patients
Not suitable for culture

Name 6 items you need for manual expression

Kidney dish
Gloves
Syringes
Urine pot
Inkopad
Handler

Name 5 advantages of cystocentesis

Suitable for culture
Not reliant on waiting for the patient
Relatively cheap
Can be done on blocked patients
Quick

Name 5 disadvantages of cystocentesis

Often needs sedation
Can only be done by a vet
Invasive
Causes trauma to bladder and soft tissue
Unsuitable for coagulopathic patients

Name 8 items needed for cystocentesis

Sterile gloves
Syringe
Long needle
Urine pot
Vet
Clippers
Skin scrub
Ultrasound

Name 5 advantages of short-term catheterisation

Don’t need to wait for the patient
Can be used for culture
Not traumatic to other organs
Good for blocked patients
Can be done by a nurse

Name 7 disadvantages of short-term catheterisation

Can be traumatic to the urethra
Requires skill
More expensive
Uncomfortable
Often requires sedation
Not suitable for coagulopathic patients
Risk of introducing infection

Name 9 items needed for short-term catheterisation

Rigid Catheter
Lube
Sterile gloves
Assistant
kidney dish
Syringe
urine pot
Speculum
Iodine

Name 7 advantages of indwelling catheters

Not reliant on waiting for patients
Can be used for blocked patients
Can be used for culture
Can measure urinary output
Good for neuro patients
Prevents urine scald
Good for infectious patients

Name 7 disadvantages of indwelling urinary catheters

Introducing infection
Takes a long time
Expensive
Requires skill
Uncomfortable for the patient
Not good for coagulopathic patients
Risk of patient interference

Name 11 items needed for an indwelling urinary catheter

Flexible catheter
Lube
Sterile gloves
Assistant
Syringe
Speculum
Iodine
Guide wire
Bag
Suture material
Buster collar

What are the two types of tubes for urine?

Plain and Boric acid

How should you store urine in a plain tube?

Process within two hours if at room temperature
Refrigerate for up to 24 hours

How should you store urine in boric acid?

Refrigerate for 48-72 hours

What 3 pieces of patient history should be obtained to aid in diagnosis?

Clinical signs observed
Changes in urinary output
Changes in urinary appearance

What three diagnostic imaging methods can you use for urinary issues?

Ultrasonography
Radiography
Contrast radiography

What four initial assessments should be made of a urine sample

Turbidity
Smell
Colour
Volume

What urine output classifies as anuria

<0.5ml/kg/hour

What urine output qualifies as oliguria?

0.5-1 ml/kg/hour

What urine output qualifies as polyuria?

>2 ml/kg/hour

What does light yellow urine indicate?

Normal, low concentration

What does yellow urine indicate?

Normal, normal concentration

What does amber urine indicate?

Normal, high concentration, or increased bilirubin

What does red urine indicate?

Haematuria or haemoglobinuria

What does brown urine indicate?

Myoglobin, methaemoglobin or bilirubinuria

what should you do with urine before using a dipstick?

warm if refrigerated

Name three advantages of dipsticks

Rapid results
non invasive
good early indicator

which protein is primarily detected on dipsticks?

Albumin

Name 2 disadvantages of monitoring protein with a dipstick

A large amount has to be present to have a positiive result
False positives are common in rabbits and equine due to alkaline urine

When does a dog qualify as having glucosuria?

when the blood glucose exceeds 180-220 mg/dL

When does a cat qualify as having glucosuria?

When the blood glucose exceeds 250-300 mg/dL

Which two ketones are detected on dipsticks?

Acetone and acetoacetate

What can be diagnosed by ketones on a dipstick?

diabetic ketoacidosis

What causes bilirubinuria?

liver disease or haemolysis

what three things are detected as blood on a dipstick?

RBCs
Haemoglobin
Myoglobinuria

How can you differentiate between a haemoglobin reading and a myoglobin reading?

check plasma or do a urine sediment

What is USG?

The ratio of the weight of s volume of liquid to the weight of an equal volume of distilled water

Define hypersthenuria

A normal urine concentration

What is a normal USG range for a cat?

1.035-1.060

What is a normal USG for a dog?

1.015-1.045

What is a normal USG range for a rabbit?

1.003-1.036

Define isothenuria

low concentration of urine, typically 1.010-1.025

Define hyposthenuria

Very low concentration of urine, <1.010

Explain the 6 steps to complete a USG reading

Wipe off any dust from the prism
Apply 2 drops of distilled water to the prism and looks through the lens
Ensure the line is set at 1.000
Wipe off distilled water
Place 1-2 drops of urine on the prism
Look through the lens and read the USG

Explain the 5 steps of using a urine dipstick

Put on gloves
Put dipstick flat on an absorbent tissue
Using a pipette, apply one drop of urine to each pad
Compare the colour of each reagent with the standards on the pack after the required amount of time
Write down the readings

Explain the steps of creating a urine sediment

Invert sample
Pipette 2-5ml of urine into an eppendorf tube
Place the tube in the centrifuge for 5 mins at 2000rpm
Discard supernatant keeping 0.5ml
Add one drop of stain
Flick the tube to resuspend the supernatant
Transfer one drip onto a microscope slide
Look under x10 and x40 microscope lens