Clinical Lab Techniques Lecture FINAL

1. Cystocentesis

2. Catheterization

3. Bladder Expression

4. Voided sample/ free catch

Collection methods of urine

What is the best/sterile urine sample to get?

Cystocentesis

If you can't do a cysto, what is the next best collection method for C&S?

Catheterization

Frequent urination

Pollakiuria

Increase urine production

Polyuria

Decrease in urine output

Oliguria

No urine output

Anuria

What color yellow indicates the increased concentration of urine and SG?

Increased yellow

What color yellow indicates the decrease concentration of urine

Pale yellow

What color of yellow indicates oliguria?

Very yellow or yellow brown

If the urine is brown/green, what does this indicate?

Bile pigments

If the urine is red/brown, what does this this indicate?

Hematuria (blood in urine)

If the urine is brownish, what does this indicate?

Myoglobinuria (over exertion, lysing of muscle cells)

1. Refractometer

2. Urinometer

3. Dipstick/Reagent strip

Methods to determine USG

What is fluid loss through panting or diarrhea?

Dehydration

With dehydration, is the concentration increased or decreased?

Increased

With dehydration, what is also increased?

TP and PCV

What is the increase of fluid administration or therapy?

Overhydration

With overhydration, is the concentration increased or decreased

Decreased

What is the term used when USG reaches glomerular filtration rate. It's 1.008-1.012, and the average is 1.010.

Isosthenuria

When using the positive reagent strip, what sources are we looking at?

Hematuria

Hemoglobinuria

Myoglobinuria

In a positive reagent strip with hematuria, what color is the urine to be labeled as normal?

Red wine

In a positive reagent strip with hemoglobinuria, what color is the urine to be labeled as normal?

Red brown

In a positive reagent strip with myoglobinuria, what color is the urine to be labeled as normal?

Brown black

What type of sample is best for a urine sample?

Pre-prandial, first morning sample

1. Squamous

2. Transitional

3. Renal

4. WBC

5. RBC

Order of cells from largest to smallest seen in urine

What type of urine are casts found in, acidic or alkaline?

Acidic

1. Leucine

2. Tyrosine

3. Cystine

4. Uric acid

5. Calcium oxalate

Crystals in acidic urine

-Seen in acidic urine

-Seen in animals that have Ethylene glycol toxicity (antifreeze)

-Square like in shape, with an 'X' in the center; resembles the back of an envelope

Calcium oxalate

1. Triple phosphate (Struvite),

2. Calcium carbonate,

3. Amorphous phosphate,

4. Ammonium biurate

Crystals in alkaline urine

-Seen in alkaline urine

-Usually takes on a coffin lid shape but can take on other shapes

Triple phosphate (Struvite)

Fluid portion of whole blood in which cells are suspended is called _______

Plasma

Plasma from which fibrinogen has been removed is called _______

Serum

Why does serum not have fibrinogen?

The fibrinogen is in the clot

-No anticoagulant

-A clotting tube

-Serology

Red top tube/Clot serum separator tube

-EDTA

-Anticoagulant

-Plasma

-Preserves cell morphology

Purple top tube/EDTA

Special chemistries

Green top tube

In a green top tube, what is used for preforming chemistries?

Heparin

-Sodium citrate

-Coagulation studies

Blue top tube/Citrate

-Sodium fluoride

-Blood glucose

Grey top tube/Oxalate

T/F: You can freeze whole blood.

False, it will lyse

T/F: You can freeze plasma.

True

What is the stain used to see reticulocytes?

NMB (New Methylene Blue)

What is the ratio you use for NMB on reticulocytes?

1:1 (1 drop of blood to 1 drop of stain)

Do you ship blood films with formalin?

No, it alters staining characteristics

Glycoprotein hormone secreted by the kidneys

Erythropoietin

What is the job of erythropoietin?

Stimulates the production of RBC in the bone marrow

Severe dehydration

Hyperproteinemia

Hyperproteinemia is an increase or decrease in TP?

Increase in TP, as well as USG and PCV

Fluid therapy/ overhydration

Hypoproteinemia

In hypoproteinemia, is there an increase or decrease in TP?

Decrease in TP

-Non nucleated, immature RBCs

-Respond to anemia

-Circulate in peripheral circulation

Reticulocytes

What form of reticulocyte do dogs have?

Aggregate

What 2 forms of reticulocytes do cats have?

Aggregate

Punctate

With cats, which reticulocyte do we count?

Aggregate

-Variation in cell size

-Commonly seen in responding anemias

Anisocytosis

In what animal is anisocytosis normal to see?

Cows

-Irregularly shaped RBC

-Variation in shape

-Seen in anemic animals

-Indicates improper production or premature destruction of --RBC (non-regenerative anemia)

Poikilocytosis

-Chromatic changes

-Slightly irregular

-Increase in size and blue/gray stain

Polychromasia

-Normal volume, just smaller

-Round sphere-like cells

-DO NOT have biconcave disc shape

Spherocytes

Irregular clumping of RBC

Agglutination

RBCs arranged in stacks or rows

Rouleaux

In what animal is rouleaux normal to see?

Horse

-Seen with NMB and Wright stains

-Precipitated hemoglobin

Heinz bodies

-Fragmented cells

-Intravascular trauma

Schistocytes

What disease is caused by an increase of schistocytes?

DIC (Disseminated Intravascular Coagulation)

-Presence of coarse or fine purple/blue staining of granules inside RBC

-Seen with Wright's and NMB stains

-Normal in cows & anemic cats (depending on their response to anemia)

Basophilic Stippling

Basophilic stippling and nRBCs in absence of anemia may suggest _____________ in dogs

Lead toxicity

-Seen inside young RBCs as purple/blue staining

-Somewhat refractile

-Round nuclear remnants/fragments

-Seen in young animals with anemia

Howell-Jolly bodies

-AKA Spur cells

-Irregular projections from the surface

-Round/blunt projections

-Unevenly distributed with longer projections

Acanthocyte

-AKA: Crenated or Burr cells

-Regular projections are spine like

-Blunt to sharp projections, evenly spaced

Echinocytes

-Segmented Neutrophil

-Eosinophil

-Basophil

Granulocytes

What's important about granulocytes?

They have granules in the cytoplasm

What is the primary function of WBC (except for lymphocytes)

Phagocytosis

-Most common and numerous in cats and dogs

-3-5 lobes with thin filaments connecting lobes

Segmented Neutrophil

What are seen in toxic neutrophils?

Vacuoles

Dohle bodies

Where do the toxic changes happen in neutrophils?

Peripheral circulation

-Immature form

-Horse-shoe shaped nucleus with rounded ends and sides are smooth and parallel

-Cytoplasm is pale gray and contains pale staining granules

Band neutrophil

-Granules release histamine and anti-heparin

-Seen with parasitic infection and allergens

Eosinophil

-Seen at the start of a reaction

-Seen with hypersensitivity

-Not commonly seen

-Produce histamine and heparin

Basophil

-Lymphocytes

-Monocytes

Agranulocytes

What's important about agranulocytes?

They don't have granules in the cytoplasm

-Largest cell

-Contains vacuoles, 95% of the time

-Migrate into inflammatory lesion and are transformed into macrophages

Monocyte

-2nd most common WBC in cats and dogs

-Round/oval/indented dense nucleus

-Increase in nucleus to cytoplasm ratio

-Immune response

Lymphocyte

In what animal are lymphocytes the most common in?

In cows

What do lymphocytes produce?

B cells and T cells

When there are many nRBCs, you may have to do a _________

Corrected WBC count

-Hypersensitivity reaction

-Parasitism, and allergies

Eosinophilia

-Associated w/ eosinophilia

-Respiratory dz, parasitism

Basophilia

-AKA lymphocytosis

-Physiologic excitement response or stress

Leukocytosis

-The most common cause for it is inflammation

-#bands > 500

Left shift

More mature than immature neutrophils

Regenerative left shift

More immature than mature cells

Degenerative left shift

Where does degeneration occur?

In the tissue, outside of blood circulation

-Cytoplasm gets more basophilic

-Dohle bodies becomes irregular shaped blue staining structures

-Toxic granules get a color change, blue/black color, esp. in horses

Toxic neutrophils

With a stress leukogram, what is the WBC pattern and serum biochemistry profile?

Monocytes and neutrophils are increased

Lymphocytes and Eosinophils decreased

-Redness

-Heat

-Swelling

-Pain

-Loss of function

cardinal signs of inflammation

What other species are susceptible to the leukocytosis/excitement response after the most common one which is a cat?

Dog

Cow

Horse

What accompanies heartworm infestation and other respiratory infections?

Basophilia

Eosinophilia

-RBC is oval and nucleated

-Most common is heterophil

Avian RBC