Difference between revisions of "Urine Analysis - Pathology"

Revision as of 18:49, 17 September 2010

()Map CLINICAL PATHOLOGY (Map)

Rationale

Urine Analysis can be a quick and inexpensive method to determine abnormalities in a patient.

Techniques

Assessment

Gross Appearance

Specific Gravity

Urine Dipsticks

pH

In dogs and cats an acidc pH is normal. In the ruminants and horses the opposite is true and the urine is alkali. The pH does however vary with diet and medications as well as in pathological states so this needs to be accounted for. The normal range is 5-9

Protein

It is not common to find protein in the urine of normal animals. However it can be normal for small amounts to be found in the urine of dogs with a high specific gravity. Therefore this needs to be taken into account.

Glucose

The presence of glucose in the urine is termed glucosuria and occurs when the level of glucose reaches the renal threshold for glucose reabsorption. It is not normal to find glucose in the urine.

Ketones

It is not normal for ketones to be present in the urine and they are indicative of pathological states

Bilirubin and Urobilinogen

Small amounts of bilirubin can be found in dogs with concentrated urine therefore this needs to be interpreted in light of the urine specific gravity. However as a rule it is not normal to find bilirubin in urine.

Urobilinogen is formed from bilirubin in the intestine and small quantities are normally found in the urine.

Blood

The presence of blood in the urine is not normal and is usually related to a pathological state.

Microscopic Examination

Cellular Deposits

Epithlial cells
- Renal
- Squamouns
- Transitional
Leucocytes
Red blood cells
- Intact
- Ghost
- Crenated
Bacteria
Other
- Fat droplets
- Yeast bodies
- Sperm
- Artefacts

Casts (Cylinduria)

Hyaline
Waxy
Granular
Cellular
Fatty
Haemoglobin
Myoglobin
Artefacts
- mucus threads

Crystalline and Amorphous Deposits

Calcium carbonate
Struvite

Calcium Oxalate

- Dihydrate
- Monohydrate
Amorphous phosphate
Leucine
Tyrosine
Cystine
Amorphous urates
Uric acid
Sodium urate
Dicalcium Phosphate
Ammonium Biurate

Culture and Sensitivity

Interpretation

@@ Line 1: / Line 1: @@
-==Introduction==
+{{unfinished}}
-Urine Analysis can be a quick and inexpensive method to determine abnormalities in a patient.
-==Techniques==
+{{toplink
-Urine samples should be processed by noting their gross appearance, testing with a urinary dipstick, measuring the specific gravity with a refractometer and by microscopic examination.
+|linkpage =Clinical Pathology - Pathology
+|linktext =Clinical Pathology
+|maplink = Clinical Pathology (Content Map) - Pathology
+|pagetype =Pathology
+}}
+<br>
-Many of the measured parameters will be adversely affected by time, so prompt assessment of urine samples is essential for accuracy.
+===Rationale===
+Urine Analysis can be a quick and inexpensive method to determine abnormalities in a patient.
-==Gross Appearance==
-===Colour===
-In the majority of the domestic species the urine should be yellow in colour. The colour of the urine is very dependant on the specific gravity so it is important to account for this.  If the urine is more concentrated it will be darker in colour and visa versa as a general rule .  Equine urine can become brown if left standing.  Discoloured urine should be taken into consideration when carrying out tests which involve a colour change such as dipsticks.  The abnormal urine colour could affect the result.
-===Turbidity===
+===Techniques===
-If the urine is not clear then this could indicate a variety of pathological states.  In the horse it is normal for it to be turbid due the mucous secreted in the renal pelvis and proximal ureters.
-===Odour===
+===Assessment===
-It is normal for urine to have a slight odour from the ammonia.  The odour increases with concentration and in some species such as the cat a pungent urine is normal.  However a strong smelling urine could indicate a pathological state such as an active bacterial infection.
+====Gross Appearance====
+====Specific Gravity====
-==Specific Gravity==
+===Urine Dipsticks===
-Urine specific gravity (USG) is measured using a refractometer calibrated for veterinary use. It must additionally be calibrated on each use using water which must match the water line on the refractometer read-out prior to measuring USG, as refractometer measurement is sensitive to room temperature. Adjustments are made using the screw on the top of the refractometer - take care not to get this screw wet when cleaning the refractometer.
+====pH====
-Specific gravity relates to the urine concentration.  It is basically a measure of the density of particles in the urine.
-Below are the normal urine specific gravities for the common domestic species.
-<TABLE CELLPADDING="2" CELLSPACING="2" WIDTH="20%">
-<TR>
-<TD BGCOLOR="#C1f0f6"><center>'''Species'''</center></TD>
-<TD BGCOLOR="#C1f0f6"><center>'''Urine Volume'''</center></TD>
-</TR>
-<TR>
-<TD><center>Dog</center></TD>
-<TD><center>1.016-1.040</center></TD>
-</TR>
-<TR>
-<TD BGCOLOR="#C1f0f6"><center>Cat</center></TD>
-<TD BGCOLOR="#C1f0f6"><center>1.020-1.060</center></TD>
-</TR>
-<TR>
-<TD><center>Cow</center></TD>
-<TD><center>1.030-1.045</center></TD>
-</TR>
-<TR>
-<TD BGCOLOR="#C1f0f6"><center>Sheep</center></TD>
-<TD BGCOLOR="#C1f0f6"><center>1.015-1.045</center></TD>
-</TR>
-<TR>
-<TD><center>Horse</center></TD>
-<TD><center>1.025-1.060</center></TD>
-</TR>
-<TR>
-<TD BGCOLOR="#C1f0f6"><center>Pig</center></TD>
-<TD BGCOLOR="#C1f0f6"><center>1.010-1.050</center></TD>
-</TR>
-</TABLE>
-==Urinary Dipsticks==
-===pH===
 In dogs and cats an acidc pH is normal.  In the ruminants and horses the opposite is true and the urine is alkali.  The pH does however vary with diet and medications as well as in pathological states so this needs to be accounted for.  The normal range is 5-9
-===Protein===
+====Protein====
 It is not common to find protein in the urine of normal animals.  However it can be normal for small amounts to be found in the urine of dogs with a high specific gravity.  Therefore this needs to be taken into account.
-===Glucose===
+====Glucose====
-The presence of glucose in the urine is termed glucosuria and occurs when the level of glucose reaches the [[Reabsorption and Secretion Along the Proximal Tubule - Anatomy & Physiology#Glucose|renal threshold]] for glucose reabsorption.  It is not normal to find glucose in the urine. Glucose is usually not detectable because ketones, ascorbic acid, or other substances found in urine may cause false negative results by reagent strips even when urinary glucose approaches clearly abnormal values.
+The presence of glucose in the urine is termed glucosuria and occurs when the level of glucose reaches the [[Reabsorption and Secretion Along the Proximal Tubule - Anatomy & Physiology#Glucose|renal threshold]] for glucose reabsorption.  It is not normal to find glucose in the urine.
-===Ketones===
+====Ketones====
 It is not normal for ketones to be present in the urine and they are indicative of pathological states
-===Bilirubin and Urobilinogen===
+====Bilirubin and Urobilinogen====
 Small amounts of bilirubin can be found in dogs with concentrated urine therefore this needs to be interpreted in light of the urine specific gravity. However as a rule it is not normal to find bilirubin in urine.
 Urobilinogen is formed from bilirubin in the intestine and small quantities are normally found in the urine.
-===Blood===
+====Blood====
-The presence of [[Haematuria|blood in the urine]] is not normal and is usually related to a pathological state.
+The presence of blood in the urine is not normal and is usually related to a pathological state.
-==Microscopic Examination==
+===Microscopic Examination===
-===Cellular Deposits===
+=====Cellular Deposits=====
 *Epithlial cells
 **Renal
@@ Line 92: / Line 55: @@
 **Sperm
 **Artefacts
-===Casts (Cylinduria)===
+=====Casts (Cylinduria)=====
 *Hyaline
 *Waxy
@@ Line 102: / Line 65: @@
 *Artefacts
 **mucus threads
-===Crystalline and Amorphous Deposits===
+=====Crystalline and Amorphous Deposits=====
 *Calcium carbonate
 *Struvite
@@ Line 118: / Line 81: @@
 *Ammonium Biurate
-==Culture and Sensitivity==
+====Culture and Sensitivity====
-Free catch samples which are collected from naturally voided urine will inevitable be contaminated by the bacteria of the external genitalia and skin. Where culture is essential for diagnositc and treatment purposes, a sample obtained by cystocentesis or catheterisation will be required. Catheterisation carries the risk of introducing infection iatrogenically.
-Culture on blood agar and CLED (with Andrades indicator - for E coli) plates will help with a speedy diagnosis of causal organisms.
+===Interpretation===
-{{unfinished}}
-[[Category:To Do]]
-[[Category:Clinical Pathology]]