Diagnostic analysis of urinalysis

Diagnostic analysis of urinalysis

Diagnostic analysis of urinalysis
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Jun 01, 2004



Urinalysis is one of our most important clinical diagnostic tools. The following questions are designed to facilitate self-assessment of your interpretation of routine urinalysis of several patients admitted to the Veterinary Teaching Hospital, University of Minnesota. When choosing your answer, remember to distinguish between observations and interpretations, and to consider the best answer in terms of probabilities rather than possibilities.



Further information about techniques and interpretations of urinalysis may be obtained from the recently published book entitled, "Urinalysis: A Clinical Guide To Compassionate Patient Care". This textbook, authored by myself and Dr. Jerry B. Stevens, was made possible by an educational grant from Bayer. For further information on how a veterinarian may obtain a copy while supplies last, contact Bayer Animal Health, Shawnee Mission, KS; (800) 633-3796, option 4.

  • 1. Consider the following results obtained by analysis of a voided urine sample obtained by cystocentesis from a 6-year-old neutered male Great Dane.

Color = Light yellow

Protein = 4+

Turbidity = Clear

RBC = 0 - 1/hpf (high power field)

Specific gravity = 1.032

WBC = 0 - 1 / hpf

PH = 6.5

Casts = Occasional hyaline/hpf

Glucose = Negative

Epithelial cells = Occasional

Acetone = Negative

Bacteria = None

Bilirubin = Negative

Crystals = None

Occult blood = Negative

The most probable interpretation of the results of this urinalysis is that the patient:

a. Is normal

b. Has generalized glomerular disease (i.e., glomerular proteinuria).

c. Has generalized tubular disease (i.e., tubular proteinuria).

d. Has an inflammatory process somewhere along the urinary tract (i.e. post-glomerular proteinuria).

e. Has findings indicative of congestive heart failure or fever (i.e., pre-glomerular proteinuria).

The most probable answer to question 1 = option b.

Comments about answers:

a. Proteinuria of this magnitude is definitely not normal.

b. Marked proteinuria in the absence of significant numbers of red blood cells and white cells is the hallmark of generalized glomerular disease.

c. Proteinuria of this magnitude would not be expected as a result of primary tubular disease.

d. Absence of significant numbers of red blood cells and white cells eliminates the likelihood of an inflammatory response.

e. Proteinuria of this magnitude would not be expected as a result of pre-glomerular causes.

  • 2. Consider the following results obtained by analysis of a fresh urine sample obtained by cystocentesis from a 5-year-old spayed female Miniature Schnauzer.

Color = Yellow

Protein = 3+

Turbidity = Cloudy

RBC = Numerous/hpf

Specific gravity = 1.014

WBC = Numerous/hpf

PH=. 8.0

Casts = None

Glucose = Negative

Epithelial cells = Many

Acetone = Negative

Bacteria = Numerous cocci

Bilirubin = Negative

Crystals = Moderate struvite

Occult blood = 4+

The best interpretation of the results of this urinalysis is that the patient:

a. Has an inflammatory process somewhere along the urinary tract caused by bacterial infection.

b. Has an inflammatory process somewhere along the genitourinary tract caused by bacterial infection.

c. Has an inflammatory process somewhere along the urinary tract caused or complicated by bacterial infection.

d. Has struvite uroliths associated with urinary tract infection.

e. Has pyelonephritis resulting in impaired ability of the kidneys to concentrate urine.