Diagnostic analysis of urinalysis - DVM
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Diagnostic analysis of urinalysis
Diagnostic analysis of urinalysis


DVM360 MAGAZINE


The most probable answer to question 2 = option c.

Comments about answers:

a. The combination of significant numbers of RBC, WBC and protein indicate inflammation. Detection of bacteria indicate the inflammation is associated with infection. However, these results do not permit differentiation between bacterial infection as a cause or complication of urinary tract inflammation. Most bacterial urinary tract infections develop secondary to underlying abnormalities in host defense mechanisms.

b. Although this answer is not totally incorrect, to conclude that the genital tract is definitely involved in a sample obtained by cystocentesis is an overstatement.

c. In light of the preceding comments for options a and b, this appears to be the best interpretation.

d. d. Although magnesium ammonium phosphate uroliths may be present, struvite crystalluria is not by itself a reliable index of their occurrence.

e. Although these findings are consistent with bacterial infection of the kidneys associated with impaired urine concentration, further diagnostic investigation would be required to verify or exclude this interpretation.

  • 3. Consider the following results obtained by analysis of a urine sample collected by cystocentesis from a 7-year-old spayed female Malamute.

Color = Pink

Protein = 3+

Turbidity = Slightly turbid

RBC = >100/hpf

Specific gravity = 1.035

WBC = 0 to 1/hpf

PH = 7

Casts = None

Glucose = Negative

Epithelial cells = Occasional

Acetone = Negative

Bacteria = None

Occult blood = 3+

Crystals = Occasional struvite

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

a. An inflammatory disease of the urinary tract

b. Pyelonephritis

c. Hematuria induced by struvite uroliths

d. A hemorrhagic lesion of the urinary tract excluding the urethra.

e. Iatrogenic hematuria induced by trauma during cystocentesis.

The best answer to question 3 = option e.

Comments about answers:

a. The paucity of white cells compared to red blood cells is not indicative of an inflammatory response.

b. The findings are not indicative of renal involvement in an inflammatory process.

c. Struvite crystalluria is not a reliable index of magnesium ammonium phosphate uroliths. In addition, most canine struvite uroliths occur as a result of infection with urease-producing bacteria and therefore are associated with an inflammatory response.

d. The urethra cannot be excluded as a source of hemorrhage just because the sample was obtained by catheterization.

e. Trauma to the bladder wall during cystocentesis commonly is associated with hematuria and proteinuria. Proteinuria is primarily caused by loss of plasma proteins with RBC in whole blood. Whereas the sensitivity of diagnostic reagent strips to protein in ~20mg/dl; the normal plasma concentration of protein is 6,000 to 8,000 mg/dl.

  • 4. Consider the following results obtained by analysis of a voided urine sample collected from a 5-year-old spayed female mixed Golden Retriever.

Color = yellow

Protein = Neg

Turbidity = cloudy

RBC = Neg

Specific gravity = 1.029

WBC = Neg

PH = 8.0

Casts = Neg

Glucose = Neg

Epithelial cells = Occasional

Acetone = Neg

Bacteria = Many Rods & Cocci

Bilirubin = Neg

Crystals = Many struvite

Occult blood = Neg

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

a. The sample was collected in a nonsterilized container and was analyzed several hours following collection.

b. The patient has bacterial infection of the urinary bladder.

c. The patient has bacterial infection of the kidneys.

d. The patient has bacterial infection of the genital or urinary tract.

e. The patient probably has infection-induced struvite uroliths.

The best answer to question 4 = option a.

Comments about answers:

a. Lack of an inflammatory response suggests that the bacteriuria represents contamination. Detection of rods and cocci also suggest contamination since 75 percent of the bacterial urinary tract infections in dogs are caused by one species of bacteria, while only 18 percent are caused by two species of bacteria. The degree of alkalinity is consistent with analysis of an unpreserved sample many hours following collection. The struvite crystals probably formed in vitro.

b. See comment in option a. It is not possible to localize bacteriuria in voided samples without additional information.

c. See comments in options a and b.

d. See comments options a and b.

e. See comments options a and b.

  • 5. Consider the following results obtained by analysis of a voided urine sample from an 8-year-old, spayed female Miniature Dachshund:

Color = Yellow

Protein = 1+

Turbidity = Clear

RBC = 0 - 1/hpf

Specific gravity = 1.050

WBC = 0 - 1/hpf

PH = 6.5

Casts = None

Glucose = Negative

Epithelial cell = Occasional

Acetone = Negative

Bacteria = None

Bilirubin = 1+

Crystals = Few amorphous

Occult blood = Negative

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

a. Has hepatic disease

b. Has an inflammatory disorder of the urinary tract.

c. Is normal

d. Has acute renal failure

e. Has slight injury of the glomeruli adversely affecting their ability to selectively retain plasma proteins in capillary lumens.

The most probable answer to question 5 = option c.

Comments about answers to question 5:

a. Although this interpretation is possible, a mild degree of bilirubinuria in dog urine is often a normal finding. Thus, commonly available tests for bilirubinuria are not reliable as screening tests for abnormalities in bilirubin metabolism in dogs.

b. Proteinuria, RBC and WBC of this magnitude are normal findings, especially in highly concentrated urine.

c. Small quantities of bilirubin are often observed in concentrated urine samples formed by healthy dogs. This phenomenon appears to be related to the fact that their renal tubular epithelial cells can form bilirubin from hemoglobin. Thus, healthy dogs may have mild bilirubinuria even when serum bilirubin concentrations are normal.

d. Concentration of urine to this degree eliminates a diagnosis of primary renal failure.

e. Detection of slight proteinuria in highly concentrated urine is a common finding in healthy dogs.

  • 6. Consider the following results obtained by analysis of a urine sample collected by cystocentesis from a 5-year-old neutered male Persian cat:

Color = Yellow

Protein = 1+

Turbidity = Clear

RBC = 5 - 10/hpf

Specific gravity = 1.045

WBC = 0 - 1/hpf

PH = 7.0

Casts = None

Glucose = Negative

Epithelial cells = Occasional

Acetone = Negative

Bacteria = None

Bilirubin = 1 +

Crystals = Few amorphous

Occult blood = Negative

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

a. Has significant bilirubinuria

b. Has inflammatory disease syndrome along the urinary tract.

c. Is normal

d. Has acute renal failure

e. Has lower urinary tract disease

The best answer to question 6 = option a.


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