SlideShare a Scribd company logo
1 of 36
Training Module III Urinalysis
The Urinalysis
What You Will Need (and where to find it) Urinalysis Stickers-upper cabinet to the left of the refrigerator Pipettes (droppers) – in the clear plexiglass shelves on counter behind fecal workstation Urine Dipsticks-cabinet above fecal workstation Refractometer-cabinet above fecal workstation V-shaped tube-first drawer left of microscope Glass slides and cover slips-fecal workstation
Urinalysis An important test for several organ systems.  For some things, as important as blood tests or more important than blood tests!!! Tests for  Urinary Tract Infection Diabetes screening test Renal (Kidney) Disease Rule in or out UTI in dog’s with incontinence Endocrine Disease Cushing’s Disease Diabetes Mellitus Diabetes Insipidus
Patient selection Senior Wellness Screening Polyuria/Polydipsia Urinating outside the litter box or well-trained dog urinating in house Urine spraying in cats Frequent urination, straining to urinate, painful urination Visibly discolored or bloody urine Incontinence
Signs of Urinary Tract Disease	 Straining to urinate Frequent urination or frequent attempts to urinate Repeatedly assuming a urination posture Discomfort on urination Visible blood in urine Urinating in the house when well house-trained Urinating outside the litter box (cat) Visibly abnormal urine color Urinating large volumes and drinking excessive amounts of water (polyuria/polydipsia) Passing a visible bladder stone!
Urinary Tract Infection Could be anywhere in urinary tract Urethritis/Vaginitis/Balanoposthitis Bladder Infection Prostate Infection Kidney Infection (pyelonephritis) Of the above, the bladder is the most common.  Kidney infections in dogs and cats are rare
Indicators of UTI High urine pH  Carnivores should be less than 7 High pH may mean there is an infection or that the patient is predisposed to infection or to struvite stones Proteinuria (elevated protein level) on dipstick Hematuria (blood in urine) on dipstick White Blood Cells on sediment exam Red Blood Cells on sediment or + blood on dipstick  Bacteria on sediment exam
Other things that can mimic UTI Hematuria, Pyuria, Proteinuria and High pH can also occur in a bladder with stones Animals tend to form stones in the urinary bladder, not in the kidneys Bladder stones are very common in dogs; less so in cats Struvite bladder stones are most often associated with high pH and UTI Hematuria, Pyuria, Proteinuria can also occur in cases where there are tumors in the urinary tract Prostate Cancer, Prostatitis or Prostate Cysts in intact male dogs Intact female dogs in heat will have hematuria and proteinuria
Sample Collection Methods Be sure to record the method of collection Voided Collected in a cup or tray by the owner or veterinary staff member Clean catch, for our purposes, means it was not collected off the floor nor did it splash off leaves or grass nor was it stepped in by the patient Special cat litter for urine collection (Kit4Cat) Catheterized Cystocentesis Collected usually by the veterinarian by tapping the bladder with a 22gauge 1½ inch needle on a 6 cc syringe Most accurate method, especially if doing a culture and sensitivity
Owner Psychology & Voided Specimens A urine specimen is often every bit as important as blood tests in determining general health, especially with senior pets If the veterinarian has recommended a urinalysis and the owner is going to attempt to collect it, it is best if the owner pre-pays for the test.  They are much more likely to comply if it is something for which they have already paid. It doesn’t have to be a “first morning” urine, but that is the time at which most pets need to urinate somewhat urgently Sometimes they’ll need to confine pets overnight to keep them from urinating on their wee-wee pads or in the litter box. Sometimes we need to keep pets caged here for several hours to allow their bladders to be full so that we can collect a voided sample or can do a cystocentesis
Sample Handling If collected by owner, it should be brought in as soon as possible Refrigerated if there is any time lapse in getting it to us. Ideally less than 12 hours old (much less preferred) Ask the owner how and when it was obtained Is there a chance it may’ve splashed off grass or leaves”? Is there a chance it was stepped in? Could there be fecal contamination?
Performing the Urinalysis Color Turbidity Specific Gravity Dipstick Sediment
Color Observe the urine grossly Write down an easily understandable color: Yellow Pale Yellow Dark Yellow Goldenrod (a very deep gold color)  May contain Bilirubin Pink Red Port wine May contain myoglobin, a protein that indicates muscle breakdown Greenish May contain deteriorated blood
Turbidity Clear Can see through it like tap water Hazy A tiny bit murky but easy to see through Cloudy Somewhat opaque but you could still read a newspaper through it Opaque You can’t read a newspaper through it
Specific Gravity A measure of how concentrated urine is Urine color can be misleading here! Read with a hand-held device called a refractometer Based on distilled water having a specific gravity of 0.000 Tells a lot about how well the kidneys are functioning Normal kidneys are capable of both diluting and concentrating urine High Specific Gravity is a good thing Cats > 1.040 Dogs >1.030
Refractometer
Measuring the specific gravity Lift the cover flap on the refractometer Place 2 or 3 drops of urine on the stage Lower the cover flap and gently press it down Aim the device up at the light and look through the viewfinder Read the scale on the right of the viewfinder It will read in four digits, the first two being 1.0__ If it is off the scale high, record it as >1.040 Hyposthenuria = <1.012 Isosthenuria = 1.012-1.018
The Urine Dipstick Commercially made test strips Color pads are exposed to urine and compared to a chart on the test strip bottle In our office, kept in the cabinet above the fecal workstation
The Urine Dipstick Designed to be dipped into a specimen in a cup Here, we hold the strip horizontally and drip the urine onto each color pad with a dropper When all color pads are saturated with urine, begin timing and compare to the color pads on the side of the bottle of test strips at specified time Record the results on a Urinalysis sticker Some things are recorded as “normal” and some “negative” Some can be given a number of + signs or a numeric result Record pH Protein Glucose Ketones Bilirubin Urobilinogen Blood Here, We Do Not record Specific Gravity Nitrite White Blood cells The test strips are designed for humans. These tests are inaccurate in animal medicine
The Urine Sediment You will:  Place about 1 ml of urine in a v-shaped centrifuge tube Spin in the Statspin Centrifuge on the Urine setting Have a dropper, a glass slide and coverslip ready The vet or tech will Discard most of the top layer of urine (called the supernantent) Tap the tube to suspend sediment in the urine that remains Place one drop on a slide and cover Read under the microscope
Statspin Centrifuge and tube Kept in first drawer to left of centrifuge On counter to right of microscope
Urine Sediment Results RBCs = red blood cells Unit of “measure”is /hpf, meaning per high power field WBCs = white blood cells Unit of “measure” is /hpf, meaning per high power field Crystals Struvite Oxalate Urate Casts Other Lipid globules Epithelial cells Bacteria Spermatozoa Amorphous or trash – debris that cannot be categorized
Completed Urinalysis Record
Special Circumstances Bashful dogs -  urine collecting stick “Olympic Clean Catch” The urine is so badly discolored that it is hard to read the test strips Spin the urine and run the test on the clearer supernatant (the urine that rises to the top after spinning) The patient is a cat! Collection litter (Kit4Cat) Styrofoam peanuts in a clean litter box Peeing on plastic!!! Some cats will urinate on    grocery bags or saran wrap placed in or beside     the litter box Sometimes owners can actually catch it in a cup! If we need to do a culture and sensitivity Only choice is cystocentesis
Olympic Clean Catch An ingenious tool!!! Generally kept between the refrigerator and the lab counter Collection cups are in the exam table cabinet in Exam   Room 2
Kit4Cat Urine Collection Set Contains  Non-absorbent litter Pipette Sample vial Kept in the exam table cabinet in Exam   Room 2
What we mean by “Collection Set” A flat tray to slide under the dog Very useful for “low rider” dogs We use recycled vaccine trays! A pipette to transfer the urine from tray to urine specimen cup A urine specimen cup Beggars can’t be choosers, we will take urine in any container  it can be caught in
Other Tests Run On Urine at AViD Labs Culture and Sensitivity Run on Cystocentesis samples only Cortisol:Creatinine Ratio A screening test for Cushing’s disease Protein:Creatinine Ratio To assess urine protein loss
Bladder Stone Analysis Sent to Minnesota Urolith Center We now have a practitioner portal to submit and receive information from MN Urolith Center Can go to the portal to submit a case and print an address label Doesn’t take six to eight weeks like it used to!! Alternately, can send to AViD Labs
Dr. Burns likes to recheck Urinalyses on pets with UTI’s in this manner: About 2 to 3 weeks after last antibiotic was given. Near the end of the antibiotic prescription but BEFORE the pet is out of antibiotic	 On pet that have had struvite bladder stones removed, Dr. Burns likes to check them: ,[object Object]
Then every 3 to 4 months, for life.,[object Object]
Quiz, continued Which of the following is not a component of the urinalysis? a.  Specific Gravity b.  Color c.   Odor/Smell d.  Turbidity e.  Dipstick Turbidity means Bacteria in the urine Red blood cells in the urine The clarity of the urine Abnormal urine pH
Quiz, continued   5	Urine from cats may be collected by all of the following except: Emptying the litter box and putting Styrofoam peanuts in it Kit4Cat collecting litter Urine collected on plastic bags in or near the litter box Following the cat around with a cup 6.  Which of the following is/are not a useful parameter to record from the urine dipstick? a.  Blood b.  pH c.  Nitrite d.  Ketones  e.  Specific Gravity  f.  C & E g.  A & D
Quiz Which of the following can be assessed with urine Vestibular disease Kidney disease Addison’s disease Heart disease Which of the following is an acceptable color to record for the urinalysis Fuschia Burnt Sienna Goldenrod Crimson
Quiz, continued Dr. Burns likes to recheck urine after a UTI Before the last antibiotic has been given. In two months Two to three weeks after the last antibiotic A & B A &C The Urinalysis can be used to  a.  Screen for diabetes b.  Check for bladder stones          c.  Test for urinary tract infection          d. A & C          e.  All of the Above

More Related Content

What's hot

Intestinal parasite by Armia Naguib
Intestinal parasite by Armia NaguibIntestinal parasite by Armia Naguib
Intestinal parasite by Armia NaguibArmia Naguib
 
Ascites in domestic animals
Ascites in domestic animalsAscites in domestic animals
Ascites in domestic animalsDr. Prabhu kumar
 
Blackleg (black quarter)
Blackleg (black quarter)Blackleg (black quarter)
Blackleg (black quarter)Muhammad Bilal
 
Diabetes mellitus in Dogs.
Diabetes mellitus in Dogs.Diabetes mellitus in Dogs.
Diabetes mellitus in Dogs.Raaz Eve Mishra
 
ICAWC 2013 - Sarcoptic and Demodectic Mange - David Grant
ICAWC 2013 - Sarcoptic and Demodectic Mange - David GrantICAWC 2013 - Sarcoptic and Demodectic Mange - David Grant
ICAWC 2013 - Sarcoptic and Demodectic Mange - David GrantDogs Trust
 
Congenital Heart Disease
Congenital Heart DiseaseCongenital Heart Disease
Congenital Heart Diseaseupstatevet
 
Recent advanes in handling of dystocia
Recent advanes in handling of dystociaRecent advanes in handling of dystocia
Recent advanes in handling of dystociarahulvet27
 
Enterotoxemia in sheep Goat
Enterotoxemia in sheep Goat Enterotoxemia in sheep Goat
Enterotoxemia in sheep Goat tasbeehullahjan
 
Presetation on rumen impaction lactic acidosis final osr
Presetation on rumen impaction lactic acidosis final osrPresetation on rumen impaction lactic acidosis final osr
Presetation on rumen impaction lactic acidosis final osrHarshit Saxena
 
TRANSMISSIBLE VENEREAL TUMOR N DOGS
TRANSMISSIBLE VENEREAL TUMOR N DOGSTRANSMISSIBLE VENEREAL TUMOR N DOGS
TRANSMISSIBLE VENEREAL TUMOR N DOGSTANUVAS
 

What's hot (20)

Dog Diseases
Dog DiseasesDog Diseases
Dog Diseases
 
Anaemia veterinary
Anaemia veterinaryAnaemia veterinary
Anaemia veterinary
 
Intestinal parasite by Armia Naguib
Intestinal parasite by Armia NaguibIntestinal parasite by Armia Naguib
Intestinal parasite by Armia Naguib
 
Ascites in domestic animals
Ascites in domestic animalsAscites in domestic animals
Ascites in domestic animals
 
Repeat breeding
Repeat breedingRepeat breeding
Repeat breeding
 
Therapeutic management of skin diseases in animals
Therapeutic management of skin diseases in animalsTherapeutic management of skin diseases in animals
Therapeutic management of skin diseases in animals
 
Blackleg (black quarter)
Blackleg (black quarter)Blackleg (black quarter)
Blackleg (black quarter)
 
Animal parameters lecture
Animal parameters lectureAnimal parameters lecture
Animal parameters lecture
 
Diabetes mellitus in Dogs.
Diabetes mellitus in Dogs.Diabetes mellitus in Dogs.
Diabetes mellitus in Dogs.
 
Lamness in cattle
Lamness in cattleLamness in cattle
Lamness in cattle
 
Clinical examination of Cattle
Clinical examination of CattleClinical examination of Cattle
Clinical examination of Cattle
 
Colic in horses
Colic in horsesColic in horses
Colic in horses
 
ICAWC 2013 - Sarcoptic and Demodectic Mange - David Grant
ICAWC 2013 - Sarcoptic and Demodectic Mange - David GrantICAWC 2013 - Sarcoptic and Demodectic Mange - David Grant
ICAWC 2013 - Sarcoptic and Demodectic Mange - David Grant
 
Congenital Heart Disease
Congenital Heart DiseaseCongenital Heart Disease
Congenital Heart Disease
 
Equine diseases
Equine diseasesEquine diseases
Equine diseases
 
Recent advanes in handling of dystocia
Recent advanes in handling of dystociaRecent advanes in handling of dystocia
Recent advanes in handling of dystocia
 
Pyometra in bitches
Pyometra in bitchesPyometra in bitches
Pyometra in bitches
 
Enterotoxemia in sheep Goat
Enterotoxemia in sheep Goat Enterotoxemia in sheep Goat
Enterotoxemia in sheep Goat
 
Presetation on rumen impaction lactic acidosis final osr
Presetation on rumen impaction lactic acidosis final osrPresetation on rumen impaction lactic acidosis final osr
Presetation on rumen impaction lactic acidosis final osr
 
TRANSMISSIBLE VENEREAL TUMOR N DOGS
TRANSMISSIBLE VENEREAL TUMOR N DOGSTRANSMISSIBLE VENEREAL TUMOR N DOGS
TRANSMISSIBLE VENEREAL TUMOR N DOGS
 

Viewers also liked

2011 Navy Leader Planning Guide
2011 Navy Leader Planning Guide2011 Navy Leader Planning Guide
2011 Navy Leader Planning Guideoscarc414
 
Lp 16 urinary system & urinalysis 2008
Lp 16 urinary system & urinalysis 2008Lp 16 urinary system & urinalysis 2008
Lp 16 urinary system & urinalysis 2008Kirstyn Soderberg
 
characteristics of urine
characteristics of urinecharacteristics of urine
characteristics of urinesana sana
 
Normal constituents of urine
Normal constituents of urineNormal constituents of urine
Normal constituents of urineDr. Janice DSa
 
Urine Interpretation / Test / Analysis
Urine Interpretation / Test / AnalysisUrine Interpretation / Test / Analysis
Urine Interpretation / Test / AnalysisDr Anshul Varshney
 

Viewers also liked (10)

Urinalysis
UrinalysisUrinalysis
Urinalysis
 
2011 Navy Leader Planning Guide
2011 Navy Leader Planning Guide2011 Navy Leader Planning Guide
2011 Navy Leader Planning Guide
 
Urine analysis
Urine analysisUrine analysis
Urine analysis
 
Lp 16 urinary system & urinalysis 2008
Lp 16 urinary system & urinalysis 2008Lp 16 urinary system & urinalysis 2008
Lp 16 urinary system & urinalysis 2008
 
Urinalysis 3/27
Urinalysis 3/27Urinalysis 3/27
Urinalysis 3/27
 
characteristics of urine
characteristics of urinecharacteristics of urine
characteristics of urine
 
Urinalysis
UrinalysisUrinalysis
Urinalysis
 
Normal constituents of urine
Normal constituents of urineNormal constituents of urine
Normal constituents of urine
 
Urine analysis
Urine analysisUrine analysis
Urine analysis
 
Urine Interpretation / Test / Analysis
Urine Interpretation / Test / AnalysisUrine Interpretation / Test / Analysis
Urine Interpretation / Test / Analysis
 

Similar to Training module III - Urinalysis

Training module 1- Fecal Testing
Training module 1- Fecal TestingTraining module 1- Fecal Testing
Training module 1- Fecal TestingJacquelyn Burns
 
Elimination summer 2012
Elimination summer 2012Elimination summer 2012
Elimination summer 2012JHU Nursing
 
2 diagnosis of colic in equines prof.dr hamed attia
2  diagnosis of colic in equines prof.dr hamed attia2  diagnosis of colic in equines prof.dr hamed attia
2 diagnosis of colic in equines prof.dr hamed attiaHamedAttia3
 
sample collection and safety.pdf
sample collection and safety.pdfsample collection and safety.pdf
sample collection and safety.pdfOMJHA20
 
sample collection and safety.pdf
sample collection and safety.pdfsample collection and safety.pdf
sample collection and safety.pdfOMJHA20
 
Sample collection and safety procedure in laboratory
Sample collection and safety procedure in laboratorySample collection and safety procedure in laboratory
Sample collection and safety procedure in laboratoryPriyanka Buragohain
 
03 laboratory tests part 2
03 laboratory tests part 203 laboratory tests part 2
03 laboratory tests part 2jhonee balmeo
 
Laboratory and diagnostic examination(urine analysis)
Laboratory and diagnostic examination(urine analysis)Laboratory and diagnostic examination(urine analysis)
Laboratory and diagnostic examination(urine analysis)anjalatchi
 
Care of patients with elimination needs
Care of patients with elimination needsCare of patients with elimination needs
Care of patients with elimination needsjannet reena
 
laboratory tests part 2
laboratory tests part 2laboratory tests part 2
laboratory tests part 2jhonee balmeo
 
Medicina felina chirurgie - bases de chirurgie féline
Medicina felina   chirurgie - bases de chirurgie félineMedicina felina   chirurgie - bases de chirurgie féline
Medicina felina chirurgie - bases de chirurgie félineGuillaume Michigan
 
Utility of Renal function tests and value in differential diagnosis in renal,...
Utility of Renal function tests and value in differential diagnosis in renal,...Utility of Renal function tests and value in differential diagnosis in renal,...
Utility of Renal function tests and value in differential diagnosis in renal,...meducationdotnet
 
Urine dr.hamada elsadaway
Urine dr.hamada elsadawayUrine dr.hamada elsadaway
Urine dr.hamada elsadawayFarragBahbah
 

Similar to Training module III - Urinalysis (20)

Training module 1- Fecal Testing
Training module 1- Fecal TestingTraining module 1- Fecal Testing
Training module 1- Fecal Testing
 
Elimination summer 2012
Elimination summer 2012Elimination summer 2012
Elimination summer 2012
 
2 diagnosis of colic in equines prof.dr hamed attia
2  diagnosis of colic in equines prof.dr hamed attia2  diagnosis of colic in equines prof.dr hamed attia
2 diagnosis of colic in equines prof.dr hamed attia
 
Performing-the-Urinalysis.ppt
Performing-the-Urinalysis.pptPerforming-the-Urinalysis.ppt
Performing-the-Urinalysis.ppt
 
Clinical pathology ppt
Clinical pathology pptClinical pathology ppt
Clinical pathology ppt
 
sample collection and safety.pdf
sample collection and safety.pdfsample collection and safety.pdf
sample collection and safety.pdf
 
sample collection and safety.pdf
sample collection and safety.pdfsample collection and safety.pdf
sample collection and safety.pdf
 
Sample collection and safety procedure in laboratory
Sample collection and safety procedure in laboratorySample collection and safety procedure in laboratory
Sample collection and safety procedure in laboratory
 
03 laboratory tests part 2
03 laboratory tests part 203 laboratory tests part 2
03 laboratory tests part 2
 
Laboratory and diagnostic examination(urine analysis)
Laboratory and diagnostic examination(urine analysis)Laboratory and diagnostic examination(urine analysis)
Laboratory and diagnostic examination(urine analysis)
 
Urine and faeces investigation
Urine and faeces investigation Urine and faeces investigation
Urine and faeces investigation
 
Stool
StoolStool
Stool
 
Specimen collection
Specimen collectionSpecimen collection
Specimen collection
 
Care of patients with elimination needs
Care of patients with elimination needsCare of patients with elimination needs
Care of patients with elimination needs
 
laboratory tests part 2
laboratory tests part 2laboratory tests part 2
laboratory tests part 2
 
Giardia Infection
Giardia InfectionGiardia Infection
Giardia Infection
 
Medicina felina chirurgie - bases de chirurgie féline
Medicina felina   chirurgie - bases de chirurgie félineMedicina felina   chirurgie - bases de chirurgie féline
Medicina felina chirurgie - bases de chirurgie féline
 
Utility of Renal function tests and value in differential diagnosis in renal,...
Utility of Renal function tests and value in differential diagnosis in renal,...Utility of Renal function tests and value in differential diagnosis in renal,...
Utility of Renal function tests and value in differential diagnosis in renal,...
 
Urine FEME
Urine FEMEUrine FEME
Urine FEME
 
Urine dr.hamada elsadaway
Urine dr.hamada elsadawayUrine dr.hamada elsadaway
Urine dr.hamada elsadaway
 

More from Jacquelyn Burns

My Dog has Arthritis! Now What?
My Dog has Arthritis! Now What?My Dog has Arthritis! Now What?
My Dog has Arthritis! Now What?Jacquelyn Burns
 
My Dog Has Otitis! Now What?
My Dog Has Otitis! Now What?My Dog Has Otitis! Now What?
My Dog Has Otitis! Now What?Jacquelyn Burns
 
My pet has allergies! What now?
My pet has allergies!  What now?My pet has allergies!  What now?
My pet has allergies! What now?Jacquelyn Burns
 
My pet has chronic renal failure!
My pet has chronic renal failure!My pet has chronic renal failure!
My pet has chronic renal failure!Jacquelyn Burns
 
My Puppy Has Parvo! Now What?
My Puppy Has Parvo!  Now What?My Puppy Has Parvo!  Now What?
My Puppy Has Parvo! Now What?Jacquelyn Burns
 
Training module II - Heartworm Testing
Training module II - Heartworm TestingTraining module II - Heartworm Testing
Training module II - Heartworm TestingJacquelyn Burns
 
My dog has heartworms. Now what?
My dog has heartworms.  Now what?My dog has heartworms.  Now what?
My dog has heartworms. Now what?Jacquelyn Burns
 

More from Jacquelyn Burns (9)

My Dog has Arthritis! Now What?
My Dog has Arthritis! Now What?My Dog has Arthritis! Now What?
My Dog has Arthritis! Now What?
 
My Dog Has Otitis! Now What?
My Dog Has Otitis! Now What?My Dog Has Otitis! Now What?
My Dog Has Otitis! Now What?
 
My pet has allergies! What now?
My pet has allergies!  What now?My pet has allergies!  What now?
My pet has allergies! What now?
 
My pet has chronic renal failure!
My pet has chronic renal failure!My pet has chronic renal failure!
My pet has chronic renal failure!
 
My dog has diabetes!
My dog has diabetes!My dog has diabetes!
My dog has diabetes!
 
My Puppy Has Parvo! Now What?
My Puppy Has Parvo!  Now What?My Puppy Has Parvo!  Now What?
My Puppy Has Parvo! Now What?
 
Training module II - Heartworm Testing
Training module II - Heartworm TestingTraining module II - Heartworm Testing
Training module II - Heartworm Testing
 
Shirlfest 2011
Shirlfest  2011Shirlfest  2011
Shirlfest 2011
 
My dog has heartworms. Now what?
My dog has heartworms.  Now what?My dog has heartworms.  Now what?
My dog has heartworms. Now what?
 

Recently uploaded

Nirshaa Ecommerce_Ready To Ship Products
Nirshaa Ecommerce_Ready To Ship ProductsNirshaa Ecommerce_Ready To Ship Products
Nirshaa Ecommerce_Ready To Ship Productsnirshaacom
 
Transformative Learning Experience at Sattva Yoga Academy
Transformative Learning Experience at Sattva Yoga AcademyTransformative Learning Experience at Sattva Yoga Academy
Transformative Learning Experience at Sattva Yoga AcademyMamta Mehra
 
How Can A Life Coach Help You Deal With Self-Limiting Beliefs
How Can A Life Coach Help You Deal With Self-Limiting BeliefsHow Can A Life Coach Help You Deal With Self-Limiting Beliefs
How Can A Life Coach Help You Deal With Self-Limiting BeliefsExecutive Coaching Orlando
 
A case study on customer satisfaction towards First cry products.
A case study on customer satisfaction towards First cry products.A case study on customer satisfaction towards First cry products.
A case study on customer satisfaction towards First cry products.mantashanaaz25
 
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdf
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdfCommon Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdf
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdfNada Elgazaar
 
Horsley U3A monthly slide show June 2024.pptx
Horsley U3A monthly slide show June 2024.pptxHorsley U3A monthly slide show June 2024.pptx
Horsley U3A monthly slide show June 2024.pptxMarkBlowers2
 
How to Maintain Healthy Life style.pptx
How to Maintain  Healthy Life style.pptxHow to Maintain  Healthy Life style.pptx
How to Maintain Healthy Life style.pptxrdishurana
 
Leadership Development: Empowering Women Leaders
Leadership Development: Empowering Women LeadersLeadership Development: Empowering Women Leaders
Leadership Development: Empowering Women LeadersLas Vegas Leading Ladies
 
Exploring the Timeless Beauty of Diamond Heart Pendants
Exploring the Timeless Beauty of Diamond Heart PendantsExploring the Timeless Beauty of Diamond Heart Pendants
Exploring the Timeless Beauty of Diamond Heart PendantsCharleston Alexander
 
Life in the Tang Dynasty in the Ancient Times.pptx
Life in the Tang Dynasty in the Ancient Times.pptxLife in the Tang Dynasty in the Ancient Times.pptx
Life in the Tang Dynasty in the Ancient Times.pptxLannaHarumiya1
 
Landscape Gardeners in Sussex and Surrey
Landscape Gardeners in Sussex and SurreyLandscape Gardeners in Sussex and Surrey
Landscape Gardeners in Sussex and SurreyAskXX.com
 

Recently uploaded (12)

Nirshaa Ecommerce_Ready To Ship Products
Nirshaa Ecommerce_Ready To Ship ProductsNirshaa Ecommerce_Ready To Ship Products
Nirshaa Ecommerce_Ready To Ship Products
 
Transformative Learning Experience at Sattva Yoga Academy
Transformative Learning Experience at Sattva Yoga AcademyTransformative Learning Experience at Sattva Yoga Academy
Transformative Learning Experience at Sattva Yoga Academy
 
Take Back Control: Moving Forward with Scleroderma - Gregory Cohen
Take Back Control: Moving Forward with Scleroderma - Gregory CohenTake Back Control: Moving Forward with Scleroderma - Gregory Cohen
Take Back Control: Moving Forward with Scleroderma - Gregory Cohen
 
How Can A Life Coach Help You Deal With Self-Limiting Beliefs
How Can A Life Coach Help You Deal With Self-Limiting BeliefsHow Can A Life Coach Help You Deal With Self-Limiting Beliefs
How Can A Life Coach Help You Deal With Self-Limiting Beliefs
 
A case study on customer satisfaction towards First cry products.
A case study on customer satisfaction towards First cry products.A case study on customer satisfaction towards First cry products.
A case study on customer satisfaction towards First cry products.
 
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdf
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdfCommon Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdf
Common Mistakes in Intermittent Fasting 204 and 168 - Presentation.pdf
 
Horsley U3A monthly slide show June 2024.pptx
Horsley U3A monthly slide show June 2024.pptxHorsley U3A monthly slide show June 2024.pptx
Horsley U3A monthly slide show June 2024.pptx
 
How to Maintain Healthy Life style.pptx
How to Maintain  Healthy Life style.pptxHow to Maintain  Healthy Life style.pptx
How to Maintain Healthy Life style.pptx
 
Leadership Development: Empowering Women Leaders
Leadership Development: Empowering Women LeadersLeadership Development: Empowering Women Leaders
Leadership Development: Empowering Women Leaders
 
Exploring the Timeless Beauty of Diamond Heart Pendants
Exploring the Timeless Beauty of Diamond Heart PendantsExploring the Timeless Beauty of Diamond Heart Pendants
Exploring the Timeless Beauty of Diamond Heart Pendants
 
Life in the Tang Dynasty in the Ancient Times.pptx
Life in the Tang Dynasty in the Ancient Times.pptxLife in the Tang Dynasty in the Ancient Times.pptx
Life in the Tang Dynasty in the Ancient Times.pptx
 
Landscape Gardeners in Sussex and Surrey
Landscape Gardeners in Sussex and SurreyLandscape Gardeners in Sussex and Surrey
Landscape Gardeners in Sussex and Surrey
 

Training module III - Urinalysis

  • 1. Training Module III Urinalysis
  • 3. What You Will Need (and where to find it) Urinalysis Stickers-upper cabinet to the left of the refrigerator Pipettes (droppers) – in the clear plexiglass shelves on counter behind fecal workstation Urine Dipsticks-cabinet above fecal workstation Refractometer-cabinet above fecal workstation V-shaped tube-first drawer left of microscope Glass slides and cover slips-fecal workstation
  • 4. Urinalysis An important test for several organ systems. For some things, as important as blood tests or more important than blood tests!!! Tests for Urinary Tract Infection Diabetes screening test Renal (Kidney) Disease Rule in or out UTI in dog’s with incontinence Endocrine Disease Cushing’s Disease Diabetes Mellitus Diabetes Insipidus
  • 5. Patient selection Senior Wellness Screening Polyuria/Polydipsia Urinating outside the litter box or well-trained dog urinating in house Urine spraying in cats Frequent urination, straining to urinate, painful urination Visibly discolored or bloody urine Incontinence
  • 6. Signs of Urinary Tract Disease Straining to urinate Frequent urination or frequent attempts to urinate Repeatedly assuming a urination posture Discomfort on urination Visible blood in urine Urinating in the house when well house-trained Urinating outside the litter box (cat) Visibly abnormal urine color Urinating large volumes and drinking excessive amounts of water (polyuria/polydipsia) Passing a visible bladder stone!
  • 7. Urinary Tract Infection Could be anywhere in urinary tract Urethritis/Vaginitis/Balanoposthitis Bladder Infection Prostate Infection Kidney Infection (pyelonephritis) Of the above, the bladder is the most common. Kidney infections in dogs and cats are rare
  • 8. Indicators of UTI High urine pH Carnivores should be less than 7 High pH may mean there is an infection or that the patient is predisposed to infection or to struvite stones Proteinuria (elevated protein level) on dipstick Hematuria (blood in urine) on dipstick White Blood Cells on sediment exam Red Blood Cells on sediment or + blood on dipstick Bacteria on sediment exam
  • 9. Other things that can mimic UTI Hematuria, Pyuria, Proteinuria and High pH can also occur in a bladder with stones Animals tend to form stones in the urinary bladder, not in the kidneys Bladder stones are very common in dogs; less so in cats Struvite bladder stones are most often associated with high pH and UTI Hematuria, Pyuria, Proteinuria can also occur in cases where there are tumors in the urinary tract Prostate Cancer, Prostatitis or Prostate Cysts in intact male dogs Intact female dogs in heat will have hematuria and proteinuria
  • 10. Sample Collection Methods Be sure to record the method of collection Voided Collected in a cup or tray by the owner or veterinary staff member Clean catch, for our purposes, means it was not collected off the floor nor did it splash off leaves or grass nor was it stepped in by the patient Special cat litter for urine collection (Kit4Cat) Catheterized Cystocentesis Collected usually by the veterinarian by tapping the bladder with a 22gauge 1½ inch needle on a 6 cc syringe Most accurate method, especially if doing a culture and sensitivity
  • 11. Owner Psychology & Voided Specimens A urine specimen is often every bit as important as blood tests in determining general health, especially with senior pets If the veterinarian has recommended a urinalysis and the owner is going to attempt to collect it, it is best if the owner pre-pays for the test. They are much more likely to comply if it is something for which they have already paid. It doesn’t have to be a “first morning” urine, but that is the time at which most pets need to urinate somewhat urgently Sometimes they’ll need to confine pets overnight to keep them from urinating on their wee-wee pads or in the litter box. Sometimes we need to keep pets caged here for several hours to allow their bladders to be full so that we can collect a voided sample or can do a cystocentesis
  • 12. Sample Handling If collected by owner, it should be brought in as soon as possible Refrigerated if there is any time lapse in getting it to us. Ideally less than 12 hours old (much less preferred) Ask the owner how and when it was obtained Is there a chance it may’ve splashed off grass or leaves”? Is there a chance it was stepped in? Could there be fecal contamination?
  • 13. Performing the Urinalysis Color Turbidity Specific Gravity Dipstick Sediment
  • 14. Color Observe the urine grossly Write down an easily understandable color: Yellow Pale Yellow Dark Yellow Goldenrod (a very deep gold color) May contain Bilirubin Pink Red Port wine May contain myoglobin, a protein that indicates muscle breakdown Greenish May contain deteriorated blood
  • 15. Turbidity Clear Can see through it like tap water Hazy A tiny bit murky but easy to see through Cloudy Somewhat opaque but you could still read a newspaper through it Opaque You can’t read a newspaper through it
  • 16. Specific Gravity A measure of how concentrated urine is Urine color can be misleading here! Read with a hand-held device called a refractometer Based on distilled water having a specific gravity of 0.000 Tells a lot about how well the kidneys are functioning Normal kidneys are capable of both diluting and concentrating urine High Specific Gravity is a good thing Cats > 1.040 Dogs >1.030
  • 18. Measuring the specific gravity Lift the cover flap on the refractometer Place 2 or 3 drops of urine on the stage Lower the cover flap and gently press it down Aim the device up at the light and look through the viewfinder Read the scale on the right of the viewfinder It will read in four digits, the first two being 1.0__ If it is off the scale high, record it as >1.040 Hyposthenuria = <1.012 Isosthenuria = 1.012-1.018
  • 19. The Urine Dipstick Commercially made test strips Color pads are exposed to urine and compared to a chart on the test strip bottle In our office, kept in the cabinet above the fecal workstation
  • 20. The Urine Dipstick Designed to be dipped into a specimen in a cup Here, we hold the strip horizontally and drip the urine onto each color pad with a dropper When all color pads are saturated with urine, begin timing and compare to the color pads on the side of the bottle of test strips at specified time Record the results on a Urinalysis sticker Some things are recorded as “normal” and some “negative” Some can be given a number of + signs or a numeric result Record pH Protein Glucose Ketones Bilirubin Urobilinogen Blood Here, We Do Not record Specific Gravity Nitrite White Blood cells The test strips are designed for humans. These tests are inaccurate in animal medicine
  • 21. The Urine Sediment You will: Place about 1 ml of urine in a v-shaped centrifuge tube Spin in the Statspin Centrifuge on the Urine setting Have a dropper, a glass slide and coverslip ready The vet or tech will Discard most of the top layer of urine (called the supernantent) Tap the tube to suspend sediment in the urine that remains Place one drop on a slide and cover Read under the microscope
  • 22. Statspin Centrifuge and tube Kept in first drawer to left of centrifuge On counter to right of microscope
  • 23. Urine Sediment Results RBCs = red blood cells Unit of “measure”is /hpf, meaning per high power field WBCs = white blood cells Unit of “measure” is /hpf, meaning per high power field Crystals Struvite Oxalate Urate Casts Other Lipid globules Epithelial cells Bacteria Spermatozoa Amorphous or trash – debris that cannot be categorized
  • 25. Special Circumstances Bashful dogs - urine collecting stick “Olympic Clean Catch” The urine is so badly discolored that it is hard to read the test strips Spin the urine and run the test on the clearer supernatant (the urine that rises to the top after spinning) The patient is a cat! Collection litter (Kit4Cat) Styrofoam peanuts in a clean litter box Peeing on plastic!!! Some cats will urinate on grocery bags or saran wrap placed in or beside the litter box Sometimes owners can actually catch it in a cup! If we need to do a culture and sensitivity Only choice is cystocentesis
  • 26. Olympic Clean Catch An ingenious tool!!! Generally kept between the refrigerator and the lab counter Collection cups are in the exam table cabinet in Exam Room 2
  • 27. Kit4Cat Urine Collection Set Contains Non-absorbent litter Pipette Sample vial Kept in the exam table cabinet in Exam Room 2
  • 28. What we mean by “Collection Set” A flat tray to slide under the dog Very useful for “low rider” dogs We use recycled vaccine trays! A pipette to transfer the urine from tray to urine specimen cup A urine specimen cup Beggars can’t be choosers, we will take urine in any container it can be caught in
  • 29. Other Tests Run On Urine at AViD Labs Culture and Sensitivity Run on Cystocentesis samples only Cortisol:Creatinine Ratio A screening test for Cushing’s disease Protein:Creatinine Ratio To assess urine protein loss
  • 30. Bladder Stone Analysis Sent to Minnesota Urolith Center We now have a practitioner portal to submit and receive information from MN Urolith Center Can go to the portal to submit a case and print an address label Doesn’t take six to eight weeks like it used to!! Alternately, can send to AViD Labs
  • 31.
  • 32.
  • 33. Quiz, continued Which of the following is not a component of the urinalysis? a. Specific Gravity b. Color c. Odor/Smell d. Turbidity e. Dipstick Turbidity means Bacteria in the urine Red blood cells in the urine The clarity of the urine Abnormal urine pH
  • 34. Quiz, continued 5 Urine from cats may be collected by all of the following except: Emptying the litter box and putting Styrofoam peanuts in it Kit4Cat collecting litter Urine collected on plastic bags in or near the litter box Following the cat around with a cup 6. Which of the following is/are not a useful parameter to record from the urine dipstick? a. Blood b. pH c. Nitrite d. Ketones e. Specific Gravity f. C & E g. A & D
  • 35. Quiz Which of the following can be assessed with urine Vestibular disease Kidney disease Addison’s disease Heart disease Which of the following is an acceptable color to record for the urinalysis Fuschia Burnt Sienna Goldenrod Crimson
  • 36. Quiz, continued Dr. Burns likes to recheck urine after a UTI Before the last antibiotic has been given. In two months Two to three weeks after the last antibiotic A & B A &C The Urinalysis can be used to a. Screen for diabetes b. Check for bladder stones c. Test for urinary tract infection d. A & C e. All of the Above