Increased protein in the urine of a cat: evaluation of the results of the analysis. Increased protein in the urine of a cat: causes of proteinuria. Treatment of proteinuria in dogs and cats

It is widely accepted that a cat's urine pH can be directly related to the health of its urinary tract. Is your cat at risk for bladder crystals? How does feeding a cat affect the pH of her urine? Let's unravel the mysteries of the normal range of cat urine pH and how these numbers can correlate with the health of a cat's urinary tract.

What is urine pH and why is it important for your cat's health?

pH- a measure of acid or alkali in any liquid.

The pH level in urine - whether human or cat - reflects the difference between health and disease.

Cats are particularly prone to problems with pH changes. When the pH is too high or too low, conditions are favorable for the formation of salt crystals in the bladder and urethra (urethra). This causes irritation, local swelling, capillary bleeding, infection, and possibly obstruction (blockage) of the urinary tube. The condition of blockage and obstruction of the urethra in cats is called FLUTD in English. Complete blockage of the urethra can lead to the death of the animal within 72 hours if the problem is not corrected in time.

Normal urine pH in cats

For cats to have a healthy urinary tract, their urine must be acidic. The normal pH range is 6.0 to 6.5. A pH higher than this can lead to the formation of struvite crystals (magnesium phosphate crystals, ammonium). A pH below 6.0 may cause the formation of calcium oxalate crystals. In my veterinary practice, "alkalinization" of urine is more common than "acidification". And, for example, in cat owners, the process is reversed, that is, their blood has a more acidic pH. What is the reason for this and how to normalize the pH of urine, you can find out. There you can measure this important indicator.

Other Factors Affecting Cat Urinary Health

An excess concentration of minerals in the urine, which is considered to come from poor-quality and unbalanced feeding. For many years, the total ash content of cat food has been considered an indicator that affects the appearance and development of "feline urolithiasis" (as it was then called), in fact, ash is the amount of dry residue from burning food, which in no way determines share, nor the quality of what it consists of. For this reason, in the developed countries of old Europe, it is legally prohibited to indicate such inscriptions as “low ash” on cat food labels. There are recommended normative indicators for the content of various minerals, nutrients and biologically active substances in cat and kitten food, but we will write about this in one of the following articles.
Excess magnesium and phosphorus. Magnesium and phosphorus have recently been cited as potential culprits in FLUTD. The source of magnesium is also important. Veterinarians believe that magnesium oxide causes an increase in the pH of urine, and magnesium chloride, on the contrary, leads to its "acidification". The recommended ratio of phosphorus and calcium is also taken into account in the recommendations of organizations that control feed production in the developed countries of the world.
Water consumption and water regime. The normal functioning of the kidneys and the urinary tract system requires that the blood contains a sufficient amount of fluid. That is, the saline solution of the minerals of the liquid part of the blood should be of such a concentration that it would not provoke the formation of crystals in the urine. A cat that consumes a normal amount of drinking water will urinate quite often. As a result, the urine will also be less concentrated, which will help prevent crystal formation.

Relationship between cat diet and urinary tract health

This connection is so important that many of the best cat food manufacturers list urine pH range information on the packaging for various recipes of their cat food. This information is much more important than the label on the ash content of the feed.

If the company that provides you with their cat food does not disclose this information on their packaging, or if there is no mention of pH at all, then we recommend that you refrain from purchasing such food for your cat.

But before describing the ailments that affect the release of protein inclusions into the urine, it should be noted that normally this indicator should be zero and any upward fluctuations may indicate serious pathologies developing in the body.

Increased protein in the urine of a cat cannot immediately indicate the type of disease that provoked this kind of side effect, while the degree of its deviation from the norm, on the contrary, speaks volumes. So, the more protein in the urine of a cat, the more acute the disease is, but an additional examination of the pet's body will help determine its nature. We are not talking about a complete examination, because today a general list of ailments is already known that can provoke the appearance of protein in the urine of a pet. Most often, the main cause of such manifestations are infectious diseases of various kinds, anemia, pyelonephritis (bacterial inflammation of the kidneys) and kidney failure, cystitis (inflammation of the bladder), urethritis (inflammation of the urethra), as well as pyometra (inflammation of the uterus in cats).

To maximize the facilitation and acceleration of the diagnosis process, it is recommended not only to pay attention to other quantitative and qualitative indicators of the urine under study, as well as its color and the presence of sediment, but also to additionally donate blood for biochemical analysis. So, for example, plasma screening will help to finally confirm or, on the contrary, refute anemia in an animal by the level of hemoglobin (the number of erythrocytes or, as they are also commonly called, red blood cells in grams per liter of the test material). Elevated leukocytes in the urine and blood in almost all cases indicate the presence of an inflammatory process in the body, its scale can be judged by the degree of their deviation from the generally accepted norm. As for the focus of infection with increased protein and leukocytes, it is more likely that the inflammatory process has developed in organs such as the kidneys, ureters or bladder.

In addition, if a cat's urine protein exceeds the norm, you should pay attention to its transparency. The fact is that urine tends to become cloudy due to various kinds of impurities, among which not only leukocytes, but also salts can be distinguished. And in the latter case, there are all signs of urolithiasis, which very often affects fluffy pets, and, first of all, animals that have survived a forced castration procedure fall into the risk group for this indicator. The fact is that a sharp decrease in activity as a result of this type of surgical intervention leads to a sedentary lifestyle and overeating of a pet, which especially often happens when a special diet is not followed. As a result, the formation of small and large uroliths (sand and whole corals from crystals) in the organs of the genitourinary system, which cannot be eliminated without surgical intervention.

At the same time, not everything is as simple as it might seem at first glance, and the detection of protein in the urine of a cat along with salt impurities cannot give a complete picture of the existing problem. Of course, you can undergo an additional ultrasound examination, however, there is no guarantee that screening will help determine the presence of uroliths, especially when it comes to small and transparent crystals. In such cases, it is recommended to undergo a contrast radiograph, which helps to identify even the smallest instances of urolithiasis (up to 2 millimeters). At the same time, the presence of urolithiasis in a pet can be indicated not only by protein, salt and x-rays, but also by hematuria (bleeding from the urethra of various degrees), acute pain syndrome, as well as complete or partial retention of urine. In any case, adequate treatment can only be prescribed after all the examination procedures described above have been carried out.

Very often, the protein in the urine of a cat indicates such a common infectious disease as cystitis, in which the mucous membrane of the bladder becomes inflamed. And although it is less dangerous than the ICD, it is strongly not recommended to let it take its course in order to avoid the transition to chronic forms.

Urinalysis and ultrasound examination, which is performed only with a full bladder, will also help diagnose cystitis. In this case, the animal is prescribed a course of antibiotic therapy, as well as a special diet that completely excludes animal protein.

Pets, like people, get sick sometimes. To make a correct diagnosis, a veterinarian often prescribes laboratory tests, one of which is a urine test in cats and dogs.

The composition of urine is determined by the metabolic processes occurring in the body of the animal. It may vary depending on the composition of the food and the liquid drunk, seasonal and climatic factors, the physiological state of the animal (sleep, stress, pregnancy, disease, etc.). More than 160 substances formed in the process of metabolism are excreted in the urine of animals.

The physicochemical characteristics of urine can tell about the condition of the kidneys and urinary tract, the presence of infection, toxins, and the order of metabolism. Based on the results of the analysis, the doctor can diagnose and predict diseases, monitor complications, monitor the effectiveness of therapy, judge the functional state of organs, and detect metabolic disorders.

Indications for the appointment of a urine test:

diagnosis of diseases of the kidneys, bladder, ureters, urethra;
diagnosis of diabetes;
assessment of the state of internal organs in case of poisoning with toxins;
control of therapy, evaluation of effectiveness, prevention of complications.

Caring owners can independently collect biomaterial and apply for analysis if they notice an unnatural behavior of a pet: frequent visits to the tray, strained urination, plaintive meowing or whining, uncharacteristic color or smell of discharge.

Too frequent or too rare cat urination is an important reason to immediately contact a specialist

In some kidney diseases, the temperature rises, the animal may stop urinating or do it in unusual places. Delay in such cases can cost the animal its life, the owners should immediately take samples of the secretions and come to the clinic for an appointment.

The chemical structure of urine changes rapidly, so it must be delivered to the clinical laboratory within the first two hours. The required minimum volume of liquid is 20 ml.

For laboratory test results to be reliable, you must correctly collect a urine sample from your pet.

Collecting urine from cats

Biomaterial from feline representatives is collected at any time of the day. There are several simple and proven ways to collect. The choice depends on the habits of the pet itself.

specialized urinal for cats.

Collecting urine from dogs

Urine sampling from dogs is done in the morning. The container must be prepared in advance: washed and disinfected.

For females, take a tray with low sides or a cup. Remember to bring a sterile urine container and disposable gloves. The dog is kept on a short leash, being slightly behind it. At the right moment, a container is placed under the jet. It is better to take a medium portion of urine. To pour into a container, just unscrew the cap of the bottle;

If the dog urinates in the same place every time, you can put a clean film in advance and then collect the result with a syringe;
You can use a urinal for children. To fix it on the body, use diapers or accessories for dogs (overalls, pants, bodysuit)

Below are additional tips on how to collect urine from a pet outside without causing resistance.

If you find it difficult to take samples at home, you can seek help from specialists. In veterinary laboratories, urine sampling can be done using a catheter. However, this method has a number of disadvantages: pain, the need for fixation, trauma and seeding in males. Therefore, this method is used for emergency indicators.

The most sterile and informative method is cystocentesis - puncture of the bladder with a syringe. This manipulation is done by a doctor. The procedure is painless, done in a comfortable position for the animal. Sometimes cystocentesis is done under ultrasound guidance.

Video - Collecting tests from cats and dogs

How is urine tested in pets?

The simplest and most informative diagnostic method is a general (clinical) urinalysis (OAM), which consists of three interrelated studies:

Analysis of physical properties.
The study of chemical indicators.
Microscopic examination of the sediment.

Analysis results can be ready within 30 minutes.

To determine the pathological microflora, a bacterial culture of urine is performed. The results will be ready in 10-14 days.

Physical indicators of urinalysis in cats and dogs

The physical characteristics of urine are established by visual inspection. These include:

daily amount;
specific gravity or density;
color gradation;
transparency, the presence of sediment;
consistency;
reaction;
smell.

Daily amount

With urine, 70% of the fluid that enters the body is excreted. The daily amount depends on many factors: the amount of liquid drunk, the composition of the feed, the work of the sweat and sebaceous glands, the heart, lungs, organs of the digestive tract, kidneys. A quantitative indicator of urine excreted per day helps the doctor characterize the state of the body as a whole and recognize pathological processes.

If the animal uses a tray without filler, then the owners can calculate the daily amount of urine at home. In other cases, the calculation can cause difficulties, then this procedure is done in a hospital setting.

Normally, the daily amount of urine should be in proportion to the liquid drunk, per 1 kilogram of weight: 20-50 ml for dogs, 20-30 ml for cats.

An increase in the volume of daily urine is called polyuria. The reasons may be:

diabetes (diabetes and insipidus);
subsidence of edema;
infectious lesions of the kidneys;
tumor neoplasms,
metabolic disorders;
hypercalcemia;
liver dysfunction;
inflammatory processes.

A decrease in daily urine is called oliguria. Oliguria is due to:

disorders of the gastrointestinal tract (vomiting, diarrhea);
the appearance of edema;
small amount of fluid intake.

Lack of urine (urinary retention) - anuria. Serious pathology, the cause of which can be shock conditions, acute nephritis and advanced chronic kidney disease, blockage of channels by stones or tumors.

Specific gravity

Specific gravity (USG) or relative density indicates the average amount of solids dissolved in the urine and characterizes the ability of the kidneys to thicken and dilute the contents of the liquid.

This indicator changes during the day, it is influenced by food and water intake, environmental temperature, medications, and the functional state of internal organs. With dehydration, the discharge will be concentrated, with a high degree of hydration - liquefied. The density of urine is determined by special devices: urometer, hydrometer, refractometer.

Normal specific gravity of urine: in dogs is 1.015 - 1.030 g / l, in cats - 1.020 - 1.035 g / l.

An increase in urine density is called hyperstenuria. May indicate dehydration of the body, the cause of which can be:

large loss of fluid (fever, diarrhea, vomiting, profuse sweating);
low water consumption;
liver disease.

Urine density also increases with oliguria, kidney disease (acute nephritis), heart and kidney failure, accompanied by swelling of the legs and arms, bacterial infections. This often increases the amount of protein in the urine.

If the increased density is accompanied by an increase in the daily amount (polyuria), this is a pronounced symptom of diabetes mellitus. Each 1 percent sugar in urine condenses the specific gravity by 0.004 g/l.

Medications, such as radiopaque agents or diuretics (mannitol, dextran), may affect the readings.

A decrease in the density of urine is called hypostenuria. It accompanies many kidney diseases (acute and chronic nephritis - "wrinkled kidney", nephrosclerosis, chronic renal failure). For example, in severe nephrosclerosis, USG approaches 0.010 and is complemented by oliguria.

A very low specific gravity similar to water (1.002 - 1.001) occurs in diabetes insipidus. A decrease in density is also observed when taking diuretics, ketosis, and dystrophy.

Color

The color of urine (COL) is also determined by various factors: the type of food, the intake of medications, the amount of fluid taken, the condition of the internal organs.

The normal color of the urine of cats and dogs is considered to be a uniform yellow color of various shades.

The table shows the possible pathologies and natural causes of changes in urine color.

Table 1. The relationship between urine color and the state of the pet's body

Color	Pathology	Norm
Colorless	Diabetes mellitus, polyuria, nephrosclerosis
		Increasing the amount of fluid consumed
		natural color
	Fever, increased sweating	Dyes in food or drugs: riboflavin, furagin
	Oliguria	Reducing the amount of liquid
	Alkaline reaction to santonin, taking drugs - antipyrine, phenazole, pyryramidone

	-
	-
	Green-brown shades: diseases of the liver and biliary tract, the release of bilirubin into the urine	Acid reaction to the introduction of santonin
		-
		Taking sulfonamides, activated charcoal
		-
	Hemoglobinuria, when settling, there is a division into a transparent and sedimentary dark part	Administration of carbolic acid preparations
	Pyuria - leukocytes in the urine, pus, due to inflammatory processes (lipoid nephrosis, cystitis, polycystosis, kidney tuberculosis, phosphaturia, etc.)	-
		-
		-
		-
		Intravenous administration of methylene blue (for poisoning or diagnostic procedures)

It should be remembered that a sharp change in the color of urine due to food or drugs is normally short-lived. If an unnatural color persists for more than two days, this is a sign of a disease.

Transparency, precipitation

The transparency of the urinary secretions of cats and dogs depends on the amount of dissolved salts, the reaction medium, and the presence of pathological phenomena in the body. The urine of healthy domestic cats and dogs is completely transparent. To determine the level of transparency, the secretions are poured into a narrow glass vessel. Urine is considered transparent if printed text can be read through it.

If there is turbidity, flakes, visible sediment, then this indicates inflammatory processes, the presence of bacteria, leukocytes, mucoid (mucus from the urinary canals), epithelial cells, salts, red blood cells. Further analysis of the sediment will clarify the cause of the turbidity. In addition, the transparency and turbidity of the urine of cats and dogs depends on environmental conditions and transportation: with a decrease in temperature and long-term storage, salt precipitation may occur.

Consistency

This parameter is determined by slowly pouring the liquid into another container. In domestic breeds of cats and dogs, urine should flow in drops, i.e. have a liquid, watery consistency.

Normally, the consistency of the urine of cats and dogs is liquid.

In diseases, the composition of urine changes, it can become thicker, up to a jelly-like and mushy form. With cystitis, inflammation of the urinary tract, a decrease in diuresis, the consistency can become mucous.

Reaction

The reaction of urine (pH environment) determines the type of nutrition. In domestic cats and dogs, it is slightly acidic, because. they eat mostly meat. When eating plant foods, urine becomes alkaline. In the morning on an empty stomach, the indicators will be the lowest, the maximum - after eating.

Monitor changes in urine acidity if urolithiasis is suspected to identify the nature of stone formation: at pH< 5 образуются ураты, при значениях от 5,5 до 6 – оксалаты, выше 7,0 – фосфаты.

Also, the urine pH environment is checked for endocrine disorders, dieting, taking diuretics, and neurological pathologies.

Acidity is checked with special litmus test strips. They do this immediately after taking the material, before handing it over to the laboratory, because. urine tends to become alkaline over time.

Normal pH values for domestic cats and dogs are 5.5 - 7.

An increase in the pH value means alkalization of the medium (pH > 7). May indicate bacterial infections of the urinary tract, hyperkalemia, increased levels of protein in the urine, metabolic disorders (alkalosis, hyperfunction of the thyroid gland), renal canal acidosis, CRF, oncological processes in the genitourinary system.

A decrease in pH value means acidic urine (pH< 5). Это происходит при увеличении мяса в рационе, гипокалиемии, сахарном диабете, обезвоживании организма, голодании.

Smell

The smell of urine is due to ongoing metabolic processes, the state of internal organs, the nature of the feed, and the intake of medications.

The normal smell of urine in domestic cats and dogs is specific, unsharp.

The manifestation of an uncharacteristic odor of urinary secretions can be due to a number of reasons listed below.

Table 2. The smell of urine and the reasons that caused it

Chemical indicators of urine analysis in domestic cats and dogs

Analysis of chemical elements allows you to identify organic and inorganic compounds in the composition of urine. It is performed using special reagent test strips or an analyzer. Chemical components of urine:

protein level;
glucose (sugar);
bile pigments (bilirubin and urobilinogen);
ketone bodies (acetone and acetoacetic acid);
nitrites;
erythrocytes;
hemoglobin.

Protein

Protein (PRO) is a product of cellular decay, so finding it in the urine is an alarming symptom. He states the presence of destructive inflammatory processes, disruption of the organ systems. In normal urine, it can only be present in the form of traces.

In the normal urine of domestic cats and dogs, the protein level should not exceed 0.3 g / l

The loss of protein compounds in the urine is called proteinuria. This may be a temporary phenomenon (physiological proteinuria), which occurs after stress, hypothermia.

Also, protein fluctuations can occur in the last days of pregnancy and in newborns in the first 72 hours. With physiological proteinuria, the protein is found within the normal range of 0.2 - 0.3 g / l.

Glucose

Glucose (GLU) in the urine of healthy animals should not be present. Stressful conditions, intake of carbohydrate foods, childbirth, trauma, uncontrolled intake of medications can provoke a physiological increase in sugar in the urine. However, this phenomenon is short-term, and disappears when the shaping factor is removed.

Glucose in the urine of healthy domestic cats and dogs should not exceed 0.2 mmol/l.

An increase in glucose levels in urine is called glucosuria. At the same time, other characteristics also change: urine becomes light, almost colorless, has an acidic environment, and quickly becomes cloudy. Pathological glucosuria can provoke a number of diseases:

Diabetes. At the same time, the density of urine increases and the level of sugar in the blood rises.
Dysfunction of the renal tubules (secretion, absorption, etc.)

Certain breeds of dogs, such as the Scottish Terrier, are predisposed to glucosuria.

Some breeds of dogs are predisposed to this type of disease: Scottish Terrier, Besenge, Scottish Sheepdog, Norwegian Elhound, etc. In the case of dogs, diseases that cause an increase in blood glucose are:

Diseases of the nervous system, lesions of the brain and spinal cord, distemper, rabies.
Toxic poisoning.

Sometimes test strips are not informative and may show incorrect results: in cats with cystitis, a false positive response is possible, in dogs, when taking ascorbic acid, a false negative.

bile pigments

Bile pigments include bilirubin (BIL) and its derivative urobilinogen (UROBIL). They are indicators of the functionality of the liver and bile ducts. In a healthy body, they should not be detected in the urine. May be present in dogs as traces, especially in males.

Normally, the level of bilirubin in domestic cats is 0.0, in dogs - 0.0-1.0, and the level of urobilinogen in domestic cats is 0.0-6.0, in dogs - 0.0-12.0.

An increase in indicators may be the result of damage to the liver and bile ducts, jaundice, poisoning with toxins, disorders in the digestive tract (enterocolitis, peptic ulcers, intestinal obstruction).

Ketone bodies

Ketone bodies (KET) are acetone, acetoacetic and beta-hydroxybutyric acids. They are synthesized in the liver during starvation, carbohydrate-free nutrition, stress, fatty foods. Their function is the breakdown of fats and maintaining the energy balance of the body at the time of lack of glucose.

If ketone bodies appear in the urine, it acquires a strong smell of acetone. This phenomenon is called ketonuria. There are no ketone bodies in a healthy body.

Normally, the urine of cats and dogs does not contain ketone bodies.

If glucose is detected simultaneously with ketonuria, then this is a criterion for diabetes mellitus. An increase in ketone bodies can also be with oncological degeneration of the pituitary gland, coma, severe intoxication.

Nitrites

Nitrite (NIT) is a waste product of pathogenic bacteria. Their presence in the urine indicates an infectious infection of the urinary tract.

The urine of healthy cats and dogs does not contain nitrites.

An analysis for nitrites is also done for diagnostic purposes in animals after operations on the organs of the urogenital area.

red blood cells

The appearance of blood cells - red blood cells in urine give it shades of red. This is a serious symptom, indicating injuries and infections of the excretory system. In medicine, this is called hematuria.

The urine of healthy cats and dogs does not contain red blood cells.

If blood during urination appears in the first drops of urine, then the urethra is injured, if in the last - the bladder. In the presence of kidney stones, the blood increases with their movement, combined with pain during probing. At O If blood is found in the urine of an animal, you should immediately contact a veterinary clinic.

Hemoglobin

Hemoglobin (HGB) is a blood protein that enters the urine during the breakdown of red blood cells from exposure to hemolytic poisons. These are dangerous toxins such as arsenic, lead, insect and snake venom. Urine becomes dark brown, sometimes black. When settling, it is divided into a transparent upper part and a dark precipitate. The appearance of hemoglobin in the urine is called hemoglobinuria.

Normal urine of cats and dogs does not contain hemoglobin.

Reasons for the appearance of hemoglobin in the urine:

The final part of the laboratory analysis of the urine of cats and dogs is the microscopic examination of the sediment. It helps to differentiate diseases of the urogenital area. The objects of research are:

crystalline precipitates (salts);
epithelial cells;
leukocytes (white blood cells);
erythrocytes (red blood cells);
urinary cylinders;
bacteria;
mushrooms;
slime.

crystalline precipitation

Salt crystals precipitate when the reaction of urine changes to the acidic or alkaline side. They are also observed in healthy animals, may appear when drugs are removed from the body. Some crystalline precipitates can diagnose diseases.

Table 3. Types of crystalline precipitation and related diseases

Crystal precipitate	Norm	Concomitant diseases
	No	Cystitis, pyelitis, dehydration, vomiting
	No	In large numbers - urolithiasis
	No	Alkalinization of urine, gastric lavage, vomiting, arthritis, rheumatism
	No The exceptions are dalmatians	Cystitis, pyelitis, pyelonephritis
	Single	Can form oxalate kidney stones, pyelonephritis, calcium metabolism disorder, diabetes mellitus
	No	Inflammation of the small intestine
	No Occasionally seen in Dalmatians and English Bulldogs	Acid urine, high fever, pneumonia, leukemia, high protein diet
	Single	Form urate stones, chronic kidney failure, glomerulonephritis
	No	Liver damage, leukemia, poisoning
	No	Damage to the nervous system, liver disease, intoxication
	No	Diseases of the liver and bile ducts, jaundice
	No	Pyelitis, echinococcus, fatty degeneration of the kidneys
	No	Cytinosis, liver cirrhosis, hepatic coma, viral hepatitis
	No	Hepatitis, cystitis

epithelial cells

Epithelial cells are usually divided into three types according to the place of their formation:

genitals - flat;
urinary tract (ureter, bladder, pelvis) - transitional;
renal epithelium.

Normally, only single cells (0 - 2) of squamous epithelium can be present in the urine of cats and dogs, there should not be other epithelial cells.

To avoid inaccuracies in the test results, follow the instructions of the veterinarian exactly and monitor the hygiene of the pet

If the amount of squamous epithelium in the urine is increased, then this may be:

poor-quality preparation for analysis, non-compliance with hygiene when collecting urine;
inflammation of the vaginal mucosa (in females);
squamous metaplasia.

If transitional epithelial cells are found in the urine, the cause may be:

inflammation of the urinary tract: cystitis, urethritis, urolithiasis;
intoxication;
postoperative period;
urinary tract tumors.

When renal epithelium appears in the urine, they speak of kidney damage:

pyelonephritis;
nephritis;
necrotic nephrosis;
lipoid nephrosis;
renal amyloidosis.

Leukocytes

Leukocytes are white blood cells that protect the body from foreign invaders. In the urine of a healthy animal, they should be very small.

Normally, in the urine of cats and dogs, leukocytes should be 0 - 3 cells in the microscope field at 400x magnification.

An increase in the number of leukocytes more than 3 is called leukocyturia, more than 50 - pyuria. Urine becomes cloudy, purulent.

An increased number of leukocytes is a sign of inflammation in the urogenital area: cystitis, pyelonephritis, glomerulonephritis, pyometra, endometritis.

red blood cells

Under the microscope, you can see not only the presence or absence of red blood cells. Red blood cells may be altered (without hemoglobin) and whole. The first diagnose renal lesions (bleeding, nephritis, tumors in the kidneys). The latter appear when the urinary tract is affected (urolithiasis, cystitis, etc.).

Normally, in the urine of domestic cats and dogs, there should be no more than 3 erythrocytes in the field of view of the microscope.

urinary casts

Urinary cylinders are protein formations that clog the lumen of the urinary canals. They are washed out with urine, while maintaining the shape of the channel. Depending on the cells that formed them, the cylinders are divided into different subspecies (epithelial, leukocyte, fatty, etc.). The loss of cylinders of any kind in urine is a sign of pathological changes in the renal structures.

In the urine of healthy cats and dogs, there should be no cylinders in the field of view of the microscope.

The prolapse of casts in the urine is called cylindruria. The shape and origin of the cylinders are used to judge the nature and area of the lesion.

Hyaline cylinders are barely visible under a microscope, translucent, light gray in color. They can take on the color of the coloring pigment - red in the presence of blood in the urine or yellow in the presence of bilirubin. They are formed by kidney protein, so their appearance in the urine is a sign of degenerative phenomena in the kidneys (nephrosis, pyelonephritis, etc.).
Waxy cylinders are dense, sometimes with cracks. They are formed from the superficial cells of the renal tubules, which indicates their inflammation and degenerative decay.
Erythrocyte cylinders are formed from blood cells - erythrocytes. Formed with bleeding in the kidneys.
Leukocyte cylinders, in a similar way, form white blood cells - leukocytes. A sign of purulent inflammation in the urinary tract.
Bacterial casts are accumulations of bacteria that have blocked the kidney canals.
Granular cylinders look like grains - this is how decaying epithelium and coagulated protein look. This is a sign of deep pathological changes in the structures of the kidney.

Cylinders are a sign of acidity in urine, because. under the action of alkalis, they disintegrate.

bacteria

In healthy animals, the discharge is sterile. If bacteria are found in the urine sediment under a microscope, this indicates either a violation of hygiene during the collection of the analysis, or an infection of the urinary tract.

The quantity is of diagnostic importance: less than 1000 microbial bodies per ml of urine means contamination (normal in females), from 1000 to 10,000 - infection of the urinary tract (cystitis, urethritis), more than 10,000 - damage to the bladder and kidneys (pyelonephritis).

In the urine of healthy domestic cats and dogs, bacteria should not be in the field of view of the microscope.

If an infection is suspected, a bacteriological analysis of urine (tank culture) is done. Cultures of urine bacteria are grown on a special medium, their type and sensitivity to drugs are determined.

Mushrooms

In the urine sediment, microscopic examination can reveal yeast fungi of the genus Candida. The cause may be high sugar, anticancer drugs.

In the urine of healthy domestic cats and dogs, fungi should not be in the field of view of the microscope.

Mycotic infection is differentiated by a urine test for fungi, which is performed similarly to a bacterial study.

Fat

Fat (lipids) is found in urine in microdoses. It is associated with the quality of feed, the level of metabolism in the animal.

Normally, fat in single drops is found in the urine of cats, in dogs - only traces.

An increase in the rate is called lipuria. This phenomenon is rare, indicates a pathology in the activity of the kidneys, may be the result of urolithiasis.

Slime

Mucus in the urine is found in microdoses. It is synthesized by epithelial cells and increases during inflammation and infections.

Small amounts of mucus appear in the urine of healthy domestic cats and dogs.

Vitamin C

Ascorbic acid (VTC) does not accumulate in the body and is excreted in the urine, so its volume in urine can be used to judge the transport of vitamin C in the body, vitamin deficiency or overdose.

The urine of healthy domestic cats and dogs can contain up to 50 mg of vitamin C.

Sperm (spermatozoa)

Sometimes, during catheterization of males (cats and males), spermatozoa enter the urine, which can also be seen with a microscopic analysis of the urinary sediment. They have no diagnostic value. At the end of the study, the results of physical, chemical and microscopic studies are summarized in a single table. It shows a general picture of the health of the animal. Based on these data, the veterinarian makes a diagnosis and prescribes treatment.

Urinalysis is an important method of investigation of patients with diseases of the lower urinary tract. Urine samples for analysis can be obtained in a variety of ways, although cystocentesis is the preferred method in most cases. Collection of urine from a litter box, obtaining a medium portion of urine by free urination or using catheterization - these methods can be considered as alternative methods. When interpreting the results of the study, the method of obtaining urine should be taken into account. This article will discuss the differences between normal urine values in cats and dogs, as well as the limitations of some of the available tests.

Urine samples can be collected by cystocentesis, catheterization, voiding midstream urine collection, and directly from the litter box.

Depending on the requirements for analysis, it is perfectly acceptable to use urine collected from a litter box or obtained from free urination. A litter box urine sample may be “contaminated” with epithelial cells, contain increased amounts of protein and bacteria from the urethra/genital tract, and litter box contamination, which may interfere with the interpretation of some test results.

Table 1 summarizes the "optimal" requirements for urine samples, although it is important to emphasize that urine samples obtained from the litter box can still be used for testing for bacteriuria, protein/creatinine ratio and other indicators, just in this case interpretation of the results will be more difficult.

Table 1. Preferred type of urine sample for analysis

Obtaining urine samples from a cat by cystocentesis

Urine samples can be obtained from conscious cats using gentle restraint of the animal. One-inch 23-gauge Stubbs needles can be used with a 5 ml or 10 ml syringe.

The patient should be held as level as possible in a standing, lateral, or dorsal recumbent position. In any case, it is best to keep the cat in the position in which she feels most comfortable. If the cat is tense, it is much more difficult to palpate the bladder, so it is in the clinician's interest to keep the cat as calm as possible. With one hand, the bladder is palpated and fixed, and the syringe is manipulated with the other hand. If the cat is lying on its back, then the bladder can be advanced caudally so as to fix it between the arm and the pelvic bones (Figure 1a).

Cystocentesis in cats, supine position

Cystocentesis in cats, lateral position

Picture 1. Urine collection from the bladder (cystocentesis) in cats can be performed in the standing position, in the supine position (a), and in the lateral position (b)

If the cat is in a standing or lateral recumbency position, the bladder can be immobilized by placing the thumb on the cranial pole of the bladder and using the other fingers to gently lift the bladder toward you (Figure 1b).

Once the bladder has been fixed, remove the cap from the needle and gently insert the needle through the skin into the bladder. During the slow and smooth passage of the needle through the skin, most cats feel almost nothing and will not show motor activity (startle). The needle is fully immersed so that the cannula of the needle touches the skin.

Aspiration of urine is performed with one hand, after which pressure from the other hand should be relieved before removing the needle. Complications after cystocentesis are very rare in healthy cats, but may include bruising and hemorrhage (usually minor but may affect urinalysis), transient vagal tone (vomiting, dyspnea, collapse), and leakage of urine into the abdomen and bladder rupture (rarely seen in cats with urethral obstruction).

If the bladder is not palpable but a cystocentesis is needed (eg, for urine culture), an ultrasound-guided cystocentesis may be performed to accurately locate the bladder and guide the needle. Sufficient ultrasound gel is applied prior to ultrasound imaging and sampling. In this case, you must be extremely careful not to accidentally insert the needle through the gel or through the probe tip!

In dogs, cystocentesis can be performed with the animal in a standing or lateral recumbency position. It is necessary to localize and fix the bladder. Bladder fixation can be difficult in very large or obese dogs. In such situations, it may be advisable to press the palm of the hand on the abdominal wall opposite the one from which the sample will be taken. Blind cystocentesis is not recommended; this method usually fails and may cause damage to the abdominal organs. Gentle shaking of the bladder during abdominal palpation helps to obtain material that may have settled in the lower part of the bladder. It is recommended to use a 22 G needle, 1.5-3 cm long, depending on the size of the dog. The needle is inserted from the ventral side of the abdominal wall and passed into the bladder in a caudoventral direction. The urine is then gently aspirated into a syringe. It is important not to apply excessive pressure to the bladder, as this can cause urine to leak into the abdominal cavity.

As with cats, if the dog's bladder cannot be palpated or the clinician has any doubts about the procedure, then performing an ultrasound-guided cystocentesis will make it easier to obtain a urine sample.

Obtaining urine samples by litter box sampling

To obtain urine samples from a litter box, the cat must use a litter box with no litter or one of the non-absorbent litters (commercial brands include Katkor®, kit4cat®, Mikki®; non-commercial litter options include clean aquarium gravel or plastic balls). After the cat has urinated, a urine sample is collected using a pipette or syringe and placed in a sterile tube for later analysis (Figure 2).

Figure 2. Urine samples obtained from the toilet tray can be used for general clinical analysis. However, in the study of bacteriuria or proteinuria, the results of the analysis may be unreliable.

Sample analysis should be carried out as soon as possible. The sample should be stored in a refrigerator if it is not possible to analyze it immediately.

During natural urine collection in dogs, the first urine sample is not collected and only the middle urine can be used for analysis. Although in some cases manual pressure on the bladder may induce urination, this method may have some negative impact on the patient and on the quality of the specimens obtained, so the authors do not recommend its use.

Obtaining urine samples by catheterization

In cats, urine sampling by this method is used when catheterization is required for other diagnostic or therapeutic purposes, such as treatment of urethral obstruction or retrograde opacification. The catheterization procedure can cause injury or promote urinary tract infections.

Therefore, catheterization should be avoided unless necessary, and a non-traumatic material and asepsis should be used during the procedure. Most dogs can be catheterized using 4-10 diameter catheters, but the clinician should try to use the smallest diameter catheter to facilitate the procedure.

Urinalysis in a veterinary clinic

If possible, routine urinalysis should be done in-house. When samples are sent to an external laboratory, analysis may be delayed and results may not be accurate.

Determination of physical properties and specific gravity of urine
When examining a urine sample, it is necessary to determine its color, transparency, and the presence of sediment. Urine specific gravity (USG) should be determined using a refractometer (Figure 3).

Figure 3. Urine specific gravity should be measured with a refractometer, not with test strips.

Urine can be classified as isostenuria (USG = 1.007-1.012, equal to glomerular filtrate - primary urine), hypostenuria (USG< 1,007) и гиперстенурия (USG > 1,012).

Urinary test strips are unreliable for assessing USG, nitrite, urobilinogen, and leukocytes in cats and dogs.

A urine sample (5 ml) can be centrifuged and the resulting pellet stained and examined by light microscopy.

Normal results are summarized in Table 2.

table 2. Urine analysis in the clinic and interpretation of the results:

Index	Reference values	A comment
Urine Specific Gravity (USG)	1,040-1,060 (cats), 1,015-1,045 (dogs)	Always measure with a refractometer and not with test strips! Decreased specific gravity of urine may be physiological (due to fluid intake), iatrogenic (eg, furosemide), or pathological (eg, chronic kidney disease). An increase in USG can occur with severe forms of glucosuria and proteinuria, as well as after the introduction of a radiopaque substance.
test strips	Glucose: negative	A positive dipstick glucose test indicates glucosuria, which can result from stress, diabetes, hyperglycemia, intravenous glucose-containing fluid, or, less commonly, renal tubular dysfunction.
	Ketone bodies: negative	A positive reaction may be in some cats with diabetes. Occasionally, ketones can be found in non-diabetic cats (non-diabetic ketonuria) when catabolic processes in the body predominate.
	Blood: negative	Urinary strips are sensitive to small amounts of red blood cells, hemoglobin and myoglobin found in the urine - all of which can give a red color to the urine and give a positive blood test on the test strips.
		Urinary pH can be affected by the composition of the diet, stress (a state of hyperventilation), acid-base imbalance, drugs, the development of renal tubular acidosis, and urinary tract infections. pH results should be interpreted with caution; urine that is slightly acidic on the test strip may change the pH value to slightly alkaline. If accurate pH specifications are critical, then the clinician should consider using a pH meter or sending a urine sample to an external laboratory.
	negative/traces/1+ (for cats and dogs)	Test strips are relatively insensitive for determining proteinuria and do not take into account the concentration of urine. Therefore, the results must be interpreted in terms of USG values (measured with a refractometer, not with a test strip!). Protein-to-creatinine (PCR) testing is recommended in all patients with diagnosed kidney disease or when urinary protein testing is required.
	Bilirubin: negative	Unlike dogs, cats should not normally have bilirubin in their urine. Traces of bilirubin (1+ or 2+ [in highly concentrated urine]) may be normal, especially in males.
urine sediment	Normal urine contains: Less than 10 RBCs per field of view, under microscope magnification (x400) Less than 5 leukocytes per field of view, under microscope magnification (x400) epithelial cells (amount more in sample collected at free urination nii than when taking cysto- centesis) +/- Struvite crystals (see comment)	According to the method of obtaining a urine sample (collected from a toilet tray or by cystocentesis): The presence, appearance, and number of epithelial cells may vary. Can detect tumor cells from the bladder, urethra and prostate. Microorganisms should not normally be detected in urine samples, but may be present if the samples were obtained from a litter box or during free urination of the animal. Normally, struvite crystals can be present in the urine of cats. After sample preparation, there is often an increase in crystalluria due to additional precipitation, mainly as a result of a decrease in sample temperature (and a change in pH). When assessing crystalluria, it is important to consider the type of crystals and their number. Urate crystals can be found in cats with hepatopathy (eg, when the animal has a portosystemic shunt), and oxalate crystals are found in cats with hypercalcemia. It is important that crystalluria is not misdiagnosed, as in many cases of idiopathic lower urinary tract disease, crystalluria is a normal (side) phenomenon.
Protein/creatinine ratio (PCR)	Most healthy cats and dogs have CBS< 0,2, хотя обычно приводится верхний предел 0,4-0,5	Significance for patients with chronic kidney disease Cats: Dogs: < 0,2 - нет протеинурии < 0,2 - нет протеинурии 0.2-0.4 - insignificant proteinuria - 0.2-0.5 - insignificant proteinuria (borderline riya (boundary value) value) > 0.4 - proteinuria > 0.5 - proteinuria

In the article I will give a transcript of the results of a biochemical analysis of the urine of a cat. I'll tell you what indicators are the norm. I will describe what impurities can be detected in the analysis, and what are the reasons for this phenomenon.

The study of urine of cats and dogs is carried out for diagnosis and further treatment. Timely laboratory analysis allows timely detection of serious disorders of the urinary system caused by infection, trauma, etc.

The liquid for analysis is collected in three ways: using a special filler that does not absorb liquid, a puncture of the bladder and a catheter. The last two procedures are necessarily carried out in a veterinary clinic.

The results of the study of cat urine are recorded on a special plate, which greatly facilitates their decoding.

Physical indicators

This group includes the following indicators:

Quantity. Normally, an adult cat, weighing 4-5 kg, excretes about 100-150 ml of urine per day. An increase in this amount indicates the possible development of diabetes mellitus, pyelonephritis, chronic renal failure. Lack of urine can be observed with dehydration caused by diarrhea, vomiting.
Sediment. A small amount is acceptable. It consists of epithelial cells, stones (crystals and salts), microorganisms. If the amount of sediment exceeds the norm, this indicates the development of the disease.
Color or COL. Cat urine should be yellow. A red or brownish color indicates the presence of blood in the urine. indicates an increased amount of bilirubin. If there is pus, the urine will be slightly greenish. Very light, almost white urine indicates an increase in the amount of phosphates.
Transparency or CLA. Normal cat urine is clear. With various diseases, it may contain inclusions of salts, bacteria, leukocytes, erythrocytes, fat drops. Also, transparency depends on the period and temperature of storage of urine.
Smell. The appearance of an acetone odor in urine indicates the development of diabetes mellitus. If the urine smells like ammonia, the animal is developing a bacterial infection. Also, some foods and medicines can change the smell of urine.
Density. In cats, urine should have an average density of 1.020-1.040. An increase in these indicators indicates the presence of protein and glucose in the urine. Also, the density may increase against the background of intravenous infusions and taking certain medications. A decrease in the indicator indicates chronic renal failure, kidney disease, and diabetes mellitus.

Chemistry of cat urine

This group includes the study of such indicators as pH, protein, glucose, bilirubin, urobilinogen, ketone bodies, nitrites, red blood cells, hemoglobin.

The normal alkaline pH balance in cats is 5-7.5. An increase indicates alkalization, which may be the result of the development of cystitis, the presence of a large amount of plant foods in the diet, and hyperkalemia.

A decrease in the indicator (acidification of urine) may be the result of chronic renal failure, dehydration, fever, prolonged fasting, diabetes mellitus.

Proteins in the urine should not be present.

Permissible concentration - 100 mg per liter. The appearance of protein may be the result of increased stress, eating cat foods rich in protein.

Proteinuria is also observed in anemia, heart failure, dehydration, fever, and diabetes. Often the appearance of protein accompanies the development of cystitis, urethritis, prostatitis, kidney disease (amyloidosis, pyelonephritis, etc.).

The appearance of glucose in the urine is a deviation. This may indicate the development of diabetes. Also, the appearance of glucose is observed against the background of intravenous infusions and the introduction of steroids, adrenaline.

The presence of bilirubin in the urine is due to jaundice. The norm of urobilinogen is no more than 10 mg per liter. An increase in this indicator may indicate the following diseases: enterocolitis, cirrhosis of the liver, hepatitis, poisoning with toxic substances.

The appearance of ketone bodies in the urine is observed in diabetic coma, prolonged fasting, and fever. The presence of nitrites indicates an infection in the urinary tract.

The presence of hemoglobin may be a sign of babesiosis.

The appearance of red blood cells in the urine indicates the development of such serious pathologies as leptospirosis, pyelonephritis, systemic lupus erythematosus, tumors in the bladder cavity, cystitis. Also, blood appears with urolithiasis, injuries of the kidneys and other organs of the urinary tract.

Sediment microscopy

The development of the disease can be recognized by microscopic examination of the sediment:

Epithelium. A significant increase indicates nephritis, intoxication, nephrosis.
red blood cells. Valid content is 0-3 per field of view. Elevated levels are often seen in infections.
cylinders. An increase in the number indicates the development of inflammatory processes in the kidneys, bleeding into the parenchyma. Cylindria is also observed with pyelonephritis, fever, dehydration.
bacteria. Small amounts of bacteria may be present in urine collected with a catheter. An increase indicates the development of an infection or urolithiasis.
Leukocytes. An increase in the level occurs with nephritis, glomerulonephritis and other infectious diseases.
salt. Often the appearance of stones in the urine (sand, oxalates, struvites, etc.) speaks of.

Urinalysis is an effective measure for diagnosing diseases of the urinary system.

With the help of this analysis, it is possible to recognize the development of infection in a timely manner. However, a slight deviation from the norm of some indicators is sometimes observed when taking certain medications, malnutrition or drinking regimen.