We read tests of cats. General urine analysis

General clinical examination of urine includes the determination of physical properties, chemical composition and microscopic examination of the sediment.

physical properties.

QUANTITY.

Fine The daily amount of urine averages 20-50 ml per kg of body weight for dogs and 20-30 mg per kg of body weight for cats.

Increased daily diuresis - polyuria.
Causes:
1. Convergence of edema;
2. Diabetes mellitus (Diabetes maleus) (together with a positive level of glucose in the urine and a high specific gravity of the urine);
3. Glomerulonephritis, amyloidosis, pyelonephritis (together with a negative glucose level, high specific gravity of urine and severe proteinuria);
4. Cushing's syndrome, hypercalcemia, hypokalemia, tumors, uterine disease (pyometra), hyperthyroidism, liver disease (along with negative glucose levels, high urine specific gravity and negative or mild proteinuria)
5. Chronic renal failure or diuresis after acute renal failure (together with low urine specific gravity and elevated blood urea levels);
6. Diabetes insipidus (together with a low specific gravity of urine, which does not change during a test with fluid deprivation and a normal level of urea in the blood);
7. Psychogenic craving for drinking (along with low specific gravity of urine, which increases during a test with deprivation of fluid and a normal level of urea in the blood)
Often causes polydipsia.

Decreased daily diuresis - oliguria.
Causes:
1. Profuse diarrhea;
2. Vomiting;
3. The growth of edema (regardless of their origin);
4. Too little fluid intake;

Lack of urine or too little urine (lack of urination or urination) - anuria.
Causes:
a) Prerenal anuria (due to extrarenal causes):
1. Heavy blood loss (hypovolemia - hypovolemic shock);
2. Acute heart failure (cardiogenic shock);
3. Acute vascular insufficiency (vascular shock);
4. Indomitable vomiting;
5. Severe diarrhea.
b) Renal (secretory) anuria (associated with pathological processes in the kidneys):
1. Acute nephritis;
2. Necronephrosis;
3. Transfusion of incompatible blood;
4. Severe chronic kidney disease.
c) Obstructive (excretory) anuria (impossibility of urination):
1. Blockage of the ureters with stones;
2. Compression of the ureters by tumors that develop near the ureters (neoplasms of the uterus, ovaries, bladder, metastases from other organs.

COLOR

Normal urine color is straw yellow.
Color change may be due to the release of coloring compounds formed during organic changes or under the influence of food, drugs or contrast agents.

Red or red-brown color (color of meat slops)
Causes:
1. Macrohematuria;
2. Hemoglobinuria;
3. The presence of myoglobin in the urine;
4. The presence of porphyrin in the urine;
5. The presence in the urine of certain drugs or their metabolites.

Dark yellow color (may be with a greenish or greenish-brown tint, the color of dark beer)
Causes:
1. Isolation of bilirubin in the urine (with parenchymal or obstructive jaundice).

greenish yellow color
Causes:
1. A large amount of pus in the urine.

Dirty brown or gray color
Causes:
1. Pyuria with alkaline urine.

Very dark, almost black
Causes:
1. Hemoglobinuria in acute hemolytic anemia.

whitish color
Causes:
1. Phosphaturia (the presence in the urine of a large amount of phosphates).
It should be borne in mind that with prolonged standing urine, its color may change. As a rule, it becomes more saturated. In the case of the formation of urobilin from colorless urobilinogen under the influence of light, the urine becomes dark yellow (to orange). In the case of the formation of methemoglobin, the urine acquires a dark brown color. In addition, a change in odor may be associated with the use of certain drugs, feed or feed additives.

TRANSPARENCY

Normal urine is clear.

Cloudy urine can be caused by:
1. The presence of erythrocytes in the urine;
2. The presence of leukocytes in the urine;
3. The presence of epithelial cells in the urine;
4. The presence of bacteria in the urine (bacteruria);
5. The presence of fatty drops in the urine;
6. The presence of mucus in the urine;
7. Precipitation of salts.

In addition, the transparency of urine depends on:
1. Salt concentrations;
2. pH;
3. Storage temperatures (low temperature contributes to the precipitation of salts);
4. Duration of storage (with prolonged storage, salts fall out).

SMELL

Normally, the urine of dogs and cats has a mild specific odor.

A change in odor can be caused by:
1. Acetonuria (the appearance of the smell of acetone in diabetes mellitus);
2. Bacterial infections (ammonia, bad smell);
3. Taking antibiotics or nutritional supplements (a special specific smell).

DENSITY

Normal density of urine in dogs 1.015-1.034 (minimum - 1.001, maximum 1.065), in cats - 1.020-1.040.
Density is a measure of the ability of the kidneys to concentrate urine.

What matters is
1. The state of hydration of the animal;
2. Drinking and eating habits;
3. Ambient temperature;
4. Injected drugs;
5. Functional state or number of renal tubules.

Causes of increased urine density:
1. Glucose in the urine;
2. Protein in the urine (in large quantities);
3. Drugs (or their metabolites) in the urine;
4. Mannitol or dextran in the urine (as a result of intravenous infusion).

Causes of a decrease in the density of urine:
1. Diabetes mellitus;
3. Acute kidney damage.

You can talk about adequate kidney response when, after a short abstinence from drinking water, the specific gravity of urine rises to the average figures of the norm. An inadequate reaction of the kidneys is considered if the specific gravity does not rise above the minimum values ​​\u200b\u200bwhen refraining from taking water - isosthenuria (a greatly reduced ability to adapt).
Causes:
1. Chronic renal failure.

Chemical research.

pH

Normal urine pH dogs and cats can be either slightly acidic or slightly alkaline, depending on the protein content of the diet. On average, the pH of urine ranges from 5-7.5 and is often slightly acidic.

Increasing the pH of urine (pH> 7.5) - alkalization of urine.
Causes:
1. The use of plant foods;
2. Profuse sour vomiting;
3. Hyperkalemia;
4. Resorption of edema;
5. Primary and secondary hyperparathyroidism (accompanied by hypercalcemia);
6. Metabolic or respiratory alkalosis;
7. Bacterial cystitis;
8. Introduction of sodium bicarbonate.

Decreased pH of urine (pH about 5 and below) - acidification of urine.
Causes:
1. Metabolic or respiratory acidosis;
2. Hypokalemia;
3. Dehydration;
4. Fever;
5. Fasting;
6. Prolonged muscle load;
7. Diabetes mellitus;
8. Chronic renal failure;
9. Introduction of acidic salts (for example, ammonium chloride).

PROTEIN

Normal urine protein absent or its concentration is less than 100 mg/l.
Proteinuria- the appearance of protein in the urine.

Physiological proteinuria- cases of temporary appearance of protein in the urine, not associated with diseases.
Causes:
1. Reception of a large amount of feed with a high protein content;
2. Strong physical activity;
3. Epileptic seizures.

Pathological proteinuria happens renal and extrarenal.

Extrarenal proteinuria may be extrarenal or postrenal.

extrarenal extrarenal protenuria more often there is a temporary mild degree (300 mg / l).
Causes:
1. Heart failure;
2. Diabetes mellitus;
3. Elevated temperature;
4. Anemia;
5. Hypothermia;
6. Allergy;
7. The use of penicillin, sulfonamides, aminoglycosides;
8. Burns;
9. Dehydration;
10. Hemoglobinuria;
11. Myoglobinuria.
Severity of proteinuria is not a reliable indicator of the severity of the underlying disease and its prognosis.

Extrarenal postrenal proteinuria(false proteinuria, accidental proteinuria) rarely exceeds 1 g / l (except in cases of severe pyuria) and is accompanied by the formation of a large sediment.
Causes:
1. Cystitis;
2. Pyelitis;
3. Prostatitis;
4. Urethritis;
5. Vulvovaginitis.
6. Bleeding in the urinary tract.

Renal proteinuria occurs when protein enters the urine in the kidney parenchyma. In most cases, it is associated with increased permeability of the renal filter. At the same time, a high protein content in the urine is found (more than 1 g / l). Microscopic examination of urine sediment reveals casts.
Causes:
1. Acute and chronic glomerulonephritis;
2. Acute and chronic pyelonephritis;
3. Severe chronic heart failure;
4. Amyloidosis of the kidneys;
5. Neoplasms of the kidneys;
6. Hydronephrosis of the kidneys;
7. Lipoid nephrosis;
8. Nephrotic syndrome;
9. Immune diseases with damage to the renal glomeruli by immune complexes;
10. Severe anemia.

Renal microalbuminuria- the presence of protein in the urine at concentrations below the sensitivity of the reagent strips (from 1 to 30 mg / 100 ml). It is an early indicator of various chronic kidney diseases.

Paraproteinuria- the appearance in the urine of a globulin protein that does not have the properties of antibodies (Bence-Jones protein), consisting of light chains of immunoglobulins that easily pass through glomerular filters. Such a protein is released during plasmacytoma. Paraproteinuria develops without primary damage to the renal glomeruli.

tubular proteinuria- the appearance in the urine of small proteins (α1-microglobulin, β2-microglobulin, lysozyme, retinol-binding protein). They are normally present in the glomerular filtrate but are reabsorbed in the renal tubules. When the epithelium of the renal tubules is damaged, these proteins appear in the urine (determined only by electrophoresis). Tubular proteinuria is an early indicator of renal tubular damage in the absence of concomitant changes in circulating urea and creatinine levels.
Causes:
1. Medicines (aminoglycosides, cyclosporine);
2. Heavy metals (lead);
3. Analgesics (non-steroidal anti-inflammatory substances);
4. Ischemia;
5. Metabolic diseases (Fanconi-like syndrome).

False positive indicators of the amount of protein, obtained using a test strip, are characteristic of alkaline urine (pH 8).

False negatives for protein, obtained using the test strips are due to the fact that the test strips show, first of all, the level of albumins (paraproteinuria and tubular proteinuria are not detected) and their content in the urine is above 30 mg / 100 ml (microalbuminuria is not detected).
Assessment of proteinuria should be carried out taking into account clinical symptoms (fluid accumulation, edema) and other laboratory parameters (blood protein level, albumin and globulin ratio, urea, creatinine, serum lipids, cholesterol levels).

GLUCOSE

Normally, there is no glucose in the urine.

Glucosuria- the presence of glucose in the urine.

1. Glucosuria with high specific gravity of urine(1.030) and elevated blood glucose (3.3 - 5 mmol / l) - a criterion for diabetes mellitus (Diadetes mellitus).
It should be borne in mind that in animals with type 1 diabetes mellitus (insulin-dependent), the renal glucose threshold (the concentration of glucose in the blood above which glucose begins to enter the urine) can change significantly. Sometimes, with persistent normoglycemia, glucosuria persists (the renal glucose threshold is lowered). And with the development of glomerulosclerosis, the renal glucose threshold increases, and there may be no glucosuria even with severe hyperglycemia.

2.Renal glucosuria- is recorded at an average specific gravity of urine and a normal level of glucose in the blood. A marker of tubular dysfunction is deterioration in reabsorption.
Causes:
1. Primary renal glucosuria in some dog breeds (Scottish Terriers, Norwegian Elkhounds, mixed breed dogs);
2. A component of the general dysfunction of the renal tubules - Fanconi-like syndrome (maybe hereditary and acquired; glucose, amino acids, small globulins, phosphate and bicarbonate are excreted in the urine; described in Besenji, Norwegian Elkhounds, Shetland Sheepdogs, Miniature Schnauzers);
3. The use of certain nephrotoxic drugs.
4. Acute renal failure or aminoglycoside toxicity - if the level of urea in the blood is elevated.

3. Glucosuria with reduced specific gravity of urine(1.015 - 1.018) can be with the introduction of glucose.
4. Moderate glucosuria occurs in healthy animals with a significant alimentary load of feeds with a high content of carbohydrates.

False positive result when determining glucose in the urine with test strips, it is possible in cats with cystitis.

False negative result when determining glucose in the urine with test strips, it is possible in dogs in the presence of ascorbic acid (it is synthesized in dogs in various quantities).

BILIRUBIN

Normally, there is no bilirubin in the urine of cats., there may be trace amounts of bilirubin in concentrated dog urine.

Bilirubinuria- the appearance of bilirubin (direct) in the urine.
Causes:
1. Parenchymal jaundice (lesion of the liver parenchyma);
2. Obstructive jaundice (violation of the outflow of bile).

It is used as an express method for the differential diagnosis of hemolytic jaundice - bilirubinuria is not typical for them, since indirect bilirubin does not pass through the renal filter.

UROBILINOGEN

Upper limit of normal urobilinogen in the urine about 10 mg / l.

Urobilinogenuria- increased levels of urobilinogen in the urine.
Causes:
1. Increased hemoglobin catabolism: hemolytic anemia, intravascular hemolysis (transfusion of incompatible blood, infections, sepsis), pernicious anemia, polycythemia, resorption of massive hematomas;
2. Increase in the formation of urobilinogen in the gastrointestinal tract: enterocolitis, ileitis;
3. An increase in the formation and reabsorption of urobilinogen in inflammation of the biliary system - cholangitis;
4. Impaired liver function: chronic hepatitis and cirrhosis of the liver, toxic liver damage (poisoning with organic compounds, toxins in infectious diseases and sepsis); secondary liver failure (cardiac and circulatory failure, liver tumors);
5. Liver bypass: cirrhosis of the liver with portal hypertension, thrombosis, obstruction of the renal vein.

Of particular diagnostic importance is:
1. With lesions of the liver parenchyma in cases that occur without jaundice;
2. For the differential diagnosis of parenchymal jaundice from obstructive jaundice, in which there is no urobilinogenuria.

KETONE BODIES

Normally, there are no ketone bodies in the urine.

Ketonuria- the appearance of ketone bodies in the urine (as a result of accelerated incomplete oxidation of fatty acids as an energy source).
Causes:
1. Severe decompensation of type 1 diabetes mellitus (insulin-dependent) and long-term type II diabetes (insulin-independent) with depletion of pancreatic beta-cells and the development of absolute insulin deficiency.
2. Pronounced - hyperketonemic diabetic coma;
3. Precomatose states;
4. Cerebral coma;
5. Prolonged fasting;
6. Severe fever;
7. Hyperinsulinism;
8. Hypercatecholemia;
9. Postoperative period.

NITRITES

Normally, nitrites are absent in the urine.

The appearance of nitrites in the urine indicates infection of the urinary tract, since many pathogenic bacteria restore the nitrates present in the urine to nitrites.
Of particular diagnostic importance is when determining asymptomatic infections of the urinary tract (in the risk group - animals with prostate neoplasms, patients with diabetes mellitus, after urological operations or instrumental procedures on the urinary tract).

erythrocytes

Normally, there are no erythrocytes in the urine or allowed physiological microhematuria in the study of test strips is up to 3 erythrocytes / μl of urine.

Hematuria- the content of erythrocytes in the urine in an amount of more than 5 in 1 µl of urine.

Gross hematuria- installed with the naked eye.

Microhematuria- is detected only with the help of test strips or microscopy. Often due to cystocentesis or catheterization.

Hematuria originating from the bladder and urethra.
Approximately 75% of cases of gross hematuria, often combined with dysuria and pain on palpation.
Causes:
1. Stones in the bladder and urethra;
2. Infectious or drug-induced (cyclophosphamide) cystitis;
3. Urethritis;
4. Bladder tumors;
5. Injuries of the bladder and urethra (crushing, ruptures).
An admixture of blood only at the beginning of urination indicates bleeding between the neck of the bladder and the opening of the urethra.
The admixture of blood mainly at the end of urination indicates bleeding in the bladder.

Hematuria originating from the kidneys (approximately 25% of cases of hematuria).
Uniform hematuria from beginning to end of urination. Microscopic examination of the sediment in this case reveals erythrocyte cylinders. Such bleeding is relatively rare, associated with proteinuria and less intense than bleeding in the urinary tract.
Causes:
1. Physical overload;
2. Infectious diseases (leptospirosis, septicemia);
3. Hemorrhagic diathesis of various etiologies;
4. Coagulopathy (poisoning with dicumarol);
5. Consumption coagulopathy (DIC);
6. Kidney injury;
7. Thrombosis of the vessels of the kidneys;
8. Neoplasms of the kidneys;
9. Acute and chronic glomerulonephritis;
10. Pyelitis, pyelonephritis;
11. Glomerulo- and tubulonephrosis (poisoning, taking medications);
12. Strong venous congestion;
13. Displacement of the spleen;
14. Systemic lupus erythematosus;
15. Overdose of anticoagulants, sulfonamides, urotropine.
16. Idiopathic renal hematuria.
Bleeding, occurring independently of urination, are localized in the urethra, prepuce, vagina, uterus (estrus) or prostate gland.

HEMOGLOBIN, MYOGLOBIN

Normally, when examining with test strips, it is absent.

Causes of myoglobinuria:
1. Muscle damage (the level of creatine kinase in the circulating blood increases).
Hemoglobinuria is always accompanied by hemoglobinemia. If hemolyzed red blood cells are found in the urinary sediment, the cause is hematuria.

Microscopic examination of the sediment.

There are elements of organized and unorganized urine sediments. The main elements of organized sediment are erythrocytes, leukocytes, epithelium and cylinders; unorganized - crystalline and amorphous salts.

EPITHELIUM

Fine in the urine sediment, single cells of the squamous (urethra) and transitional epithelium (pelvis, ureters, bladder) are found in the field of view. The renal epithelium (tubules) is normally absent.

Squamous epithelial cells. Normally, females are found in greater numbers. Detection of layers of squamous epithelium and horny scales in the sediment is a sign of squamous metaplasia of the mucous membrane of the urinary tract.

Transitional epithelial cells.
The reasons for the significant increase in their number:
1. Acute inflammatory processes in the bladder and renal pelvis;
2. Intoxication;
3. Urolithiasis;
4. Neoplasms of the urinary tract.

Epithelial cells of the urinary tubules (renal epithelium).
The reasons for their appearance:
1. Jades;
2. Intoxication;
3. Insufficiency of blood circulation;
4. Necrotic nephrosis (in case of poisoning with sublimate, antifreeze, dichloroethane) - epithelium in a very large amount;
5. Amyloidosis of the kidneys (rarely in the albuminemic stage, often in the edematous-hypertonic and azotemic stages);
6. Lipoid nephrosis (desquamated renal epithelium is often found to be fat-transformed).
When conglomerates of epithelial cells are found, especially moderately or significantly varying in shape and / or size, further cytological examination is necessary to determine the possible malignancy of these cells.

leukocytes

Normally, there are no leukocytes or there may be single leukocytes in the field of view (0-3 leukocytes in the field of view at a magnification of 400).

Leukocyturia- more than 3 leukocytes in the field of view of the microscope at a magnification of 400.
Piuria- more than 60 leukocytes in the field of view of the microscope at a magnification of 400.

Infectious leukocyturia, often pyuria.
Causes:
1. Inflammatory processes in the bladder, urethra, renal pelvis.
2. Infected discharge from the prostate, vagina, uterus.

Aseptic leukocyturia.
Causes:
1. Glomerulonephritis;
2. Amyloidosis;
3. Chronic interstitial nephritis.

erythrocytes

Normally, in the urine sediment there are no or single in the preparation (0-3 in the field of view at a magnification of 400).
The appearance or increase in the number of red blood cells in the urine sediment is called hematuria.
Reasons see above in the section "Urine chemistry".

CYLINDERS

Fine hyaline and granular casts can be found in the urine sediment - single in the preparation - with unchanged urine.
urinary casts not present in alkaline urine. Neither the number nor the type of urinary casts is indicative of the severity of the disease and is not specific for any kidney disease. The absence of casts in the urine sediment does not indicate the absence of kidney disease.

Cylindruria- the presence in the urine of an increased number of cylinders of any type.

Hyaline casts are composed of protein that has entered the urine due to congestion or inflammation.
Reasons for the appearance:
1. Proteinuria not associated with kidney damage (albuminemia, venous congestion in the kidneys, strenuous exercise, cooling);
2. Feverish conditions;
3. Various organic lesions of the kidneys, both acute and chronic;
4. Dehydration.
There is no correlation between the severity of proteinuria and the number of hyaline casts, since the formation of casts depends on the pH of the urine.

Granular cylinders are made up of tubular epithelial cells.
Reasons for education:
1. The presence of severe degeneration in the epithelium of the tubules (necrosis of the epithelium of the tubules, inflammation of the kidneys).
Waxy cylinders.
Reasons for the appearance:
1. Severe lesions of the kidney parenchyma (both acute and chronic).

erythrocyte casts are formed from accumulations of erythrocytes. Their presence in the urine sediment indicates a renal origin of hematuria.
Causes:
1. Inflammatory diseases of the kidneys;
2. Bleeding into the kidney parenchyma;
3. Kidney infarctions.

Leukocyte casts- are quite rare.
Reasons for the appearance:
1. Pyelonephritis.

SALT AND OTHER ELEMENTS


Salt precipitation depends on the properties of urine, in particular, on its pH.

In acidic urine they precipitate:
1. Uric acid
2. Uric acid salts;
3. Calcium phosphate;
4. Calcium sulfate.

In the urine, giving the main (alkaline) reaction precipitate:
1. Amorphous phosphates;
2. Tripelphosphates;
3. Neutral magnesium phosphate;
4. Calcium carbonate;
5. Crystals of sulfonamides.

crystalluria- the appearance of crystals in the urinary sediment.

Uric acid.
Fine uric acid crystals are absent.
Reasons for the appearance:
1. Pathologically acidic pH of urine in renal failure (early precipitation - within an hour after urination);
2. Fever;
3. Conditions accompanied by increased tissue breakdown (leukemia, massive decaying tumors, pneumonia in the resolution stage);
4. Heavy physical activity;
5. Uric acid diathesis;
6. Feeding exclusively meat feed.

Amorphous urates- uric acid salts give the urine sediment a brick-pink color.
Fine- single in the field of view.
Reasons for the appearance:
1. Acute and chronic glomerulonephritis;
2. Chronic renal failure;
3. "Congestive kidney";
4. Fever.

Oxalates- salts of oxalic acid, mainly calcium oxalate.
Fine oxalates are single in the field of view.
Reasons for the appearance:
1. Pyelonephritis;
2. Diabetes mellitus;
3. Violation of calcium metabolism;
4. After epilepsy attacks;
5. Ethylene glycol (antifreeze) poisoning.

Tripelphosphates, neutral phosphates, calcium carbonate.
Fine missing.
Reasons for the appearance:
1. Cystitis;
2. Abundant intake of plant foods;
3. Vomiting.
Can cause the development of stones.

Acidic ammonium urate.
Fine absent.
Reasons for the appearance:
1. Cystitis with ammonia fermentation in the bladder;
2. Uric acid kidney infarction in newborns.
3. Insufficiency of the liver, especially with congenital portosystemic shunts;
4. Dalmatian dogs in the absence of pathology.

cystine crystals.
Fine absent.
Reasons for the appearance: cytinosis (congenital disorder of amino acid metabolism).

Crystals of leucine, tyrosine.
Fine missing.
Reasons for the appearance:
1. Acute yellow liver atrophy;
2. Leukemia;
3. Phosphorus poisoning.

Cholesterol crystals.
Fine missing.


Reasons for the appearance:
1. Amyloid and lipoid dystrophy of the kidneys;
2. Neoplasms of the kidneys;
3. Kidney abscess.

Fatty acid.
Fine missing.
Reasons for the appearance (they are very rare):
1. Fatty degeneration of the kidneys;
2. Disintegration of the epithelium of the renal tubules.

Hemosiderin is a breakdown product of hemoglobin.
Fine absent.
Reasons for the appearance - hemolytic anemia with intravascular hemolysis of erythrocytes.

Hematoidin- a product of the breakdown of hemoglobin that does not contain iron.
Fine absent.
Reasons for the appearance:
1. Calculous (associated with the formation of stones) pyelitis;
2. Kidney abscess;
3. Neoplasms of the bladder and kidneys.

BACTERIA

Bacteria are normally absent or are determined in urine obtained by spontaneous urination or with the help of a catheter, in an amount not exceeding 2x103 bact. / ml of urine.

Of decisive importance is the quantitative content of bacteria in the urine.
 100,000 (1x105) or more microbial bodies per ml of urine - an indirect sign of inflammation in the urinary organs.
 1000 - 10000 (1x103 - 1x104) microbial bodies per ml of urine - cause suspicion of inflammatory processes in the urinary tract. In females, this amount may be normal.
 less than 1000 microbial bodies per ml of urine is regarded as the result of secondary contamination.

In the urine obtained by cystocentesis, bacteria should normally not be present at all.
In the study of a general analysis of urine, only the fact of bacteriuria is stated. In the native preparation, 1 bacterium in the oil immersion field of view corresponds to 10,000 (1x104) bacteria/ml, but bacteriological examination is necessary to accurately determine the quantitative characteristics.
The presence of a urinary tract infection can be signaled by simultaneously detected bacteriuria, hematuria and pyuria.

YEAST FUNGI

Normally absent.
Reasons for the appearance:
1. Glucosuria;
2. Antibiotic therapy;
3. Long-term storage of urine.

Yekaterinburg city,
Thai Cat Club

URINE STUDY

Material under study: urine

Material sampling technique: For general clinical analysis, urine is collected in the morning in a dry, clean dish. It is advisable to collect urine in the vessel in which it will be delivered to the laboratory. A catheter or bladder puncture may only be used in extreme cases. Urine for research cannot be taken from a long standing catheter!

Terms of storage and delivery: Long-term storage of urine at room temperature leads to a change in physical properties, destruction of cells and reproduction of bacteria. Urine can be stored 1.5 - 2 hours in the refrigerator.

Factors affecting the results:

overestimate the results of glucose levels in the urine - corticosteroids, diuretics (thiazide, furosemide), nicotinic acid, etc.

underestimate the results - ascorbic acid, tetracycline, mercury diuretics, etc.

overestimate the performance of ketone bodies - preparations of acetylsalicylic acid, methionine.

approximately 50% of cells are destroyed after 2-3 hours at room temperature.

overestimate the results of the determination of erythrocytes - anticoagulants, acetylsalicylic acid, indomethacin, penicillin, sulfonamides, radiopaque agents.

overestimate the definition of leukocytes - ampicillin, acetylsalicylic acid, kanamycin, iron salts,

many drugs can form crystals in the urine, especially at extreme pH values, which can interfere with the assessment of crystals in the urine sediment.

CLINICAL URINE ANALYSIS

• Dark yellow- a large concentration of coloring substances (with loss of moisture due to vomiting, diarrhea, edema, etc.);
• Light yellow, watery- low concentration of dyes;
• dark brown- hemoglobinuria (urolithiasis, hemolytic kidney); urobilinogenuria (hemolytic anemia);
• Black- melanin (melanosarcoma), hemoglobinuria;
• Greenish brown, beer color- pyuria (pyelonephritis, urocystitis), bilirubinemia, urobilinogenuria;
• Red- gross hematuria - fresh blood (renal colic, kidney infarction);
• The color of "meat slops"- gross hematuria - altered blood (glomerulonephritis).

Transparency: Average transparent. Turbidity may be due to a large number of leukocytes, bacteria, epithelial cells, mucus, salt crystals.

Acidity: On average, in carnivores - slightly acidic. Depending on the type of feeding (the predominance of the protein or carbohydrate type), it can be pH 4.5 - 8.5. Lowering the pH of urine below 5.0 (to the acid side) - acidosis (metabolic, respiratory), feeding with a high protein content, hypokalemia, dehydration, fever, taking ascorbic acid, corticosteroids. An increase in urine pH over 8.0 (in the alkaline direction) - alkalosis (metabolic, respiratory), feeding with a high content of carbohydrates, hyperkalemia, chronic renal failure, bacterial decomposition of urea.

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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).

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 infection.

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:

To make an accurate diagnosis of a sick cat, it is not enough for a doctor to have high professional skills. Examining the animal, according to external symptoms - poor condition of the coat, watery eyes, fever, etc., he can only say that the cat is unhealthy.

However, the external signs of many feline diseases are similar, therefore, it is possible to determine exactly what a pet is sick with only through laboratory tests. The more complex the disease, the rarer it is, the more tests will have to be done by specialists working in the laboratory.

One of the main studies that help establish the diagnosis of the disease is a general urine test. When conducting a standard analysis, the physical properties of the liquid, its chemical composition and the microscopy of the resulting urine sediment are evaluated.

urine color

First of all, the color of urine is evaluated, the color of which is influenced by many factors, among them the type of diet, medication and the presence of pathologies in the animal's body:

• Normal urine color is various shades of yellow. It becomes lighter if the cat drinks a lot of water, hence has more frequent urination.
• The dark color is characteristic of many diseases, during which an increased amount of bilirubin enters the urine, in case of poisoning and hemoglobinuria - the appearance of hemoglobin in the urine, which is absent in a healthy pet. In the latter case, urine acquires an almost black color.

The amount of urine excreted

1. In a healthy cat, the amount of urine excreted per day is equal to the volume of fluid drunk by her during this time. At home, this amount can be determined only when using a clean tray. Then its contents can be drained into a measuring container and find out if the volume of urine excreted by the pet is normal.
2. Increased urine output is characteristic of diseases such as diabetes, various inflammatory processes, and chronic kidney failure.
3. Fluid excretion in a volume below normal may be a sign of acute kidney failure, or shock suffered by a pet.

Normally, urine should be clear. Turbidity indicates the presence of microbes in the urine. Their cause always becomes inflammation of any organs of the urinary system - urolithiasis or inflammation of the urinary tract is possible.

Urine density

To assess the functional ability of the kidneys, the concentration of urine is used to determine its relative density. The study is carried out by comparison with the density of water. Normal density values urine are considered 1.020 - 1.035. Measurements are made with instruments such as a urometer or refractometer.

pH value

In the general analysis of urine, the pH indicator is also examined, which reveals the presence of an acidic or alkaline reaction in it. Basically, these indicators depend on the composition of the cat's diet. If in her diet the main part of the feed is represented by meat products, then the urine reaction is acidic. With vegetable food (a rare occurrence - vegetarian cats), the reaction of power becomes alkaline.

Since cats are carnivores by nature, their urine reaction is:

• normally slightly acidic - a pH value of 6 to 7. At the same time, more acidic urine indicates the possibility of a cat having diseases such as diabetes, nephritis, and kidney congestion.
• an alkaline reaction appears when there are bacteria, leukocytes or protein in the urine.

You should know that the analysis should be done in fresh urine. During the delivery of the liquid to the laboratory, the urine becomes alkaline, and the pH value changes towards an increase in the amount of alkali. Therefore, for the accuracy of such a test, it is better to use a litmus strip by checking the urine immediately after it is taken for analysis.

Chemical analysis of urine

With a general analysis of urine, a chemical study of its composition is also carried out. At the same time, most of the components that can indicate the appearance of any diseases in a cat are checked in urine. First of all, urine is examined for the presence of the following substances:

• Protein- in the urine of a healthy animal it is usually not present, although the presence is allowed in an amount of up to 0.3 g / liter of liquid. The appearance of more protein accompanies disease-causing processes. An accurate diagnosis can only be made after additional studies. The list of possible diseases is long - it can be any infection, pyelonephritis, urolithiasis, urethritis, pyometra, cystitis;
• Glucose– the presence of this carbohydrate in healthy animals is not detected. Its appearance usually becomes evidence of the presence of diabetes in a cat. However, it is sometimes also found in renal failure and even in stressful situations. Glucose can appear with an excess of carbohydrates in the pet's diet and treatment with certain medications;
• Ketone (acetone) bodies- this component is absent if the cat is healthy. When it is detected together with glucose, it marks the cat's disease with diabetes mellitus. If glucose is absent, then a possible cause of the appearance of ketone bodies can be prolonged starvation, poisoning, severe fever, and even long-term nutrition with fatty foods;
• Bilirubin- bile pigment. The appearance of bilirubin in the urine indicates problems in the liver or blockage of the bile ducts. May signal hemolytic jaundice;
• Blood and hemoglobin- a signal of the animal's body about the presence of a serious pathology of the internal organs. The appearance of blood in the urine is a sign of injury to the urinary tract or bladder, nephritis, and even the occurrence of a tumor. A change in the color of urine to coffee, shows the presence of hemoglobin, which is typical for infections, burns and poisoning.

Sediment microscopy

This study is also included in the general analysis of urine. This method more accurately determines the affected area of ​​the urinary system. Particularly accurate information is provided by a urine sample obtained by puncturing the bladder, since in this case the appearance of microbes that have entered the test fluid from the genital tract is excluded in the sample.

Sediment microscopy includes looking for epithelial cells, which clinicians divide into squamous, transitional, and renal. The diagnosis is influenced by the presence of renal epithelium in the sediment, which indicates the possibility of detecting diseases such as renal failure, nephritis, intoxication, various infections or fever:

• The appearance of transitional epithelium in the sediment indicates the possible presence of diseases such as cystitis, urethritis and a malignant tumor.
• The presence of leukocytes becomes evidence of inflammation of the genitourinary system and infectious processes occurring in the body of the animal.
• The detection of urinary cylinders also speaks of kidney disease. These formations consist of cells, salts and protein.
• Their increased number is not always a sign of disease. A large amount of salts is sometimes found after taking some prescribed medications, and also because of the long time interval between urine collection and its analysis. However, some of them can become an opportunity to determine many diseases.
• The presence of mucus in the urine is an accurate sign of pathologies that have appeared in the cat's body. In healthy cats, mucus in the urine is not found.

The article allows you to understand what the urine tests of cats, cats and kittens are, as well as answers to common questions of those who have a fluffy pet at home and monitor its health.

Urine of a cat and a cat for analysis, how to collect and donate, how long can be stored, how much is enough to take at home

The most complete picture of the disease usually reflects the urine collected in the morning, as it is the longest in the bladder. Urine collected the day before should be delivered to the laboratory in less than 1-2 hours.

Ideally, you need to purchase a special container to collect urine, but in practice, an ordinary glass container is most often used for this. At the same time, it is important that the container found is clean and its walls do not contain detergent residues and have no foreign smell.

For analysis, 5-20 ml of urine is sufficient. If you get more - it's not so scary, you can not pour the excess.

The easiest way to collect urine is from a tray familiar to a cat, but it must first be washed and scalded with boiling water.

For cat owners whose animals are accustomed to using a tray with a net without filler, in this case there will be no problems.

For those who pour filler into the tray, resourceful cat breeders are advised to fill the tray with cocktail tubes cut into small cylinders, or purchase a special filler sold at a pet store, which is called “Urine Sample Collection Filler”.

In emergency cases, urine from a cat can be collected at the clinic using a catheter or puncture.

Cat urine analysis decoding norm, protein, epithelium, creatinine, tripelphosphates, erythrocytes, struvites and pathology

Deciphering the urine test of a healthy cat includes:
- protein - less than 100 mg / l or its complete absence;
- renal epithelium - normally absent;
- creatinine - not higher than 140;
- tripelphosphates - absent;
- erythrocytes - absent or up to 3 erythrocytes per μl;
Struvites should normally be absent. Their formation is associated with an excess of phosphorus and magnesium in the animal body.

Exceeding these values ​​is considered a pathology.

Urine analysis of a cat with urolithiasis cost and explanation of where to pass

You can take a cat urine test for urolithiasis at any veterinary laboratory. The average cost of testing is $25.

Urine analysis of a cat with cystitis, cocci bacteria, what are they and the main indicators

With cystitis, the cat's urine becomes cloudy, sometimes with visually noticeable flakes or crystals. The amount of protein in it increases, while the erythrocytes remain, as a rule, unchanged, but the number of cells of the transitional epithelium increases.

Cocci bacteria are normally found in the urine of almost every animal. Their concentration increases in the case of an infectious disease or inflammation.

Is it possible to do a cat urine test in a human laboratory

If the laboratory assistant performs urine analysis not in the analyzer, but under a microscope, then it is possible to do an analysis of cat urine in a human laboratory.

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