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. Urine analysis in a cat: decoding and norm

The composition of urine quite fully reflects the metabolic processes occurring in the body of the animal. Conducting a laboratory analysis allows you to identify serious deviations in the state of health, recognize diseases of the genitourinary system, determine the presence of infections or injuries.

A general urinalysis with microscopic examination of the sediment is prescribed for many diseases of cats and dogs, being informative and simple enough to perform.

Sometimes collecting animal excretions for research can be difficult: cats often go to litter trays, and dogs are walked outside. In such cases, material sampling can be carried out at the clinic during the appointment. To do this, catheterization of the bladder is used, or urine is taken using cystocentesis (puncture of the bladder with a needle through the abdominal cavity). The latter method is considered the most informative and high-quality way to take material for analysis.

Interpretation of urinalysis results

The results of physical, chemical and microscopic studies are summarized in a table. Their decoding makes it possible to compile a general picture of the state of the animal's body. Based on them, data from other tests and examinations, an experienced specialist diagnoses and prescribes treatment.

Physical properties of urine

They are examined by the method of organoleptic analysis. Its essence lies in the assessment of visual characteristics: color, smell, consistency, the presence of visible impurities.

The following indicators are noted:

COL (color)- a yellow and light yellow tint of the liquid is considered normal.

CLA (transparency)- in healthy animals, discharge of complete transparency.

Presence of sediment- may be present in small amounts.
It is formed from insoluble salts, crystals, epithelial cells (kidneys, urethra, bladder, vulva), organic compounds, microorganisms. A large amount of sediment is observed with metabolic disorders, the presence of diseases.

Additionally, there may be an uncharacteristic odor, a change in consistency.

The owner of the animal should pay attention to the nature of urination and the appearance of the discharge. If there is a change in color or smell, the appearance of clots of mucus or pus, blood particles when urinating, it is necessary to show the dog or cat to the veterinarian.

Chemical properties of urine

Investigated using an analyzer. This method analyzes the composition of the separated liquid for the presence and amount of organic and chemical substances.

BIL (bilirubin)- normally in dogs this substance is contained in small undetectable quantities. In cats, this component is not present in the normal composition.

Dogs - absent (traces).

Cats are missing.

An increase in the indicator (bilirubinuria) may indicate liver diseases, obstruction of the bile ducts, and a violation of hemolytic processes.

URO (urea)- formed as a result of the breakdown of proteins.

Dogs - 3.5-9.2 mmol / l.

Cats - 5.4-12.1 mmol / l.

An increase in the indicator is evidence of renal failure, protein nutrition, acute hemolytic anemia.

KET (ketone bodies)- in a healthy body are not allocated.

The presence of ketones is the result of metabolic disorders arising from diabetes mellitus, malnutrition, sometimes as a manifestation of acute pancreatitis or extensive mechanical damage.

PRO (protein)- an increase in the number of protein compounds accompanies most kidney diseases.

Dogs - 0.3 g / l.

Cats - 0.2 g / l.

An increase in the level of protein in the urine accompanies many kidney diseases. It may be due to a meat diet or cystitis. Often, an additional comprehensive study is required to differentiate the disease of the urinary system.

NIT (nitrite)- in healthy animals, these substances should not be in the urine, but it is not always possible to reliably judge the presence of pathogenic microflora in the urinary tract. Refined analysis will show a more accurate picture.

GLU (glucose)- in a healthy animal, this substance is absent. The appearance can be triggered by a stressful condition, which is more common in cats.

An increase in glucose levels is an indicator of diabetes mellitus, for clarification, a blood test for sugar is performed. Other causes of glucosuria can be: pancreatic disease, acute renal failure, hyperthyroidism, glomerulonephritis, taking certain medications.

pH (acidity)- an indicator of the concentration of free hydrogen ions.
Changes in acidity is one of the factors leading to the formation of stones in the urinary tract. Deviations of the indicator can occur with protein overfeeding, chronic infection of the urinary ducts, pyelitis, cystitis, vomiting, diarrhea.

Dogs and cats - from 6.5 to 7.0.

S.G (density, specific gravity)- shows the concentration of dissolved substances. It is important to analyze the indicator before the start of treatment, to control the appointment of droppers and diuretic medications.

Dogs - 1.015-1.025 g / ml.

Cats - 1.020-1.025 g / ml.

An increase above 1.030 and a decrease to 1.007 indicate functional impairment of the kidneys.

VTC (ascorbic acid)- is not deposited by the body and in excess is excreted in the urine.

Cats and dogs - up to 50 mg/dL.

The increase is caused by an excess of the vitamin when feeding or taking certain medications.

The decrease is associated with hypovitaminosis, unbalanced nutrition.

Sediment microscopy

It allows you to determine the presence of certain diseases that do not have visible symptoms. In addition to substances dissolved in urine, its composition is supplemented by solid salt crystals, tissue cells, and microorganisms. Their analysis allows you to create the most reliable picture of the state of health of the animal.

Slime- a small amount is the result of the activity of the mucous glands belonging to the urinary and reproductive systems.

An increase in mucus secretion to the formation of a clot signals the presence of cystitis (inflammation of the bladder wall).

Fat (drip)- may be kept in healthy animals, especially cats. The amount often depends on the feeding.

The increase is associated with overfeeding with fatty foods, sometimes indicating a violation of the kidneys. Requires additional research to clarify the diagnosis.

Leukocytes- in a healthy animal, single, up to 3 cells in the field of view during microscopic examination.
An increase in the number indicates the presence of inflammation or infection of the urinary tract. It may also be due to incorrect sampling.

red blood cells- appear in the urine as a result of bleeding that occurs in various parts of the genitourinary system.
Therefore, it is important to know in which portion of urine blood appeared (at the beginning, at the end or throughout the entire urination).

Up to 5 cells are allowed.

An increase in red blood cells (hematuria) or its derivatives (hemoglobin) leads to urine staining. Hematuria or hemoglobinuria in the first phase of urination indicates damage to the urinary ducts or adjacent genital organs, and in the final phase - damage to the bladder. Uniform redness of the entire portion of the discharge can reveal injuries to any part of the genitourinary system.

Surface epithelium- can appear with poor-quality urine sampling, where swabs from the genital organs got into.

transitional epithelium- normally not present, its presence indicates inflammation of the urinary tract.

renal epithelium- not normally present, found in kidney disease.

crystals- are insoluble salts that can be found in healthy animals without pathologies.

An increase in the number is observed in animals prone to the formation of stones. However, this is not the reason for prescribing treatment without additional research.

bacteria- in healthy animals, urine is sterile. Bacteria can be detected in incorrectly taken samples, where swabs from adjacent organs of the reproductive system fall, as well as when the ascending tract of the genitourinary system is infected.

spermatozoa- get from the genital organs with poor-quality urine sampling for analysis.

cylinders- absent in the normal state. They have the form of urinary tubules, being a kind of plugs from organic structures of various origins accumulating in them, clogging the gaps and gradually washed out by urine.

Up to 2 in the microscope field.

An increase in the number of cylinders occurs with a disease of the urinary system. According to their form and origin, they diagnose: stagnation phenomena, inflammation processes, dehydration, pyelonephritis, necrosis, lesions of the parenchyma and tubules.

A general analysis of the animal's urine with sediment microscopy allows the doctor to make a preliminary diagnosis, which must be confirmed by additional studies.

Many cat diseases require accurate laboratory diagnosis. For this, studies are carried out on the natural environments of the body, such as urine, blood, feces, sputum and various kinds of scrapings. The most difficult thing is to get a urine sample for analysis from a cat or from a cat. And about how to get out of this difficult situation, our today's article. We'll show you how to get cat urine test and how to decipher the result.

For accurate examination of the animal and staging done correct clinical diagnosis and we advise everyone to contact the Center for Emergency Veterinary Care for Animals. "I-VET"

If for any reason you cannot bring the animal to our Center, then call by phone and a team of veterinarians will arrive at your place at a convenient time for you as quickly as possible!

Cat urine analysis - study features

It has long been known the truth that by correctly examining the urine of a four-legged patient, one can obtain a number of important information about the state of his health. By the way, the same principle underlies human laboratory research. After examining a urine sample from your cat, previously difficult health issues can be resolved.

Complete cat urine test includes:
• Density study.
• Study of the color coefficient.
• Definition of transparency.
• Determination of the PH level.

After these studies have been carried out, they begin to investigate chemical indicators of urine. It is noteworthy that by analyzing urine, a veterinarian can determine the nature of the diet of your pet fluffy. When feeding excess meat to a cat, the pH of the urine will be acidic.

If a urinalysis reveals the presence of staphylococcus aureus, then this is direct evidence of a kidney or urinary tract infection. For any infectious disease, veterinarians recommend give urine for analysis.

Determined in urine the content of leukocytes, erythrocytes, microbes, pathogens (for example, staphylococcus), epithelial cells and a large number of indicators that we will not list. Just to clarify, this type of laboratory study allows you to clarify and / or confirm many diagnostic guesses.

What types of urine tests are used most often? Very often do cat urinalysis, which shows the presence of leukocytes, erythrocytes, sediment, color index, density and glucose in the urine. But in the most difficult cases, it may be necessary detailed analysis which gives more detailed information.

How to collect urine from cats for analysis

The first question that the owners ask, if necessary, to undergo an examination: “How to collect urine from cats for analysis?”

In order to collect a certain amount of urine for analysis, several methods are used, among which we describe the following:
• Collection of urine from the tray. If your pet takes a small need in the tray, then you need to empty the tray from the filler, wash it with hot water and wipe it dry with a rag. Observe the cat and after he urinates into the tray, drain the urine into a container prepared in advance.
• There are some cats who refuse to go to the toilet in an empty tray. For such frills, you can put pieces of toilet paper, pieces of cotton wool or any other neutral absorbent material on the bottom of a clean tray. After the cat goes to the toilet, squeeze this makeshift litter into a sterile container for analysis.
• With massage and some pressure on the bladder area, it is often possible to provoke urination and collect a portion of urine.
• If you can’t collect urine for analysis from your cat on your own, then you need to seek help from veterinarians. You can even call them to your home by calling the Animal Emergency Veterinary Care Center.

No need to try to collect a large amount of urine. IN container for testing you can put 120 ml, but even if you can collect a smaller amount of urine from the cat, this will be enough for the analysis. For urine analysis in cats, 10 ml of urine is enough.

In a veterinary clinic, urine can be collected bladder catheterization. But this method has the danger of retrograde, that is, the reverse introduction of infection into the urinary organs. So microorganisms of staphylococcus can penetrate into the kidneys, which actively develops in the urethra during its inflammation.

If it is impossible to perform catheterization, perform the procedure cystocentesis. To do this, the bladder is punctured through the abdominal wall with a puncture needle and the required amount of urine is aspirated for research. Dignity this method is the purity of urine analysis from the flora in cats, and shortcomings- the possibility of massive bleeding into the cavity of the bladder.

Cat urine analysis: how to store and transport urine for research

The best option is to conduct urine tests in cats no later than half an hour after receiving a portion of urine. But, most often, this is impossible and a large amount of time will pass until the moment of research. Therefore, the study is carried out later, and collected urine should be stored in a container in a cool place.

This can be explained simply. 2 hours after collection in urine the growth of pathogenic flora begins, including staphylococcal. In addition, already after such a period of time, the acidity index changes in the urine, the cellular inclusions of the sediment are destroyed and other biochemical and chemical changes occur that distort the results and the decoding will be incorrect. If the urine before the study is too cold, this will lead to the phenomenon of crystallization. in vitro, that is, it will significantly enhance the process of crystallization of the cat's urine.

For long-term preservation of urine before analysis, a special preservative must be added to it. It can be taken from a biomaterial research laboratory and it has a very low cost, accessible to almost everyone.

It is necessary to tell the owners of clawed pets that testing is recommended to be taken regularly. at least once every six months. This is due to the fact that cats suffer from certain diseases with subtle symptoms. For example, a neutered cat has an increased risk of developing urolithiasis. And this disease must be prevented by changing and adjusting the diet. Yes, and other diseases, more often of an exchange nature, occur more often in castrates. This fact is an occasion to think carefully before deciding to castrate your pet.

For kidney disease most often noted the presence of staphylococcus, and seen in urinalysis how severe the disease is. There are a huge number of diseases determined by urine. And only one analysis is able to give a clear picture of the state of the organism of a beloved cat.

In the Center for Emergency Veterinary Care for Animals, they will quickly and painlessly take urine for a general and / or detailed analysis, conduct a study and study of urinary indicators. Analyzes are deciphered in our Center within a few hours.

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 best 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 standing, supine (a) and lateral (b) positions.

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 cystocentesis is needed (eg, for culture of urine), 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:

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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Proteinuria is the presence of excessive protein in the urine, in cats, is the presence of excessive protein in the urine. The protein particles are small enough to pass through the glomeruli, and a small amount of protein in the urine is normal.

Proteinuria is divided into three types:

• prerenal
• Postrenal
• Glomerular

With glomerular proteinuria, the glomeruli are damaged and, as a result, a large amount of albumin is lost (albumin is the main blood protein).

Causes

There are a number of diseases associated with glomerular proteinuria:

• Immune-mediated disease (systemic lupus erythematosus)
• Infectious diseases, such as ehrlichiosis, Lyme disease, and chronic bacterial infections
• Diabetes
• Pituitary-dependent hyperadrenocorticism (Cushing's disease)
• Hypertension (high blood pressure)
• Heredity
• Inflammation
• Amyloidosis (violation of protein-carbohydrate metabolism, which leads to the deposition of amyloid in the internal organs)

Diagnostics

Diagnosis of proteinuria may be as follows:

• Analysis of urine
• Urinalysis for the presence of creatinine
• Complete medical examination including blood pressure measurement

Clinical signs

Clinical signs may be subtle until the protein loss is significant or indicative of an underlying disease.

• Animals showing signs of anorexia (loss of appetite), vomiting, weight loss, lethargy and weakness
• Hereditary amyloidosis (may occur in Shar-Peis)

When your cat has proteinuria and you are looking for advice on this topic on the Internet in the forums, we recommend that you do not self-medicate and experiment on your beloved cat. The fact is that there are many reasons for vomiting in an animal, and the consequences of your experiment may disappoint you and your family.

Treatment

There are three main goals of treatment:

• Identification and elimination of causative antigens
• Reduced glomerular inflammation
• Immunomodulation

First you need to establish and eliminate the main causes of proteinuria. It is necessary to stop the spread of infections or cancerous processes. It is necessary to exclude the presence of infectious and immune diseases with the help of diagnostics.

The use of immunosuppressive therapy is controversial. The main indication for its use is a reaction to steroids.

Reduce the amount of protein in the urine.

Pets with kidney failure are shown a diet low in phosphorus and protein. And animals with high blood pressure (hypertension) should remove salt from their diet. To prevent the spread of inflammation, it is worth adding omega-3 fatty acids to your pet's food.

Small doses of aspirin may be given to the cat to prevent blood clots from forming. Your veterinarian may also prescribe medications to control blood pressure in animals with hypertension.

Care and maintenance

• Control over medication prescribed by your veterinarian.
• Watch for pet's appetite, possible signs of ascites, or swelling of the paws/muzzle, which may indicate fluid accumulation
• Difficulty breathing or limb weakness, thirst, frequent urination, vomiting, lethargy or loss of appetite may indicate the development of thromboembolism.
• Regular visits to the vet.