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what is the most important part of urinalysis
specimen hangling
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macroscopic
=gross + chemical exam
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microscopic
look at specimen
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parts of urinalysis
- gross exam
- chemical exam
- sediment exam
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gross exam
- color
- odor
- clarity
- specific gravity
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sediment exam
microscopic exam
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SG
- density
- one of the most important
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macroscopic vs microscopic exam
if the macroscopic (dipstick,SG,ect) examination of urine from healthy animal is normal, the microscopic examination (sediment) is also likely to be normal
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what should the macroscopic exam always be part of
M.D.B
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what should be done for every min data base (MDB) in every surgery
macroscopic urinalysis and PCV/TS
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what is TS
albumin + globulins
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do we do microscopic exam if macroscopic exam is normal
no
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GFR
- glomeruler filtration rate
- measure of blood flow through the kidneys
- the more blood pushed through the more toxin are flushed out
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urine production
- filtration
- reabsorption
- secretion
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filtration
in glomerulus of renal nephron
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reabsortion
in renal tubule
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secretion
in renal tubule
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major functions of kidneys
- control water loss
- absorbtion
- pH balance
- excrete toxin
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what should not make it through the glomerulous
RBC, WBC, and albumin because they are too big
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what can damage cause in the glomerulous
- cause filter holes to get smaller or bigger
- when biger albumin can pass thru
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what are the 2 important things about the function of the kidney
- filter size
- kidney ability to concentrate urine
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1st and 2nd urine
- 1st urine formed is very dilute SG of 1.008-1.012
- 2nd reabsorbtion of electrolytes, glucose, amino acid, and stuff body needs to filter down
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what gets thru the glomerulous
it has filters what are little holes that allow protein, water, glucose, and toxin to get thru
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what should you look for what will show change before bloodwork
- urine SG
- presense of protein in urine
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what is microalbuminurine
presense of low level of albumin in urine
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what is the first sign of kidney disease
loss of the ability to concentrate urine
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what won't change until 2/3 of kidneys are damaged
BUN and CREA
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whos urine is more concentrated cats or dogs
cats
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what should the kidneys do if you are dehydrated
should pull water out
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how would you know the kidneys are not working
your dehydrated and urine is dilute
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ADH
- anti-diuretic hormone
- makes kidneys hold water
- steriods alcohol and caffine block this so they urinate a lot
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diuresis
flush out kidneys/toxin by giving patients lots of fluids
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urine samples are affected by
- collection method
- sample collection timing
- storage techniques/changes over time
- must evalute results based on above info
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what can give you false results in urine
improper handling
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randomly obtained urine samples
- -ok for general screening
- -more likely to be dilute due to h2o intake
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early morning (fasting) samples
- best to evalute tubular functions
- likely to have concentrated urine
- sample tend to be acidic (preserves proteinaceous structures)
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what happens if 1st a.m urine is dilute
that means theres a problem, want it to be concentrated
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what does alkalyn urine so to there cells
breaks them down
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post prandial samples
- after eating
- 3-6 hours
- good to evaluate effectiveness of diet on pH, crystalluri, gloucosuria, etc.
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collection methods
- free catch
- manual expression of bladder
- urethral catherization
- cystocentesis
- method affects interpratation
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which collection method gives us the best sample
cystocentesis
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free catch
- prefer first sample in a.m
- midstream best
- in clean dry container
- in clinic may wash area first
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what is free catch commonly used on
pets PU/PD, heraturia
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why is it best to collect 1st am sample for free catch
because concentrated and acidic
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why do you want 2 containers for free catch
- 1st- will have stuff from vaginal area/distal urethra
- 2nd- collects midstream
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how would you get urine for a dog doing a free catch
cup with or without stick
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how would you get urine for a cat doing a free catch
platic liner or beads in litter box
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how would you get urine for a cow doing a free catch
rub ventral to vulva
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how would you get urine for a horse doing a free catch
- whistle
- place in clean stall
- rub warm moist cloth on belly
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express bladder
- in clinic with relaxed animal
- clean external genitalia
- gently compress posterior abdomen with fingers
- done rectally in large animals
- usually don't do
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catheterization
- technique varies with species and sex
- requires sedation
- need sterile catheter and lube
- often creates contamination
- collect in sterile container
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what do you usually disregard with catheterization
the 1st few cc's of sample because catheter can cause damage to urethra and rthe 1st part of sample will have RBC in it
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cystocentesis
- preferred for sterile sample
- aseptically prepare adbomen
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how should a bladder be for a cystocentesis
bladder must be 1/2 full and plapable
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what size needle should you use for cystocentesis
- 1-1.5 inch needle
- never use needle over 22G
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how should you enter the bladder doing a cystocentesis
at an angle
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