Senior Wellness~Nellie’s Health Series Part 5: Urinalysis

Senior Wellness~Nellie’s Health Series Part 5: Urinalysis

How does one collect a urine sample?

The best time to collect a urine sample for diagnostic tests is the first urine sample of the morning. This will give you the best Specific Gravity results (more on that later). Once collected it should be stored in the refrigerator until you can bring it into the clinic, if left out bacteria can multiple and crystals can form and you don’t know if this is part of the results or artifacts. . It shouldn’t be older than 12 hours. If you can’t collect a sample at home you can let the clinic know and set up a time to come in and have a lovely technician collect the sample. If you are feeling adventurous you  can collect the sample at home it is best to use as sterile of container as you can. Using a clean rubbermaid flat container, a clean butter container, a soup ladle or a coat hanger with a plastic bag. If collecting at the clinic and the dog doesn’t want to pee in the cup then the doctor can get the sample via urinary catherization or cystocentesis both of those methods are considered sterile samples as a regular collection is a free catch sample. The technician and doctor will take the collection device into consideration when looking at and reading the urine results.

The urine collection system that my mom designed.

As you can see Nellie is very happy to show off my urine collection system….NOT!

Success, it worked.

Once the female dog squats you slide the bag under her whoo ha and collect the urine. A male dog, you slide it under if it squats or stick it around the side if it lifts it’s leg, being careful not to get it out of there in time before it steps in it when he brings his foot down. If winter time like it is now in WI you want to be careful not to get snow in the sample as it my alter the results.

Components of the Urinalysis – What is the Doctor looking at when reading urinalysis results?

1. Color and Clarity of urine sample –  odor or no odor

2. Specific Gravity

3. Dipstick

4. Microscopic Exam

5. Culture

Components

First you will note the color and clarity of the sample, then the odor. The color will tell you how the kidneys are concentrating the urine. It’s kinda a quick glance to tell you if there is a problem before the whole urinalysis is done. You then want to smell it and note if it has a odor or not, again that will tell you if there is a problem before you are done.

Refractometer – checking urine specific gravity.

Second you need to put a drop of urine on the refractometer to see what the urine specific gravity is. The specific gravity will tell you how the kidneys are concentrating the urine. Dark urine means they urine is well concentrated, light urine means the kidneys are not concentrating the urine meaning there might be a problem with the kidneys.

Urine dipstick

Third we will do a urine dipstick. The dipstick will tell us the PH of the urine, if blood is present, if protein is present, if glucose or ketones are present and if bilirubin is present. All these test could mean there is a problem with the urine, kidneys or if a animal is diabetic.

Centrifuge

Fourth we will spin down the urine in a centrifuge, the centrifuge uses great force to separate the  solid components of the urine from the liquid. After the urine sample is spun down it is set up for microscopic exam on the sediment.

It’s time to read the sediment under the microscope.

Staining of the sediment.

You can look at the sediment stained or unstained. Staining the urine sediment will make some structures more visible.

Culture on the urine.

A culture should be set up on each urine sample to check for bacteria in the bladder. It is best to do a culture on a sterile urine sample but that isn’t always the collection method so you do it on a free catch sample taking note if something grows on the plate it may be a contaminant and not a bacteria that is really causing a problem. If bacteria grows then we send it to a outside lab to run a id (tell us what bacteria it is) and sensitivity (a drug sensitivity to test which drugs will kill the bacteria). A culture may take up to 3 days to grow and another couple of days to get the sensitivity results.

Now what did Nellie’s urine tell us?

The main reason we did a urinalysis is because of her slightly high BUN from her bloodwork that I talked about on Tuesday, that you can view here. The doctor wanted a specific gravity to see if she was concentrating urine or not. If she wasn’t concentrating urine it would be another sign that the kidneys aren’t working like they should be. Since I had the urine I did a complete urinalysis. Nellie’s concentration was >1.050 which meant she was concentrating urine just fine that the kidneys were working good.

Microscopic exam showing many white blood cells (all the round cells to the right of the picture.

There was bacteria seen, epithelial cells and all the round cells to the right are all white blood cells. So at first glance you would look at this and see TNTC (too numerous to count) white blood cells and think that she has a major infection going on and needs to be put on antibiotics.

Urine results

When the doctor looked at the results and got a history from me which was that she was showing no signs of a urinary tract infection (increase drinking, increase urinating, frequent urination, blood in urine, accidents in house) she thought we need to find out if the WBC’s were really coming from the bladder (which would say bladder infection) or from the vagina (which would say vaginitis). So this lead us to the cystocentesis we performed that you saw on Wednesdays post, if you didn’t see it view it here.

Jackpot

A interesting way of getting a cysto sample. You put the dog on it’s back pour rubbing alcohol on the belly and where it pools you stick the needle in the deepest part of the pooled area and you will hit the bladder and get your sample, if there is enough urine in the bladder at that time. This is considered a sterile sample (you might hit the intestines and get fecal matter so that will not be a sterile sample if you see “floaties” and the urine is brown) so if there are WBC’s in it then we know she has a bladder infection.

Microscope exam.

You can’t see all those sheets of wbc’s in this sample so it means the wbc’s were coming from the vagina which means she has a vaginitis, which you can read about here. You need to combine the history with all the components of the urinalysis to come to a diagnosis.

Stop back tomorrow for:

Friday: Senior Wellness ~ Nellie’s Health Series Part 6: Pulled Tendon

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We are joining Linda at 2browndawgs and Jodi at Heart Like A Dog for this great blog hop.

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Senior Wellness ~ Nellie’s Health Series Part 3: Bloodwork

Today’s Tasty Tuesday post is tied in with the results of Nellie’s bloodwork.

Tuesday: Senior Wellness ~ Nellie’s Health Series Part 3: Bloodwork, why routine bloodwork is a good idea.

You say your going to poke me now?

The American Heartworm Society  recommends annual testing for heartworm disease. To test for heartworm disease you need to have a blood sample drawn as heartworm is detected in the blood from the antigen it produces. You can also see microfilaria in the blood if positive for heartworm disease. Even know I give my gang year round heartworm medication I still check them. You just never know when the medication is going to fail, when they will spit out a pill and not be protected or vomit up a pill. It’s better to catch early then later when more damage is done.

A fecal examination is also recommended once if not twice a year to check for intestinal parasites. My gang gets dewormed each month for intestinal parasites along with the heartworm medication they take. I still check a fecal sample for parasites that aren’t covered by the heartworm medication.

Since we were drawing blood for the heartworm test we drew more blood to have Nellie’s annual chemistry panel (checking internal organ function) and complete blood count (checking for infection) done. Bloodwork should be performed on young animals once a year and on seniors a couple times a year as the values can change quite quickly. Along with the chem panel/cbc I had her thyroid checked. All this was done as a package deal through the laboratory we use. Besides doing bloodwork at least once if not twice a year did I want to make sure I ran bloodwork on Nellie? Remember back on Sunday when I talked about her “funny” belly and I said her belly could have that look from cushing’s disease. If not you can read it here. As dogs get older they can come down with different diseases. One of those diseases is cushing’s disease where the adrenal gland isn’t producing any steroid this conditions medical terminology is called Hypoadrenalcorticism. The signs are lack of muscle in the abdomen making the dog look like it has a pot belly. This is the only sign I thought Nellie had. Other signs include, increase drinking/urination, excessive weight gain, fat deposits on the back end, hair loss. One way you can see if there is a chance the dog has cushing’s disease is by running bloodwork and checking the Alk Phos level. In cushing dogs the level is really high so that is one reason I wanted to do bloodwork.

Here are Nellie’s results:

The fecal exam (which isn’t shown) was negative for intestinal parasites. The heartworm test was negative. Her thyroid test was normal, her CBC (complete blood count) was normal.

CBC- Normal

Her Alk Phos that I was worried about was completely normal so really the chances of her having cushing’s disease right now is pretty much zero. The only abnormality is her kidney function. Her BUN (Blood Urea Nitrogen/Urea N) was 33 which is just over the high normal of 8-30.

 

Urea N – Slightly elevated

What does this mean? It means she has lost some kidney function. She could of lost it due to age relation, another disease going on, high protein diet that is excreting high levels of nitrogen. As long as it stays where it is and doesn’t creep up she will be ok. We do need to watch the protein levels in her diet and make sure she is getting highly digestible proteins so there are fewer nitrogen by-products that have been found in dogs with kidney failure to make the kidneys work harder. In dogs with kidney failure the excess nitrogen can become high in the bloodstream which can cause problems with other tissues. This last fall/winter Nellie took to taking off and eating deer carcass’s so her high protein diet could be coming from that. The doctor suggested we run bloodwork again in the summer when Nellie isn’t taking off and see if the values change. When the kidney value is elevated it is a good idea to run a urinalysis one to make sure the kidneys are concentrating urine and to make sure there isn’t a hidden bladder infection that may of lead to a kidney infection that might elevate the levels. Doing this urinalysis is what uncovered Nellie’s vaginitis which I wrote about yesterday, you can read it here. Thursday I will write about the components of a urinalysis.

Stop back tomorrow to read: Senior Wellness ~ Nellie’s Health Series Part 4: Cystocentesis

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