Urinalysis: What is your interpretation? - DVM
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Urinalysis: What is your interpretation?


DVM360 MAGAZINE


CASE 9

Consider the following results obtained from analysis of a voided urine sample from an anorectic obese, well-hydrated, 12-year-old male DSH cat:

Color - yellow/orange
Protein - trace
Turbidity - cloudy
RBC - none
Specific gravity - 1.035
WBC = 0-1/lpf
pH - 6.0
Casts - none
Glucose - negative
Epithelial cells - occasional
Acetone - negative
Bacteria - none
Bilirubin = 3+
Crystals - occasional calcium oxalate
Occult blood = negative

The best interpretation of the results of this urinalysis is that the patient:

a. Is normal.
b. Probably has obstructive and/or hepatocellular liver disease.
c. Probably has hemolytic jaundice.
d. Probably has generalized glomerular disease.
e. Probably has calcium oxalate uroliths.

EXPLANATION OF ANSWERS TO INTERPRETATION OF URINALYSIS

The most probable answer to question 1 = b Comments about answers to question 1:

a. Proteinuria of this magnitude is definitely not normal.
b. Marked proteinuria in the absence of significant numbers of red blood cells and white cells is the hallmark of generalized glomerular disease.
c. Absence of significant numbers of white cells eliminates the likelihood of an inflammatory response.
d. Proteinuria of this magnitude would not be expected as a result of primary tubular disease.
e. Proteinuria of this magnitude would not be expected as a result of preglomerular causes.

The most probable answer to question 2 = c Comments about answers to question 2:

a. A mild degree of bilirubinuria in dog urine often is a normal finding. However, bilirubinuria of any magnitude is usually indicative of some underlying disease in cats.
b. Proteinuria, hematuria and pyuria of this magnitude are normal findings, especially in highly concentrated urine.
c. See comment a.
d. Concentration of urine to this degree eliminates a diagnosis of primary renal failure.
e. Proteinuria of this magnitude in highly concentrated urine is not indicative of glomerular disease.

The most probable answer to question 3 = a Comments about answers to question 3:

a. Unlike dogs, bilirubinuria in cats, even when present in small quantities in concentrated urine, is usually indicative of an underlying disorder.
b. Hematuria and pyuria of this magnitude in highly concentrated urine is usually a normal finding.
c. See preceding comment in a.
d. The capacity to concentrate urine to this degree eliminates a diagnosis of primary renal failure.
e. See preceding comment in b.

The most probable answer to question 4 = c Comments about answers to question 4:

a. The results do not permit differentiation between bacterial infection as a cause or complication of urinary tract infection. Most bacterial urinary-tract infections develop secondary to abnormalities in host defense mechanisms.
b. Although this answer is not totally incorrect, to conclude that the genital tract is definitely involved in a sample obtained by cystocentesis is an overstatement.
c. In light of the preceding comments for a and b, this appears to be the best interpretation.
d. The results are definitely abnormal and would not be expected to be caused by contamination.
e. Although magnesium ammonium phosphate uroliths may be present, struvite crystalluria is not by itself a reliable index of their occurrence.


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