This article and the accompanying algorithms are intended to guide practitioners through the series of steps necessary to confirm the presence of hematuria, localize the source of the RBCs, and identify the specific cause.
A quarter-century ago, analysis of uroliths removed (usually by surgery) was optional. In fact, rather than have the stones analyzed, some veterinary practitioners gave them to their clients as a topic of conversation. What about today? Is it an acceptable standard of practice to give stones retrieved from the urinary tract to owners without knowing their composition? What would be your response to a physician who gave you stones retrieved from your urinary tract? Believe it or not, we have received uroliths for analysis formed by our veterinary colleagues that were given to them by a physician. Of course, we did not perform the requested analysis because we did not want to cross the line of practicing medicine without a license. Instead, we sent them to a laboratory licensed to provide that service.
Urinalysis is one of our most important clinical diagnostic tools. Unfortunately, most diagnostic reagent strips used to perform routine urinalyses in veterinary laboratories have been designed for human use.
Knowledge of urolith composition is important because contemporary methods of detection, treatment and prevention of the underlying causes of urolithiasis largely depend on knowledge of urolith composition.
Definitively diagnosing canine hyperadrenocorticism (Cushing's disease) can be exceptionally difficult because nonadrenal illness can affect the test results. However, I think that the urine cortisol:creatinine ratio (UC:Cr) serves an invaluable role in ruling out canine Cushing's disease since a dog with a normal UC:Cr almost assuredly does not have Cushing's disease.