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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