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Barchilon M, Perez‐Nieves N, Palerme J. Evaluation of a urine dipstick protein to urine specific gravity ratio for the detection of proteinuria in dogs and cats. J Vet Intern Med 2024; 38:1060-1067. [PMID: 38305084 PMCID: PMC10937511 DOI: 10.1111/jvim.17001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The utility of urine dipsticks for the quantification of proteinuria is limited because of the influence of urine specific gravity (USG). To circumvent the need for urine protein creatinine ratios (UPCR) some have proposed a calculated dipstick urine protein to USG ratio (DUR) for the detection of proteinuria. However, the performance of DUR has not been evaluated in veterinary patients. OBJECTIVES Evaluate the correlation between DUR and UPCR, while also assessing the effect of urine characteristics on this relationship and evaluating the performance of DUR in detecting proteinuria. ANIMALS Urine samples from 308 dogs and 70 cats. METHODS Retrospective cohort study of urinalyses and UPCRs from dogs and cats collected between 2016 and 2021. RESULTS Both canine and feline urine samples showed a positive moderate correlation between the UPCR and DUR. The correlation was not influenced by the presence of active urine sediment, glucosuria, or urine pH. In detecting canine urine samples with a UPCR >0.5, an optimal DUR of 1.4 had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 89%, 83%, 96%, and 63%, respectively. In detecting feline urine samples with a UPCR >0.4, an optimal DUR of 2.1 had sensitivity, specificity, PPV, and NPV of 70%, 100%, 100%, and 75%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Use of the DUR can be a relatively reliable method for identification of proteinuria. However, given its poor NPV, the DUR cannot be recommended for exclusion of proteinuric patients.
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Affiliation(s)
- Michael Barchilon
- Department of Veterinary Medicine and SurgeryCollege of Veterinary Medicine, University of MissouriColumbiaMissouriUSA
| | - Nichole Perez‐Nieves
- Department of Veterinary Medicine and SurgeryCollege of Veterinary Medicine, University of MissouriColumbiaMissouriUSA
| | - Jean‐Sébastien Palerme
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowaUSA
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Seigner S, Weber K, Dorsch R. [Urinalysis in dogs and cats, part 2: Urine sediment analysis]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:336-350. [PMID: 37956665 DOI: 10.1055/a-2122-5324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Examination of the urine sediment is part of a routine urinalysis and is undertaken in order to identify insoluble particles in the urine. This procedure is mainly used in the context of diagnostic evaluation of urinary tract diseases, but may also be useful for the diagnosis of systemic diseases and intoxications. Analysis of fresh urine is recommended as changes in cell morphology, cell lysis and in vitro crystal formation may occur in the course of its storage. Manual urine sediment analysis is still performed in many veterinary practices. Native wet-mount preparations are suitable for the identification and quantification of urine sediment particles. The examination of stained wet-mount preparations or air-dried smears may be necessary to further differentiate cells and to identify bacteria. For several years, automatic urine sediment analyzers have been available in veterinary medicine. These save considerable time and staff resources, however verification of the automatically generated results by an experienced observer remains necessary. Urine sediment particles that are frequently identified and clinically relevant include red blood cells, white blood cells, different types of epithelial cells, crystals, and casts as well as bacteria. Furthermore, parasite eggs, fungal hyphae, lipid droplets, spermatozoa, fibres, hair, mucus, plant parts or environmental contaminations may be found in the urine sediment and result in a complication of the result interpretation.
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Affiliation(s)
- Sandra Seigner
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität, München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität, München
| | - Roswitha Dorsch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität, München
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Cervone M, Rossi L, Cappelle J, Rannou B, Hugonnard M. Assessment of inter-observer agreement among experienced and inexperienced observers and an automated device for dipstick urinalysis in dogs and cats. J Vet Diagn Invest 2023; 35:492-499. [PMID: 37326167 PMCID: PMC10467455 DOI: 10.1177/10406387231181579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Standard visual urine dipstick analysis (UDA) is performed routinely in veterinary medicine; results can be influenced by both the operator and the method. We evaluated the agreement of results for canine and feline urine samples analyzed using a 10-patch dipstick (Multistix10SG; Siemens), both visually under double-anonymized conditions by students and a laboratory technician, and with an automated device (AD; Clinitek Status, Siemens). The mean concordance for semiquantitative urinalysis results between students and the technician and between students and the AD was fair (κ0.21-0.40) in dogs and cats; concordance was moderate between the technician and the AD (κ0.41-0.60) in dogs and good (κ0.61-0.80) in cats. For pH, the mean concordance between students and the technician and between the technician and the AD was good (ρ0.80-0.92) in dogs and cats; concordance was good between students and the AD (ρ0.80-0.92) in dogs and moderate (ρ0.59-0.79) in cats. Repeatability was higher (p < 0.001) for the technician and the AD than for a student. We found good agreement between UDA performed by an experienced operator and an AD in dogs and cats but found low reproducibility and low repeatability for urinalysis performed by an inexperienced operator.
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Affiliation(s)
- Mario Cervone
- Département des Animaux de Compagnie, de Sport et de Loisir, Université de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L’Etoile, France
| | - Lydia Rossi
- Département des Animaux de Compagnie, de Sport et de Loisir, Université de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L’Etoile, France
| | - Julien Cappelle
- UMR ASTRE, CIRAD, INRAE, Montpellier, France and UMR EPIA, INRAE, Marcy L’Etoile, France
| | | | - Marine Hugonnard
- Département des Animaux de Compagnie, de Sport et de Loisir, Université de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L’Etoile, France
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4
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Hokamp JA, Freeman K, Harr KE. Analytical performance evaluation of two automated urine chemistry analysers using two levels of commercially available quality control material. J Small Anim Pract 2023; 64:452-462. [PMID: 37129019 DOI: 10.1111/jsap.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 01/22/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Evaluate two point-of-care urine chemistry analysers, VetScan SA and VetLab UA using assayed, bilevel (two concentrations) urine quality control material to determine if performance is acceptable for semiquantitative clinical urine chemistry analysis. MATERIALS AND METHODS Normal and abnormal urine quality control material sent to 23 veterinary practices was evaluated three times by each clinic on in-clinic automated urinalysis instruments. Accuracy, precision and clinical utility were evaluated. RESULTS Normal urine quality control material: Results for blood, glucose, ketones and bilirubin were 100% accurate and precise for both analysers, and pH values were accurately acidic to neutral. However, pH from VetScan SA had clinically significant negative bias. Abnormal urine quality control material: VetScan SA: blood, microalbumin and bilirubin were 100% accurate; glucose, ketones, and protein demonstrated ≤10% inaccuracy; pH demonstrated 34% inaccuracy. VetLab UA: blood, ketones and bilirubin were 100% accurate; glucose and protein demonstrated ≤10% inaccuracy; pH was 100% accurately neutral to alkaline. CLINICAL SIGNIFICANCE VetScan SA had marked negative pH bias versus VetLab UA resulting in clinically significant, overly acidic results. Specific gravity, nitrite, and leukocyte test pads should not be used. Both instruments had excellent performance in normal quality control material. While blood, glucose, protein and bilirubin are correctly identified as present in abnormal quality control material, exact concentrations cannot be interpreted due to imprecision. Only semiquantitative results, not numerical values implying quantification, should be reported from urine test strips.
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Affiliation(s)
- J A Hokamp
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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5
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Seigner S, Weber K, Dorsch R. [Urinalysis in dogs and cats, part 1: physical and chemical urinalysis]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:168-181. [PMID: 37567179 DOI: 10.1055/a-2107-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The urinalysis of dogs and cats is an important part of the diagnostic evaluation of urinary tract diseases as well as for the identification of systemic diseases. A routine urinalysis consists of a physical and chemical examination of the urine as well as an examination of the urine sediment. Various urine collection methods (free-catch, catheterization, cystocentesis) are available. Each method has multiple advantages and disadvantages. The appropriate method must be chosen individually for each patient depending on the emphasis of the examination. The urine should ideally be examined within 30 minutes of collection as it is prone to change due to time and storage. Physical examination of the urine consists of the determination of urine color, clarity, and specific gravity which provides information regarding the concentration of the urine. The latter is determined by refractometry and needs to be interpreted in the context of the hydration status of the patient. Chemical examination of the urine consists of the determination of the pH value and the presence of blood/hemoglobin/myoglobin, protein, glucose, bilirubin, urobilinogen, nitrite, and ketones. The use of commercially available urine dipsticks is common. These must be stored and used according to the manufacturer's instructions and when interpreting the results, veterinary aspects need to be taken into consideration. The physical and chemical examinations of the urine represent rapid and readily performable methods that provide important information for the diagnosis or the exclusion of numerous diseases.
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Affiliation(s)
- Sandra Seigner
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Roswitha Dorsch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
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Leynaud V, Gillet C, Lavoué R, Concordet D, Reynolds BS. Evaluation of a smartphone-based colorimetric method for urinalysis dipstick readings in cats. J Feline Med Surg 2023; 25:1098612X231171434. [PMID: 37226706 PMCID: PMC10811987 DOI: 10.1177/1098612x231171434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES The aim of the study was to compare the diagnostic performances of a smartphone-based colorimetric method (SBCM) for urinalysis with a semi-automated point-of-care (POC) analyser using standardised solutions and cat urine. METHODS Artificial solutions (negative and positive quality controls, and purposely designed artificial urine) and natural urine from 216 cats were used. Two urine reagent strips were simultaneously dipped in each sample. One dipstick was read by the SBCM and the other by the POC analyser at the same time. Results for pH, proteins, bilirubin, 'blood', glucose and ketones were considered. Overall agreement and sensitivity, specificity and accuracy of the SBCM were determined based on selected cut-offs. RESULTS For the artificial solutions, 80 comparisons were obtained for each analyte and each expected concentration. The overall agreement (exactly the same result) between the two methods was 78.4%. SBCM sensitivity, specificity and accuracy were 99.0%, 100% and 99.3%, respectively. The correlation between the two methods was almost perfect (Cohen's kappa coefficient = 0.9851). For natural urine samples, the overall agreement (including pH) was 68.6%. Using optimal cut-offs for the SBCM determined from the results of analysis of artificial solutions, the sensitivity, specificity and accuracy of the SBCM were 100%, 76.02% and 80.5%, respectively. In this situation, the correlation between the two methods was moderate (Cohen's kappa coefficient = 0.5401). This was mostly due to a high rate of false-positive results for bilirubin (61.1%). CONCLUSIONS AND RELEVANCE With proper cut-off use (ie, considering positive or negative results) the SBCM evaluated here has a perfect sensitivity and appropriate diagnostic performances for proteins, 'blood', glucose and ketones. Based on these experimental data, this method appears suitable for dipstick urinalysis but positive results for bilirubin and proteins have to be confirmed.
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Affiliation(s)
| | - Candice Gillet
- Université de Toulouse, ENVT, Toulouse, Occitanie, France
| | - Rachel Lavoué
- InTheRes, Université de Toulouse, INRAE, ENVT, Toulouse, Occitanie, France
| | - Didier Concordet
- InTheRes, Université de Toulouse, INRAE, ENVT, Toulouse, Occitanie, France
| | - Brice S Reynolds
- InTheRes, Université de Toulouse, INRAE, ENVT, Toulouse, Occitanie, France
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Smyroglou ED, Athanasiou LV, Baka RD, Polizopoulou ZS. Comparative Evaluation between Visual and Automated Dipstick Urinalyses in Dogs. Vet Sci 2023; 10:vetsci10040284. [PMID: 37104438 PMCID: PMC10142454 DOI: 10.3390/vetsci10040284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
Urine test strips are commercially available and can be assessed with semi-automated analyzers or by visual assessment. This study aimed to compare the visual and automated evaluations of dipstick variables in canine urine samples. One hundred and nineteen urine samples were evaluated. Automated analysis was performed on a veterinary urine analyzer URIT-50Vet (URIT Medical Electronic) with UC VET13 Plus strips. Multistix 10 SG dipsticks (Siemens Healthcare GmbH, Erlangen, Germany) were used for visual evaluation, along with a refractometer (Clinical Refractometer Atago T2-Ne, Atago Co., Tokyo, Japan) for urine specific gravity measurements. A linear relationship was observed between the pH measurements (p = 0.2) of the two methods; the Passing-Bablok procedure was valid since neither proportional nor systematic significant errors were observed. Comparing the two methods, the correlation for urine specific gravity was poor (p = 0.01, CI 0.667-1.000). Moderate agreement was demonstrated for proteins (κ = 0.431), bilirubin (κ = 0.434) and glucose (κ = 0.450). Agreement was substantial for blood (κ = 0.620) and poor for leukocytes (κ = 0.100). Poor agreement was observed for ketones (κ = -0.006). Apart from the pH analysis, visual and automated dipstick urinalyses should not be used interchangeably. Multiple urine samples obtained from the same dog during the day should be evaluated using the same method to overcome erroneous results.
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Affiliation(s)
- Erasmia D Smyroglou
- Diagnostic Laboratory, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Labrini V Athanasiou
- Clinic of Medicine, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece
| | - Rania D Baka
- Diagnostic Laboratory, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Zoe S Polizopoulou
- Diagnostic Laboratory, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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8
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Aldridge CF, Behrend EN, Smith JR, Welles EG, Lee HP. Accuracy of urine dipstick tests and urine glucose-to-creatinine ratios for assessment of glucosuria in dogs and cats. J Am Vet Med Assoc 2021; 257:391-396. [PMID: 32715884 DOI: 10.2460/javma.257.4.391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the accuracy of automated readings of urine dipstick results for assessment of glucosuria in dogs and cats, compare visual versus automated readings of urine glucose concentration, and determine the utility of the urine glucose-to-creatinine ratio (UGCR) for quantification of glucosuria. SAMPLE 310 canine and 279 feline urine samples. PROCEDURES Glucose concentration was estimated in 271 canine and 254 feline urine samples by visual assessment of urine dipstick results and with an automated dipstick reader. Absolute urine glucose and creatinine concentrations were measured in 39 canine and 25 feline urine samples by colorimetric assay with a clinical chemistry analyzer (reference standard for detection of glucosuria), and UGCRs were determined. RESULTS Automated assessment of the urine dipsticks yielded accurate results for 163 (60.1%) canine urine samples and 234 (92.1%) feline urine samples. Sensitivity of the automated dipstick reader for detection of glucosuria was 23% for canine samples and 68% for feline samples; specificity was 99% and 98%, respectively. Visual readings were more accurate than automated readings for both canine and feline urine. The UGCR was significantly correlated with absolute urine glucose concentration for both dogs and cats, yet there was incomplete distinction between dipstick categories for glucose concentration and UGCR. CONCLUSIONS AND CLINICAL RELEVANCE Urine dipstick readings for dogs and cats were useful for ruling glucosuria in when the result was positive but not for ruling it out when the result was negative. The evaluated dipsticks were more accurate for detection of glucosuria in cats than in dogs. Visual dipstick readings were more accurate than automated readings. The UGCR did not appear to provide additional useful information.
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9
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Zeugswetter FK, Schwendenwein I. Basal glucose excretion in dogs: The impact of feeding, obesity, sex, and age. Vet Clin Pathol 2020; 49:428-435. [PMID: 32970348 PMCID: PMC7702102 DOI: 10.1111/vcp.12899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/20/2020] [Accepted: 03/11/2020] [Indexed: 11/28/2022]
Abstract
Background The urine glucose (UG) measurements are an integral part of urinalyses, especially in dogs with polyuria and polydipsia. A positive dipstick result is considered pathologic for disease. This paradigm has been challenged by new ultrasensitive tests, where the manufacturers recommend tolerating slightly positive results. It implies that, as in other species, basal urine glucose losses can exceed the lower limits of detection using ultrasensitive glucose dipsticks in healthy dogs. Objectives We aimed to determine whether glucose is routinely detectable using a sensitive quantitative wet chemistry method in the urine of nondiabetic, nonazotemic dogs, and investigate the impact of food intake, obesity, sex, castration status, and age. Methods Serial UG measurements were performed in healthy clinic‐owned Beagle dogs that were randomly fasted or fed. Glucose was measured in morning urine samples from normal‐weight healthy and obese dogs, and the university's electronic database was searched for quantitative UG measurements (Gluco‐quant Enzyme Kit/Roche Diagnostics). Results Small amounts of glucose were detected in 555 (99.1%) of 560 urine samples analyzed. All urine samples from the clinic‐owned Beagle dogs, as well as from privately owned obese and normal‐weight healthy dogs that tested positive for glucose. The median (range) UG concentration obtained from the university's electronic database was 0.39 (0‐1.55) mmol/L, and 2.2% of the samples tested negative. Feeding, obesity, gender, castration status, and age did not affect UG concentrations. Conclusions Studies, including a larger number of healthy dogs, are warranted to define a cut‐off between physiologic and pathologic glucosuria.
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Affiliation(s)
- Florian K Zeugswetter
- Clinical Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Ilse Schwendenwein
- Department of Pathobiology, Central Laboratory, University of Veterinary Medicine Vienna, Vienna, Austria
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Arnold JE, Camus MS, Freeman KP, Giori L, Hooijberg EH, Jeffery U, Korchia J, Meindel MJ, Moore AR, Sisson SC, Vap LM, Cook JR. ASVCP Guidelines: Principles of Quality Assurance and Standards for Veterinary Clinical Pathology (version 3.0): Developed by the American Society for Veterinary Clinical Pathology's (ASVCP) Quality Assurance and Laboratory Standards (QALS) Committee. Vet Clin Pathol 2020; 48:542-618. [PMID: 31889337 DOI: 10.1111/vcp.12810] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Melinda S Camus
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | | | - Luca Giori
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Emma H Hooijberg
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Unity Jeffery
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jérémie Korchia
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, USA
| | | | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sandra C Sisson
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Linda M Vap
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Afsahi A, Ahmadi-Hamedani M, Khodadi M. Comparative evaluation of urinary dipstick and pH-meter for cattle urine pH measurement. Heliyon 2020; 6:e03316. [PMID: 32055734 PMCID: PMC7005549 DOI: 10.1016/j.heliyon.2020.e03316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/10/2019] [Accepted: 01/24/2020] [Indexed: 11/17/2022] Open
Abstract
Urinary dipsticks are often used for the diagnosis of kidney, liver, metabolic, and urogenital diseases in cattle clinical practice for the simplicity of use and ease of access. The aims of the present study were to evaluate the agreement between urinary dipsticks and pH-meter for the urine pH in dairy cattle, and also to compare the urine pH before and after centrifugation from each method. The agreement between urine dipstick and pH-meter methods before and after centrifuge were calculated by Passing-Bablok regression analysis demonstrated constant differences (intercept) at 0.60 and -1.01 and positive proportional differences (slope) at 0.94 and 1.13; respectively. Total bias estimated by Bland-Altman plot analysis before (0.20) and after (0.14) centrifuge were lower than the acceptable bias in urine samples. The regression analysis of this study emphasized that the urinary dipstick can be used to determine the cattle urine.
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Affiliation(s)
- Ali Afsahi
- Student Research Committee, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
| | - Mahmood Ahmadi-Hamedani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
| | - Mohammad Khodadi
- Student Research Committee, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
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12
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Evans SJM, Sharp JL, Vap LM. Optimizing the u411 automated urinalysis instrument for veterinary use. Vet Clin Pathol 2020; 49:106-111. [PMID: 31958148 DOI: 10.1111/vcp.12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/19/2019] [Accepted: 05/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Cobas u411 Analyzer (Roche Diagnostics) is an automated, reflectance photometry-based urinalysis instrument designed for use with Roche's CHEMSTRIP 10UA technology and human urine samples. OBJECTIVE We aimed to optimize and validate the Cobas u411 Analyzer for use in canine and feline urinalysis. METHODS Patient urine samples presenting to the Clinical Pathology Laboratory at the Colorado State University Veterinary Teaching Hospital were analyzed with the Cobas u411 and by manual readings in parallel. Initially, 223 canine and 83 feline urine samples were run using the u411 factory settings. Following comparisons with manual results, and evaluation for directional bias, adjustments to the reflectance values were made in the instrument's programming. An additional 183 canine and 95 feline samples were run using the adjusted settings. Total urine protein concentrations were measured in 48 samples and used to generate receiver operating characteristic curves for the protein test pad. RESULTS Following adjustments in reflectance programming, concordance between u411 and manual results was increased by 17.7% for protein, 11.7% for ketones, and 4.5% for bilirubin. Concordances for pH, glucose, and blood were not substantially changed. Discordance for all analytes was ≤3%. Canine and feline samples had similar levels of discordance, though marginal concordance was higher in dogs for ketones, bilirubin, and blood. CONCLUSIONS Adjustments to the reflectance programming of the Cobas u411 Analyzer improved concordance with manual results for canine and feline samples. This instrument has the potential to greatly increase both efficiency and consistency of urinalysis procedures in higher throughput veterinary diagnostic laboratories.
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Affiliation(s)
- Samantha J M Evans
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, USA
| | - Julia L Sharp
- Department of Statistics, College of Natural Sciences, Colorado State University, Fort Collins, CO, USA
| | - Linda M Vap
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, USA
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13
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Behrend EN, Botsford AN, Mueller SA, Hofmeister EH, Lee HP. Effect on urine specific gravity of the addition of glucose to urine samples of dogs and cats. Am J Vet Res 2019; 80:907-911. [PMID: 31556718 DOI: 10.2460/ajvr.80.10.907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of the addition of glucose to dog and cat urine on urine specific gravity (USG) and determine whether glucosuria affects assessment of renal concentrating ability. SAMPLE Urine samples from 102 dogs and 59 cats. PROCEDURES Urine for each species was pooled to create samples with various USGs. Glucose was added to an aliquot of each USG pool (final concentration, 2,400 mg/dL), and serial dilutions of the glucose-containing aliquot were created for each pool. The USG then was measured in all samples. The difference in USG attributable to addition of glucose was calculated by subtracting the USG of the unaltered sample from the USG of the sample after the addition of glucose. The relationship between the difference in USG and the USG of the unaltered, undiluted sample was evaluated by the use of linear regression analysis. RESULTS Addition of glucose to urine samples increased the USG. There was a significant relationship between USG of the undiluted sample and the difference in USG when glucose was added to obtain concentrations of 300, 600, 1,200, and 2,400 mg/dL in canine urine and concentrations of 600, 1,200, and 2,400 mg/dL in feline urine. The more concentrated the urine before the addition of glucose, the less change there was in the USG. Changes in USG attributable to addition of glucose were not clinically important. CONCLUSIONS AND CLINICAL RELEVANCE Substantial glucosuria resulted in minimal alterations in specific gravity of canine and feline urine samples. Thus, USG can be used to assess renal concentrating ability even in samples with glucosuria.
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Constable PD, Megahed AA, Hiew MWH. Measurement of urine pH and net acid excretion and their association with urine calcium excretion in periparturient dairy cows. J Dairy Sci 2019; 102:11370-11383. [PMID: 31548071 DOI: 10.3168/jds.2019-16805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/05/2019] [Indexed: 01/20/2023]
Abstract
Urine pH (UpH) and net acid excretion (NAE) are used to monitor the degree of systemic acidification and predict the magnitude of resultant hypercalciuria when feeding an acidogenic ration to control periparturient hypocalcemia in dairy cattle. The objectives of this study were to evaluate the diagnostic performance of urine dipstick and pH paper for measuring UpH, and to characterize the UpH-NAE relationship and the association of urine Ca concentration ([Ca]) with UpH and NAE. Urine samples (n = 1,116) were collected daily from 106 periparturient Holstein-Friesian cows fed an acidogenic ration during late gestation. Net acid excretion was measured by titration, and UpH was measured by a glass-electrode pH meter (reference method), Multistix-SG urine dipsticks (Siemens Medical Solutions Inc., Ann Arbor, MI), and Hydrion pH paper (Micro Essential Laboratory Inc., Brooklyn, NY). Diagnostic performance was evaluated using Spearman correlation coefficient (rs), Bland-Altman plots, and logistic regression. Urine pH measured by urine dipstick (rs = 0.94) and pH paper (rs = 0.96) were strongly associated with UpH. Method-comparison studies indicated that the urine dipstick measured an average of 0.28 pH units higher, and pH paper 0.10 pH units lower, than UpH. Urine [Ca] was more strongly associated with UpH (rs = -0.65) than NAE (rs = 0.52). Goals for controlling periparturient hypocalcemia under the study conditions were UpH <6.22 and <6.11, based on achieving urine [Ca] ≥5 mmol/L and estimated urinary Ca excretion ≥4 g/d, respectively. Urine pH was as accurate at predicting urine [Ca] as NAE when UpH >6.11. We conclude that pH paper is an accurate, practical, and low-cost cow-side test for measuring UpH and provides a clinically useful estimate of urine [Ca].
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Affiliation(s)
- P D Constable
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign 61802.
| | - A A Megahed
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign 61802; Department of Animal Medicine, Internal Medicine, Faculty of Veterinary Medicine, Benha University, Moshtohor-Toukh, Kalyobiya, 13736, Egypt
| | - M W H Hiew
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra, Selangor, 43400, Malaysia
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The diagnostic performance of human urinary dipsticks to estimate urine pH, specific gravity (SpG), and protein in horses: are they reliable? BMC Vet Res 2019; 15:242. [PMID: 31300054 PMCID: PMC6626356 DOI: 10.1186/s12917-019-1998-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/08/2019] [Indexed: 11/29/2022] Open
Abstract
Background Urinalysis is a critical diagnostic test which is performed in routine veterinary medicine practice. In this diagnostic test, semiquantitative measurement of urine biochemical substances is carried out using urinary dipstick. In the current study, we evaluated the diagnostic performance of human urinary dipsticks to estimate pH, specific gravity (SpG), and protein in 80 urine specimens collected from horses. These parameters were measured using two commercial human dipsticks (KP and MN in abbreviation) and quantitative reference methods. The reference methods for pH, SpG, and protein were pH meter, handheld refractometer, and pyrogallol red method, respectively. The correlation between the semiquantitative dipstick analysis and quantitative reference methods was determined using Spearman’s rank correlation coefficient. Results In general, our results revealed that the both human urinary dipsticks are unreliable tests for urinary pH, SpG, and protein content in horses. The analysis indicated that there was a poor correlation between the urine dipsticks and reference method (KP: rS = 0.534 and MN: rs = 0.485, Ps < 0.001) for protein. Additionally, there was a weak correlation between the results of pH measured using the urine dipsticks and reference method (KP: rS = 0.445 and MN: rs = 0.370, Ps < 0.001). Similar findings were obtained for SpG (KP: rS = 0.285, MN: rs = 0.338, Ps < 0.001). The estimation of proteinuria using the human dipsticks in horses lacked specificity, as many false positive protein results were obtained. Conclusion We observed that the human commercial urinary dipsticks used in this study were not reliable to correctly estimate urine protein, SpG, and pH in horses.
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Woodburn EV, Long KD, Cunningham BT. Analysis of Paper-Based Colorimetric Assays With a Smartphone Spectrometer. IEEE SENSORS JOURNAL 2019; 19:508-514. [PMID: 31579394 PMCID: PMC6774390 DOI: 10.1109/jsen.2018.2876631] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We report on the adaptation of a smartphone's rear-facing camera to function as a spectrometer that measures the spectrum of light scattered by common paper-based assay test strips. We utilize a cartridge that enables a linear series of test pads in a single strip to be swiped past the read head of the instrument while the phone's camera records video. The strip is housed in a custom-fabricated cartridge that slides through the instrument to facilitate illumination with white light from the smartphone's flash LED that is directed through an optical fiber. We demonstrate the ability to detect subtle changes in the scattered spectrum that enables quantitative analysis of single-analyte and multi-analyte strips. The demonstrated capability can be applied to broad classes of paper-based assays in which visual observation of colored strips is not sufficiently quantitative, and for which analysis of red-green-blue pixel values of a camera image are not capable of measuring complex scattered spectra.
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Affiliation(s)
- Elizabeth V Woodburn
- E. V. Woodburn was with the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA. She is now with the Carle Illinois College of Medicine, Champaign, IL 61820 USA . K. D. Long is with the Department of Bioengineering, University of Illinois at Urbana-Champaign and the College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA . B. T. Cunningham is with the Department of Electrical and Computer Engineering and the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA
| | - Kenneth D Long
- E. V. Woodburn was with the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA. She is now with the Carle Illinois College of Medicine, Champaign, IL 61820 USA . K. D. Long is with the Department of Bioengineering, University of Illinois at Urbana-Champaign and the College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA . B. T. Cunningham is with the Department of Electrical and Computer Engineering and the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA
| | - Brian T Cunningham
- E. V. Woodburn was with the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA. She is now with the Carle Illinois College of Medicine, Champaign, IL 61820 USA . K. D. Long is with the Department of Bioengineering, University of Illinois at Urbana-Champaign and the College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA . B. T. Cunningham is with the Department of Electrical and Computer Engineering and the Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801 USA
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Herman N, Bourgès-Abella N, Braun JP, Ancel C, Schelcher F, Trumel C. Urinalysis and determination of the urine protein-to-creatinine ratio reference interval in healthy cows. J Vet Intern Med 2019; 33:999-1008. [PMID: 30768734 PMCID: PMC6430871 DOI: 10.1111/jvim.15452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 01/30/2019] [Indexed: 12/02/2022] Open
Abstract
Background There are no reference intervals for urinalysis in cattle. Hypothesis/Objectives Characterize the urine of healthy cows, establish urine protein‐to‐creatinine ratio (UPC) reference intervals, and test possible differences among dairy and beef cattle, age groups, or stage of lactation. Animals Seventy‐seven dairy and 74 beef 2.5 to 17 year‐old cows of different breeds housed mainly in free stall. Methods In this prospective study, urine specimens were collected by catheterization. Complete urinalysis was performed within 1 hour including specific gravity, dipstick evaluation, visual urine pH evaluation with 0.3 pH unit graded strips, and microscopic evaluation of the sediment. Urinary protein and creatinine concentrations and protein electrophoresis were determined on frozen aliquots. Results Overall reference intervals were 1.020 to 1.045 for USG, 7.0 to 8.7 for pH, and 0.04 to 0.25 for UPC; because of differences in creatinine concentration, UPC was lower in beef (0.04‐0.14) than in dairy (0.05‐0.25) cows and in the latter in dry than lactating cows. With dipstick evaluation, most analytes were absent except for blood, ketone, and protein in 24.7, 16.0, and 64.7% of cases, respectively. Microscopic evaluation revealed less than 3 red blood cells, leukocytes, and epithelial cells in 84, 99.3, and 100% cows, respectively. No band was observed at electrophoresis, except in 1 case at MW ~66 000. Conclusions and Clinical Importance Creatininuria is higher in beef than dairy cows and proteinuria is likely more efficiently characterized by protein concentration than by UPC.
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Affiliation(s)
- Nicolas Herman
- Département Elevage et Produit, Santé Publique Vétérinaire, Ecole Nationale Vétérinaire de Toulouse, Université de Toulouse, Toulouse, France
| | | | - Jean-Pierre Braun
- Département Elevage et Produit, Santé Publique Vétérinaire, Ecole Nationale Vétérinaire de Toulouse, Université de Toulouse, Toulouse, France
| | - Camille Ancel
- Département Elevage et Produit, Santé Publique Vétérinaire, Ecole Nationale Vétérinaire de Toulouse, Université de Toulouse, Toulouse, France
| | | | - Catherine Trumel
- CREFRE, Université de Toulouse, INSERM, UPS, ENVT, Toulouse, France
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Zeugswetter FK, Polsterer T, Krempl H, Schwendenwein I. Basal glucosuria in cats. J Anim Physiol Anim Nutr (Berl) 2019; 103:324-330. [PMID: 30375076 PMCID: PMC7379708 DOI: 10.1111/jpn.13018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/02/2018] [Accepted: 10/02/2018] [Indexed: 12/15/2022]
Abstract
Objective of this study was to demonstrate the ubiquitous presence of glucose in urine of euglycemic cats by a highly sensitive glucose assay. The local electronic database was searched for results of quantitative urine glucose measurements in cats. A total of 325 feline urine glucose measurements were identified, of which 303 (93%) had been submitted by one of the co-authors working in a near-by small animal practice. After the exclusion of patients with kidney disease (n = 60), hyperthyroidism (n = 15), diabetes mellitus (n = 11), multiple diseases (n = 9) or steroid treatment (n = 3), as well as serial measurements (n = 87) and outliers (n = 8), the final study population consisted of 132 cats. Urine creatinine concentration was unavailable in five patients. Whereas all but one cat had glucose concentrations above the detection limit of the assay (0.11 mmol/L, Gluco-quant Enzyme Kit/Roche Diagnostics), no positive glucose dipstick test result (Combur 9-Test, Roche Diagnostics) was observed. The median (range) of urinary glucose concentration and the glucose-to-creatinine ratio (UGCR) was 0.389 (<0.11-1.665) mmol/L and 0.0258 (0.007-0.517) respectively. The UGCR was not affected by age, gender, breed or leukocyturia, whereas cats with hematuria had slightly higher values. Data show that so-called "basal glucosuria" is present in the majority of cats and by no means diagnostic for diabetes mellitus or renal glucosuria. This has to be considered when using bio-analytical methods with a low limit of quantification.
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Affiliation(s)
- Florian Karl Zeugswetter
- Clinical Department for Companion Animals and HorsesUniversity of Veterinary MedicineViennaAustria
| | - Theresa Polsterer
- Clinical Department for Companion Animals and HorsesUniversity of Veterinary MedicineViennaAustria
| | | | - Ilse Schwendenwein
- Department of PathobiologyUniversity of Veterinary MedicineViennaAustria
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Ferreira MDF, Garcia Arce M, Handel IG, Breheny CR, Gow AG. Urine dipstick precision with standard visual and automated methods within a small animal teaching hospital. Vet Rec 2018; 183:415. [DOI: 10.1136/vr.104841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/26/2018] [Accepted: 05/07/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Marisa da Fonseca Ferreira
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh; Roslin Midlothian UK
| | - Marta Garcia Arce
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh; Roslin Midlothian UK
| | - Ian Graham Handel
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh; Roslin Midlothian UK
| | - Craig Robert Breheny
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh; Roslin Midlothian UK
| | - Adam George Gow
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh; Roslin Midlothian UK
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Vientós-Plotts AI, Behrend EN, Welles EG, Chew DJ, Gaillard PR, Busler JN, Lee HP. Effect of blood contamination on results of dipstick evaluation and urine protein-to-urine creatinine ratio for urine samples from dogs and cats. Am J Vet Res 2018; 79:525-531. [DOI: 10.2460/ajvr.79.5.525] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Athanasiou LV, Katsoulos PD, Katsogiannou EG, Polizopoulou ZS, Diamantaki M, Kamatsos C, Christodoulopoulos G. Comparison between the urine dipstick and the pH-meter to assess urine pH in sheep and dogs. Vet Clin Pathol 2018; 47:284-288. [DOI: 10.1111/vcp.12581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Labrini V. Athanasiou
- Department of Medicine; Faculty of Veterinary Medicine; University of Thessaly; Karditsa Greece
| | - Panagiotis D. Katsoulos
- Clinic of Farm Animals; Faculty of Veterinary Medicine; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Eleni G. Katsogiannou
- Department of Medicine; Faculty of Veterinary Medicine; University of Thessaly; Karditsa Greece
| | - Zoe S. Polizopoulou
- Diagnostic Laboratory; Faculty of Veterinary Medicine; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Myrto Diamantaki
- Department of Medicine; Faculty of Veterinary Medicine; University of Thessaly; Karditsa Greece
| | - Constantinos Kamatsos
- Department of Medicine; Faculty of Veterinary Medicine; University of Thessaly; Karditsa Greece
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Reppas G, Foster SF. Practical urinalysis in the cat: 1: Urine macroscopic examination 'tips and traps'. J Feline Med Surg 2016; 18:190-202. [PMID: 26936492 PMCID: PMC11148903 DOI: 10.1177/1098612x16631228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
SERIES OUTLINE This is the first article in a two-part series on urinalysis in the cat. The focus of Part 1 is urine macroscopic examination. Part 2, to appear in the May 2016 issue, discusses urine microscopic examination. PRACTICAL RELEVANCE Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results. CLINICAL CHALLENGES For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process. AUDIENCE Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both can potentially benefit. EQUIPMENT Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances. EVIDENCE BASE Evidence for much of the data on urinalysis in cats is lacking. Validation of the human equipment used routinely, such as dipsticks, is also lacking. As such, the evidence base for feline urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.
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Affiliation(s)
- George Reppas
- Vetnostics, 60 Waterloo Road, North Ryde, NSW 2113, Australia
| | - Susan F Foster
- Vetnostics, 60 Waterloo Road, North Ryde, NSW 2113, Australia
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Abstract
Performing a urinalysis should be part of a minimum database in addition to physical examination, historical information gathering, complete blood cell counts, and serum/plasma biochemical analysis. Urinalysis provides information on function of various organs and information on renal function. It is necessary to interpret blood urea nitrogen and serum/plasma creatinine concentrations and is useful in assessing urine concentrating and diluting ability, glomerular barrier function, tubular function, proteinuria, discolored urine, urolithiasis, and neoplasia. Performing a urinalysis is technically easy and does not require expensive equipment or disposable supplies.
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Affiliation(s)
- Amanda J Callens
- Department of Internal Medicine, Cornell University Veterinary Specialists, 880 Canal Street, Stamford, CT 06902, USA
| | - Joseph W Bartges
- Department of Internal Medicine, Cornell University Veterinary Specialists, 880 Canal Street, Stamford, CT 06902, USA.
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