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59 Cards in this Set
- Front
- Back
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What is the functional unit of the kidney?
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The nephron
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What are the 2 main functions of the kidney?
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Filtration
Re-absorption |
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What is the first step in urine formation?
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Filtration of substances from Glomerulus to Bowman's capsule.
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The degree of filtration that occurs from the Glomerulus to the Bowman's capsule is affect by what 3 things?
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-BLOOD PRESSURE
ex.- Anesthesia induced hypotension leads to less being forced across and filtered -ACTUAL AMOUNT OF BLOOD REACHING GLOMERULUS ex.-Shock-blood pools in capillaries and there ore decreases blood flow to vital organs and filtration -FOLLOW LAWS OF DIFFUSION. SUBSTANCES MOVE FROM HIGHER TO LOWER CONCENTATION |
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What substances are freely filtered, allowed to diffuse, from the Glomerulus to the Bowmans's capsule?
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Water
Electrolytes Glucose Amino acids Urea and Creatinine:Non-protein nitrogenous waste products |
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Urea comes from
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Protein breakdown.
Protein breakdown creates ammonia-->which is converted by the liver to urea--->becomes urea. |
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Liver failure leads to a decreased or absent ability to convert _______, which leads to a ___________.
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ammonia to urea
decreased BUN |
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Creatinine comes from___________.
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Muscle cell metabolism
contraction --->creatinine ---> urine |
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The second step of Urine formation is______?
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Reabsorption of substances from the renal tubules to the bloodstream
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What are 2 main items that control reabsorption?
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-HORMONES THAT ACT ON RENAL TUBULES
-GLUCOSE |
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What are the 2 hormones responsible for acting on renal tubules and where do they come from?
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ADH: released from pituatary and tells renal tubules to REABSORB water
ALDOSTERONE:released from adrenals and controls Sodium REABSORPTION and Potassium EXCRETION. |
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What is the normal blood glucose level for dogs?
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100mgs/dl
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What is the renal threshold for glucose?
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160-180mgs/dl
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In a normal animal, the blood level of glucose is below the renal threshold and therefore ________ glucose gets reabsorbed back into the bloodstream.
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ALL
*therefore there should be NO glucose in the urine |
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In a Pt with DM, blood level of glucose is _________ renal threshhold, which leads to the glucose___________ back to bloodstream and spilling over into the urine leading to ___________.
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ABOVE
not being reabsorbed glycosuria |
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The 3rd step of urine formation is ________________?
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Storage of and excretion from the urinary bladder.
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What are the 3 steps of urine formation?
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-Filtration
-Reabsorption -Storage & excretion |
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In general, urine obtained _________ is acceptable for screening urine changes.
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anytime of day
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Urine samples obtained in the morning, due to reduced water intake overnight, tends to have the following advantages:
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-More likely to show concentration.
*normal morning sample is dark yellow. RENAL FAILURE patients cannot can't concentrate urine due to inability to reabsorb water, so water goes to bladder leading to a more dilute urine. |
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Disadvantage of early morning urine sample collection is:
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Gives a POOR cytology sample because urine has been sitting for awhile. (old urine = old cells).
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A recently formed urine sample where the animal has been drinking and urinating, such as in the afternoon, has what advantage?
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-Good for cytology because fresh urine + fresh cells
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A recently formed urine sample where the animal has been drinking and urinating, such as in the afternoon, has what DISADVANTAGES?
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-May not show urine concentration
-If urine is very dilute, then chances of observing abnormalities are DECREASED. *Very Dilute urine (hypotonic solution) can make cells such as RBC swell and burst. |
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What are the 4 methods of urine collection?
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-Voided/Free Catch
-Manual expression -Catheterization -Cystocentesis |
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What are the advantages of Voided/Free catch urine collection method?
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-Easiest on animal
-No iatrogenic trauma/infection -Client can do this and bring in a sample |
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What are the DISadvantages of Voided/Free catch urine collection method?
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-May not have a cooperative animal who will urinate now when you need the sample.
-Contamination with bacteria makes this a less ideal method for sample needed for urine culture |
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What are some suggested methods for voided sample collection for cats?
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-empty litter pan
-pan with plastic beads, packaging peanuts -saran wrap or trash bag lined litter pan with a small amount of litter |
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What is the advantage of Manual expression urine collection method?
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-Gets the bladder out of the way for Sx
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What are the DISadvantages of Manual expression urine collection method?
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-Similar to voided sample, due to possible contamination, less ideal for bacterial culturing.
-May require anesthesia. -Big dogs with tense abdominal muscles may be more difficult -May cause iatrogenic trauma and infection to bladder, leading to infection. -Can rupture the bladder -If patient has Cystitis, you can cause a retrograde infection leading to pyelonephritis. -NEVER express a bladder if a urinary obstruction is suspected. |
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What are the advantages of Catheterization urine collection method?
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-Can usually get a sample right away
-Can relieve a urinary obstruction -Monitor urinary output when using a Foley cath. -Good method for urine culture |
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What are the DISadvantages of Catheterization urine collection method?
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-Iatrogenic trauma, infection
-May require anesthesia, esp. in cats and female dogs |
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When you collect urine via a catheter, what should you do with the first part of the collected sample?
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Discard it to decrease chances of bacterial contamination.
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What are the advantages of Cystocentesis urine collection method?
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-Can usually get sample right away.
-Does NOT require anesthesia *animals tend to tolerate cysto better than cath. -BEST method for urine culture |
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What are the DISadvantages of Cystocentesis urine collection method?
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-Iatrogenic trauma --->increased RBC's
-Iatrogenic infection |
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How is the bladder located for Cystocentesis?
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-Palpated
-Female dogs: in dorsal recumbancy. drip alcohol on abdomen puncture mid-pool to find bladder. -X marks the spot between the last 2 sets of nipples in female dogs |
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What size of needle and syringe are recommended for cystocentesis?
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22g, 1 to 1.5 inches in length
6cc to 12cc syringe |
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Cystocentesis can be done in ________ as well.
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Lateral or standing
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When doing a cysto, you should draw as much urine as possible. As the bladder shrinks, the wall thickens, which leads to _________.
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The puncture hole closes.
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When doing a cysto, if you do not hit the bladder _________________ but NEVER EVER ______________.
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Backout with negative pressure
REDIRECT-you could hit the colon, leading to urinary bladder and sample contamination. |
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Urine samples are fragile and should be examined within ________ minutes.
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30 minutes at room temp
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If a urine sample is allowed to stand at room temp, then over time___________
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bacteria multiply,
crystals increase in number, urine gets cloudy, cells disintegrate, casts breakdown, ph changes-tends to increase due to loss of CO2, making sample more alkaline, typically due to urease positive bacteria |
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How long can a sample be refrigerated if unable to do ASAP?
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6 hours
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To chemically preserve urine, use ____________ but do _____________ before adding.
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1gtt of 40% formaldehyde
Chemistries with Dip stick |
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What are the 4 parts of a U/A?
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-Macroscopic evaluation
-USG (urine specific gravity) -Urine Chemistries -Microscopic evaluations |
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What is the purpose of urinalysis?
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Determines the function of kidney and other organs
-pancrease-glucose liver-bilirubin |
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When a RBC is lysed, it releases Hgb, which then goes to the __________ to become _________.
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Liver
conjugated bilirubin |
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During Macroscopic evaluation of a U/A, what is checked?
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Color
-Normal-Straw to amber -High concentration-high concentration due to less water Clarity/transparency, |
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What are some reason for discolored urine?
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-HEMATURIA-RBCs in urine
-Red to reddish brown but can be missed on Macro eval if in low #'s -HEMOGLOBINURIA-Hgb in urine -red to reddish brown, sometimes transparent. Plasma is often hemolytic with this as well. -MYOGLOBIN-O2 carrying pigment of muscle cells -Red to reddish brown, sometimes transparent. Plasma will be clear. -BILIRUBINURIA- -yellow, yellow-orange, yellow-brown to green. **Will stain fingers -Misc-psuedomonas, drugs |
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What are some causes of RBC's in urine?
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Inflammation
trauma urolithiasis neoplasia coagulopathy rough cysto catherization manual expression |
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What are some causes of Hemoglobin in the urine?
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-IAHA
-Incompatible blood type transfusion -Toxins/poisons/snake venom -RBC parasites (mycoplasma is common) |
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Causes of Myoglobinuria are:
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-Muscle cell damage due to exertional rhabdomyalisis, HBC, heat stroke, electric shock, crush injuries, shock,snake bites
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Causes of Bilirubinuria are:
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Excessive hemolysis
HBO-hepatobiliary obstruction Liver disease-sick liver "forgets" how to store bilirubin |
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When evaluating U/A for color, transparency, what type of container should you use?
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Clear
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What is the normal color for carnivores urine?
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Typically clear/transparent but with increased concentration may appear hazy
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What is the normal color for Equine urine?
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cloudy, due to crystals and mucous
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What is the normal color for ruminents urine?
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Clear, when freshly excreted
cloudy when it sits |
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What is the normal color for lab animals urine?
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Cloudy almost milky due to crystals
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If urine has a strong ammonia smell, it may indicate ___________.
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cystitis due to urease + bacteria.
Urease converts urea to ammonia and thus you get alkaline urine which us a high ph. |
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If urine has a sweet fruity smell, it may indicate __________
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infection with pseudamonas
ketones due to DM. |
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Foamy urine typically indicates_______ .
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protein in the urine.
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