Search

Objective: To determine the accuracy of 4 preoperative parameters (signalment, urinalysis, urine microbiological culture, and digital radiography) in predicting urocystolith composition, compare accuracy between evaluators of varying clinical experience and a mobile application, and propose a novel algorithm to improve accuracy., Animals: 175 client-owned dogs with quantitative analyses of urocystoliths between January 1, 2012, and July 31, 2020., Methods: Prospective experimental study. Canine urocystolith cases were randomly presented to 6 blinded "stone evaluators" (rotating interns, radiologists, internists) in 3 rounds, each separated by 2 weeks: case data alone, case data with a urolith teaching lecture, and case data with a novel algorithm. Case data were also entered into the Minnesota Urolith Center mobile application. Prediction accuracy was determined by comparison to quantitative laboratory stone analysis results., Results: Prediction accuracy of evaluators varied with experience when shown case data alone (accuracy, 57% to 82%) but improved with a teaching lecture (accuracy, 76% to 89%) and further improved with a novel algorithm (accuracy, 93% to 96%). Mixed stone compositions were the most incorrectly predicted type. Mobile application accuracy was 74%., Clinical Relevance: Use of the 4 preoperative parameters resulted in variable accuracy of urocystolith composition predictions among evaluators. The proposed novel algorithm improves accuracy for all clinicians, surpassing accuracy of the mobile application, and may help guide patient management.

Objective: To collect voided urine from dogs with clinical signs of lower UTI and determine the diagnostic performance of a commercially available rapid immunoassay (RIA) immediately after urine collection and after refrigeration at 4 and 24 hours., Animals: 40 client-owned dogs., Methods: Aerobic urine culture was performed on urine collected by cystocentesis. Urine samples were collected by voiding, and the RIA performed in triplicate within 30 minutes (time 0) and again in triplicate after 4 and 24 hours of refrigeration. Test precision and agreement between culture results and RIA results at each time point were determined, and factors possibly associated with false results investigated., Results: 14 of 40 dogs (35%) had UTI verified by aerobic urine culture, and all had positive RIA. Three dogs had false positive RIA results. Sensitivity, specificity, positive predictive value, and negative predictive value of the RIA were 100, 88%, 82%, and 100%, respectively, and results were not different after 4 and 24 hours of refrigeration. Precision was excellent., Clinical Relevance: This point-of-care RIA, performed on voided urine refrigerated up to 24 hours, rapidly and accurately identifies bacteriuria in dogs with lower urinary tract clinical signs, inexpensively.

Objective: To evaluate the urine cortisol-to-creatinine ratio (UCCR) for the diagnosis of hypoadrenocorticism (HA) in dogs and to determine whether the method of urine cortisol measurement affects results., Animals: 41 dogs with naturally occurring HA and 107 dogs with nonadrenal illness., Procedures: Urine samples were prospectively collected from dogs undergoing testing for HA. Urine cortisol concentrations were measured at a veterinary diagnostic laboratory using either a radioimmunoassay (RIA) or a chemiluminescent immunoassay (CLIA). Receiver operating characteristic (ROC) curves were constructed to assess UCCR performance by both methods for HA diagnosis. Sensitivities, specificities, accuracies, and predictive values were calculated for various cutpoints., Results: The areas under the ROC curves for UCCR diagnosis of HA were 0.99 (95% CI, 0.98 to 1.00) and 1.00 (95% CI, 1.00 to 1.00) when urine cortisol was determined by RIA and CLIA, respectively. An RIA UCCR of ≤ 2 was 97.2% sensitive, 93.6% specific, and 94.7% accurate for HA diagnosis, whereas a CLIA UCCR of ≤ 10 was 100% sensitive, specific, and accurate. An RIA UCCR > 4 and a CLIA UCCR of > 10 had negative predictive values of 100%., Clinical Relevance: The UCCR was an accurate diagnostic test for HA in this study population, although equivocal results are possible. Case characteristics, method of cortisol measurement, and laboratory-specific cutpoints must be considered when interpreting results.

OBJECTIVE To examine the effect of 24 hours of refrigeration on urine samples collected from dogs with signs of urinary tract infection (UTI). DESIGN Prospective cross-sectional study. ANIMALS 104 dogs with signs consistent with UTI that had a urine sample collected via cystocentesis as part of their diagnostic workup. PROCEDURES A 1-mL aliquot of each urine sample was refrigerated at 5°C for 24 hours in a plain glass tube, then processed for quantitative bacterial culture (QBC). A 0.5-mL aliquot was added to 3 mL of tryptic soy broth (TSB) and refrigerated at 5°C for 24 hours, then processed for QBC. The remaining portion was immediately processed for QBC, with results reported as numbers of bacterial colony-forming units (CFUs). Sensitivity of the QBC for detection of bacteria (and therefore UTI) was determined for sample refrigeration in the 2 conditions, compared with immediate processing (reference standard). RESULTS Bacterial growth was identified in 35.6% (n = 37), 33.7% (35), and 31.7% (33) of the immediately processed, refrigerated, and refrigerated-in-TSB urine samples, respectively. Sample refrigeration without TSB resulted in no significant difference in CFU counts relative to immediate processing; however, the sensitivity of this method was 95% (35/37). Sample refrigeration with TSB resulted in significantly lower CFU counts, and sensitivity was only 89% (33/37). CONCLUSIONS AND CLINICAL RELEVANCE Canine urine samples collected for bacterial culture should be immediately submitted for testing. Although CFU counts for refrigerated and immediately processed samples were statistically similar in this study, sample refrigeration in enrichment broth resulted in imperfect sensitivity for UTI detection and is not recommended.

OBJECTIVE To determine the prevalence of bacteriuria (ie, a positive microbial culture result for ≥ 1 urine sample) in dogs with chronic kidney disease (CKD) and characterize findings of subclinical bacteriuria (SBU), bacterial cystitis, or pyelonephritis in these patients. DESIGN Retrospective, observational study. ANIMALS 182 dogs. PROCEDURES Medical records from January 2010 through July 2015 were reviewed to identify dogs with CKD that underwent urinalysis and urine microbial culture. Signalment, clinicopathologic data, stage of CKD according to previously published guidelines, results of urinalysis and urine culture, and abdominal ultrasonographic findings were recorded. Dogs with positive urine culture results were categorized as having SBU, bacterial cystitis, or pyelonephritis on the basis of these data. Prevalence of bacteriuria was calculated. Associations between CKD stage, presence of bacteriuria, and diagnosis category were analyzed statistically. RESULTS 33 of 182 (18.1%) dogs (40/235 [17.0%] urine samples) had positive culture results. All dogs received antimicrobials on the basis of culture and susceptibility test findings. Most positive culture results (18/40 [45%] samples) were found for dogs with SBU, followed by dogs with pyelonephritis (16/40 [40%]) and cystitis (6/40 [15%]). Escherichia coli was the most frequently observed isolate (29/40 [73%] cultures from 25/33 dogs). The CKD stage was not associated with presence of bacteriuria or diagnosis category. CONCLUSIONS AND CLINICAL RELEVANCE The prevalence of positive urine culture results in dogs with CKD was lower than that reported for dogs with some systemic diseases that may predispose to infection. Prospective research is needed to assess the clinical importance of SBU in dogs with CKD.

OBJECTIVE To evaluate the clinical performance of a commercially available compartmentalized urine culture and antimicrobial susceptibility test plate (CCSP) for identification of canine bacteriuria and assessment of isolate antimicrobial susceptibility. DESIGN Cross-sectional study. ANIMALS 71 dogs. PROCEDURES Urine samples (n = 84) were divided into 3 aliquots. One aliquot (reference culture) was plated on culture medium ≤ 1 hour after collection for quantitative culture and testing by standard laboratory methods, another was stored at 4°C for 24 hours (to mimic storage practices at primary care facilities) and then processed by standard methods, and the third was applied to a CCSP ≤ 1 hour after collection to be processed and interpreted according to manufacturer instructions. Results were compared with those for reference culture, which was used as the criterion reference standard. Sensitivity, specificity, positive and negative predictive values, and agreement between methods was evaluated. RESULTS 43 isolates (25 single and 9 multiple isolates) were identified in 34 reference cultures. All results for stored cultures were identical to those for reference cultures. Overall sensitivity of the CCSP method to detect bacteriuria was 93%, and specificity was 100%. Thirty-three of 43 (77%) and 19 of 33 (58%) CCSP bacterial isolates were correctly identified to the genus and species level, respectively. The CCSP antimicrobial susceptibility results matched those for reference cultures for 13 of 33 (39%) isolates evaluated. CONCLUSIONS AND CLINICAL RELEVANCE Limitations of the CCSP method included inaccuracy of some antimicrobial susceptibility test results and failure to correctly identify bacteriuria in some dogs.

OBJECTIVE To use variable-number tandem-repeat (VNTR) analysis to determine the infecting serovar and strain for leptospiral DNA isolated from canine urine samples confirmed through PCR testing to contain pathogenic leptospires and to evaluate the sensitivity and specificity of microscopic agglutination testing (MAT) for identifying the infecting serogroup. DESIGN Diagnostic survey and test evaluation. SAMPLE Leptospiral DNA isolated from urine samples from 98 dogs confirmed through PCR testing to have pathogenic leptospires in their urine. PROCEDURES VNTR analysis of DNA isolates was performed to identify the infecting leptospiral serovar and strain by use of primer pairs for the loci 4, 7, 10, and Lb5. Eighteen pathogenic and 2 saprophytic leptospiral serovars were used as reference strains for VNTR analysis. Results of MAT were compared with those of the PCR assay and VNTR analysis to determine the sensitivity and specificity of MAT for diagnosing leptospirosis and identifying the infecting serovar at various reciprocal titers. RESULTS VNTR analysis identified Leptospira kirschneri serovar Grippotyphosa strain DF as the most common infecting serovar in dogs (78/98 [80%]). Thirteen unique VNTR patterns could not be identified by comparison with the Leptospira reference strains used. The MAT had a maximum sensitivity of 41% and a specificity of 100% for identifying Grippotyphosa as the infecting serogroup. CONCLUSIONS AND CLINICAL RELEVANCE Findings confirmed the importance of Leptospira serovar Grippotyphosa among dogs in the United States. Serologic testing had poor sensitivity for identifying the infecting serogroup, and conclusions about emerging serogroups should be cautiously interpreted when serologic data are reported.

Objective-To compare urine protein-to-creatinine concentration (UPC) ratios in samples collected by means of cystocentesis versus manual compression in cats. Design-Evaluation study. Animals-43 client-owned cats requiring urinalysis. Procedures-In all cats, 5 mL of urine from the midstream phase of micturition was collected by means of manual compression and, subsequently, an additional 5 mL of urine was obtained by means of ultrasound-guided cystocentesis. A complete urinalysis was performed on all samples, and UPC ratios were determined. Results-Cats were classified on the basis of the International Renal Interest Society substaging system as being free from proteinuria (UPC ratio, < 0.2; n = 19) or as having borderline proteinuria (UPC ratio, 0.2 to 0.4; 7) or proteinuria (UPC ratio, > 0.4; 17). None of the cats had postrenal proteinuria. A significant linear correlation was identified between UPC ratios in urine samples obtained by means of manual compression and ratios in samples obtained by means of cystocentesis. For all cats, UPC ratios for samples obtained by the 2 collection methods resulted in classification in the same IRIS substage. Conclusions and Clinical Relevance-Results suggested that collection of a urine sample from the midstream phase of micturition by manual compression would be a reliable alternative to cystocentesis for the determination of UPC ratio in cats, provided that postrenal proteinuria was excluded by means of urine sediment analysis. Once postrenal proteinuria was ruled out, the method used to collect urine samples did not appear to influence the quantification of urine protein concentration.

Objective: To assess whether urine protein-to-creatinine (UPC) ratios determined in urine samples collected by cystocentesis versus those collected by free catch provide similar diagnostic information for dogs., Design: Evaluation study., Animals: 115 client-owned dogs evaluated because of various health problems requiring urinalysis or to screen for proteinuria in an area endemic for leishmaniasis., Procedures: 230 paired urine samples, 1 collected by cystocentesis and 1 by free catch, were collected from the 115 dogs. The UPC ratio was determined in paired urine samples (n = 162) from 81 dogs with no indication of active inflammation according to urine sediment analysis. On the basis of the UPC ratio of urine sample collected by cystocentesis, dogs were classified as nonproteinuric (UPC ratio < 0.2), borderline proteinuric (UPC ratio of 0.2 to 0.5), or proteinuric (UPC ratio > 0.5), according to the International Renal Interest Society (IRIS)., Results: The correlation between UPC ratio in urine samples collected by cystocentesis and by free catch was strong (r(2) = 0.90); 75 of 81 (92.6%) dogs had UPC ratios from both urine samples that resulted in classification in the same IRIS substage with a kappa coefficient of 0.83., Conclusions and Clinical Relevance: The UPC ratio in dogs was minimally affected in urine samples collected by free catch, thus allowing correct grading of proteinuria with this method. The high reliability of the UPC ratio in free-catch urine samples coupled with the ease of collection should increase the use of this value for assessment of proteinuria.

Objective: To evaluate the use of dipstick, sulfosalicylic acid (SSA), and urine protein-to-creatinine ratio (UP:C) methods for use in detection of canine and feline albuminuria., Design: Evaluation study., Sample Population: 599 canine and 347 feline urine samples., Procedures: Urine was analyzed by use of dipstick, SSA, and UP:C methods; results were compared with those for a species-specific ELISA to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value, and positive and negative likelihood ratios., Results: Positive results for dipstick and SSA tests (trace reaction or greater) in canine urine had moderate specificity (dipstick, 81.2%; SSA, 73.3%) and poor PPV (dipstick, 34.0%; SSA, 41.8%). Values improved when stronger positive results (>or= 2+) for the dipstick and SSA tests were compared with ELISA results (specificity, 98.9% and 99.0% for the urine dipstick and SSA tests, respectively; PPV, 90.7% and 90.2% for the dipstick and SSA tests, respectively). Data obtained for cats revealed poor specificity (dipstick, 11.0%; SSA, 25.4%) and PPV (dipstick, 55.6%; SSA, 46.9%). Values improved slightly when stronger positive test results (>or= 2+) were used (specificity, 80.0% and 94.2% for the dipstick and SSA tests, respectively; PPV, 63.5% and 65.2% for the dipstick and SSA tests, respectively). The UP:C had high specificity for albuminuria in dogs and cats (99.7% and 99.2%, respectively) but low sensitivity (28.7% and 2.0%, respectively)., Conclusions and Clinical Relevance: Caution should be used when interpreting a positive test result of a dipstick or SSA test for canine or feline albuminuria.

Objective: To evaluate the reproducibility and accuracy of 4 portable pH meters, a reagent strip, and pH paper for measuring urine pH in dogs., Design: Prospective masked randomized study., Sample Population: 201 free-catch urine samples from 114 hospitalized dogs., Procedures: Urine samples were divided into 2-mL aliquots. Measurements of urine pH were obtained by use of a laboratory benchtop pH meter, 4 portable pH meters, a urine reagent strip, and pH paper. The pH of each aliquot was measured within 4 hours of collection by an evaluator unaware of the aliquot's origin. To assess reproducibility, the coefficient of variation for each pH measurement device was calculated. To determine which device was most accurate, the degree of agreement among the different devices was assessed in comparison with the benchtop pH meter, which was considered the reference method., Results: 3 of the 4 portable pH meters had nearly perfect agreement with the reference method. The reagent strip and pH paper had moderate to poor agreement with the reference method., Conclusions and Clinical Relevance: Urine pH measurements should be made by use of a portable or benchtop pH meter when accurate measurements are crucial for diagnosis or treatment. Reagent strips and pH papers are useful in obtaining pH approximations but are not recommended when accurate measurements of urine pH are required.

Objective: To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria., Design: Prospective study., Animals: 408 dogs., Procedures: Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis., Results: 48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays., Conclusions and Clinical Relevance: Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.

Objective: To evaluate pretreatment clinical and laboratory findings in dogs with naturally occurring primary hyperparathyroidism., Design: Retrospective study., Animals: 210 dogs with primary hyperparathyroidism and 200 randomly selected, age-matched control dogs that did not have primary hyperparathyroidism., Procedure: Medical records for dogs with primary hyperparathyroidism were reviewed for signalment; clinical features; and results of clinicopathologic testing, serum parathyroid hormone assays, and diagnostic imaging., Results: Mean age of the dogs with primary hyperparathyroidism was 11.2 years (range, 6 to 17 years). The most common clinical signs were attributable to urolithiasis or urinary tract infection (ie, straining to urinate, increased frequency of urination, and hematuria). Most dogs (149 [71%]) did not have any observable abnormalities on physical examination. All dogs had hypercalcemia, and most (136 [65%]) had hypophosphatemia. Overall, 200 of the 210 (95%) dogs had BUN and serum creatinine concentrations within or less than the reference range, and serum parathyroid hormone concentration was within reference limits in 135 of 185 (73%) dogs in which it was measured. Urolithiasis was identified in 65 (31 %) dogs, and urinary tract infection was diagnosed in 61 (29%). Mean serum total calcium concentration for the control dogs-was significantly lower than mean concentration for the dogs with primary hyperparathyroidism, but mean BUN and serum creatinine concentrations for the control dogs were both significantly higher than concentrations for the dogs with primary hyperparathyroidism., Conclusions and Clinical Relevance: Results suggest that urolithiasis and urinary tract infection may be associated with hypercalcemia in dogs-with primary hyperparathyroidism, but that development of renal insufficiency is uncommon.

A 5-year-old pit bull-type dog was examined because of lethargy and black feces, and a presumptive diagnosis of methemoglobinemia was made on the basis of grossly visible brown discoloration of the mucous membranes and urine. Heinz body formation was seen on examination of blood smears, and severe anemia developed 3 days later. The dog did not have any history of exposure to toxins or drugs that have been associated with Heinz body formation. The only remarkable historical finding was that the dog had been wandering loose the day prior to initial examination and returned home smelling strongly of skunk spray. Skunk spray contains thiols and other compounds that are strong oxidizing agents. It was speculated that the methemoglobinemia and Heinz body anemia were a result of exposure to these compounds. Skunk interactions with dogs usually have malodorous but otherwise harmless results. However, findings in this dog suggest that more serious consequences may develop in isolated cases.

Objective: To determine whether urine protein-to-creatinine ratio (UP:C) > or = 1.0 at initial diagnosis of chronic renal failure (CRF) is associated with greater risk of development of uremic crises, death, and progression of renal failure in dogs., Design: Prospective cohort study., Animals: 45 dogs with CRF PROCEDURE: Dogs were prospectively assigned to 2 groups on the basis of initial UP:C < 1.0 or 2 > or = 1.0. The association between magnitude of proteinuria and development of uremic crises and death was determined before and after dogs with initial UP:C > or =1.0 were assigned to 3 subgroups and compared with dogs with initial UP:C < 1.0. Changes in reciprocal serum creatinine concentration were used to estimate decrease in renal function., Results: Initially, dogs had similar clinical characteristics with the exception of systolic blood pressure and UP:C. Relative risks of development of uremic crises and death were approximately 3 times higher in dogs with UP:C > or =1.0, compared with dogs with UP:C < 1.0. Relative risk of adverse outcome was approximately 1.5 times higher for every 1-unit increment in UP:C. The decrease in renal function was of greater magnitude in dogs with UP:C > or =1.0, compared with dogs with UP:C < 1.0., Conclusions and Clinical Relevance: Initial UP:C > or =1.0 in dogs with CRF was associated with greater risk of development of uremic crises and death, compared with dogs with UP:C < 1.0. Initial determinations of UP:C in dogs with naturally occurring CRF may be of value in refining prognoses.

Objective: To compare the findings of light microscopic evaluation of routine unstained wet-mounted preparations and air-dried, modified Wright-stained preparations of urine sediment with results of quantitative aerobic bacteriologic culture of urine., Design: Masked prospective study., Sample Population: 459 urine samples collected by cystocentesis from 441 dogs., Procedure: Urinalyses and quantitative bacteriologic cultures of urine were performed. Unstained wet-mounted preparations and air-dried, modified Wright-stained urine sediment preparations were examined by light microscopy for the presence of bacteria., Results: Compared with results of quantitative bacteriologic culture, routine unstained preparations and modified Wright-stained preparations had sensitivities of 82.4% and 93.2%, specificities of 76.4% and 99.0%, positive predictive values of 40.1% and 94.5%, negative predictive values of 95.8% and 98.7%, and test efficiencies of 77.3% and 98.0%, respectively. Compared with 74 samples that yielded growth on bacteriologic culture, the routine unstained method had concordance and misclassification rates of 39.2% and 60.8%, respectively, whereas the Wright-stained method had concordance and misclassification rates of 78.4% and 21.6%, respectively. Significant associations between each of occult blood in urine, pyuria, female sex, and lower urine specific gravity with bacteriuria detected by Wright-stained sediment examination and quantitative bacteriologic culture of urine were identified., Conclusions and Clinical Relevance: Examination of modified Wright-stained preparations of urine sediment appeared to be a rapid, cost effective method that significantly improved the sensitivity, specificity, positive predictive value, and test efficiency of light microscopic detection of bacteriuria, compared with that of the routine unstained method.

Objective: To evaluate 3 methods for measuring urine bile acids (UBA) and compare their diagnostic performance with that of the serum bile acids (SBA) test and other routine screening tests in dogs with hepatic disorders., Design: Prospective study., Animals: 15 healthy dogs, 102 dogs with hepatic disorders, and 9 dogs with clinical signs of hepatic disorders that were found to have nonhepatic disorders., Procedures: Blood and urine samples were collected from sick dogs and healthy dogs for serum biochemical analyses, and determination of concentrations of SBA and UBA. Urine samples were obtained from 15 healthy dogs to establish an upper cutoff value for UBA concentrations. The UBA were measured by use of a quantitative-linked enzymatic colorimetric method. Three analytical modifications were evaluated; 1 quantified only urine sulfated bile acids (USBA), 1 only urine nonsulfated bile acids (UNSBA), and 1 quantified both (USBA plus UNSBA). The UBA values were standardized with the urine creatinine concentration., Results: The UNSBA-to-creatinine ratio and USBA plus UNSBA-to-creatinine ratio tests had the best diagnostic performance of the UBA tests; each had a substantially higher specificity, slightly higher positive predictive value, slightly lower negative predictive value, and lower sensitivity than the SBA test. These UBA-to-creatinine values were positively correlated with SBA values. The USBA-to-creatinine ratio had poor sensitivity, indicating a low rate of bile acid sulfation in dogs., Conclusions and Clinical Relevance: The UBA can be measured in dogs with sufficient repeatability and accuracy for clinical application. The UNSBA-to-creatinine ratio and USBA plus UNSBA-to-creatinine ratio identified dogs with hepatic disorders nearly as well as the SBA test.

Objective: To assess clinical signs and response to surgical treatment in Dalmatians with urate urolithiasis., Design: Retrospective study., Animals: 38 Dalmatians., Procedure: Medical records from 1980 to 1995 of Dalmatians with urate urolithiasis were reviewed to obtain information on history, results of physical examination, hemogram, biochemical analysis, urinalysis, bacterial culture of urine, diagnostic imaging, analysis of calculi, treatment, and recurrence., Results: 35 (92%) dogs were males. Mean age at admission was 4.9 years. Common clinical findings and initial complaints included dribbling of urine, stranguria, vomiting, tense abdomen with signs of pain, and a large bladder. Hematuria was found in 85% of dogs in which urinalysis was performed. Crystalluria was found in 54% of dogs. Bacteria were isolated from urine from 36% of dogs. Contrast radiography and abdominal ultrasonography were the most sensitive diagnostic tests for uroliths. Dogs that underwent scrotal urethrostomy and cystotomy had the fewest number of recurrent clinical signs that were attributable to urinary calculi. Clinical recurrence rate in dogs on a protein-restricted diet was 27%, compared with that (36%) for dogs on a commercial diet., Clinical Implications: Urate urolithiasis is more commonly recognized in male Dalmatians compared with females. Contrast radiography and ultrasonography appear to be the most useful techniques for detecting urate uroliths. Scrotal urethrostomy and cystotomy was the most effective surgical treatment for preventing recurrence of clinical signs associated with calculi. Complete removal of calculi and protein-restricted diets may have a beneficial effect in reducing recurrence of calculi.

Objective: To evaluate urine protein content in dogs with pituitary-dependent hyperadrenocorticism (PDHAC) and to determine the effect of mitotane administration on proteinuria in these dogs., Design: Prospective case series., Animals: 16 dogs with PDHAC were evaluated (age range, 7 to 14 years; mean age, 10 years; female-to-male ratio, 2.2:1)., Procedure: Urine protein-to-creatinine (UPC) ratios and 24-hour urine protein excretion (24-hour UPE) values were measured before beginning treatment with mitotane and after establishing appropriate maintenance treatment., Results: Before treatment, UPC ratios ranged from 0.03 to 4.16 (16 dogs, median, 0.695; reference range value, UPC ratio < 0.5; questionable value, UPC ratio > 0.5 but < 1.0; high value, UPC ratio > 1.0). Seven dogs had proteinuria with UPC ratios > 1.0. Twenty-four-hour UPE values ranged from 0.67 to 61.7 mg/kg of body weight/d (0.30 to 28.0 mg/lb/d; 13 dogs, median, 9.7 mg/kg/d [4.4 mg/lb/d]; reference value, 24-hour UPE value, < 20 mg/kg/d [9.1 mg/lb/d]). Five dogs with high UPC ratios also had high values for 24-hour UPE. After establishment of maintenance treatment with mitotane (median, 7 weeks; mean, 7.3 weeks), UPC ratios ranged from 0.02 to 6.5 (16 dogs, median, 0.36). Five dogs continued to have high UPC ratios. Values of 24-hour UPE ranged from 0.47 to 122 mg/kg/d (0.21 to 55.5 mg/lb/d; 13 dogs, median, 5.1 mg/kg/d [2.3 mg/lb/d]). Three dogs continued to have high 24-hour UPE values. Significant differences were not found between dogs before and after treatment with mitotane in terms of UPC ratios or 24-hour UPE values., Clinical Implications: In dogs with PDHAC and proteinuria, UPC ratios should be monitored closely. Some dogs with PDHAC may have a decrease in urine protein content following treatment with mitotane. We suggest that renal biopsies be considered in those dogs with progressive increases in UPC ratios.

Objective: To evaluate use of urine cortisol-to-creatinine ratio (UC:C) as a means of monitoring response to long-term mitotane treatment in dogs with pituitary-dependent hyperadrenocorticism., Design: Prospective uncontrolled study., Animals: 101 dogs with pituitary-dependent hyperadrenocorticism., Procedure: Urine samples were obtained from dogs on the morning an ACTH stimulation test was performed, and owners were asked their opinion on the health of their dog to monitor response to mitotane treatment. Urine was assayed for cortisol and creatinine concentrations, and UC:C was calculated. The UC:C was compared with post-ACTH plasma cortisol concentration., Results: Post-ACTH plasma cortisol concentration was used to categorize each dog's response to mitotane treatment. The UC:C did not correlate satisfactorily with results of ACTH stimulation testing. Twenty-seven of 85 (32%) dogs would have been incorrectly considered as having received appropriate doses using UC:C. In addition, 16 dogs that received overdoses could not be distinguished from 29 dogs that received appropriate doses., Clinical Implications: UC:C does not provide a consistent, correct assessment of mitotane-induced adrenocortical destruction. The ACTH stimulation test, although more time-consuming and expensive, is recommended for monitoring response to mitotane treatment.

Objective: To determine the usefulness of measuring urine cortisol:creatinine ratio (UCCR) as a means of monitoring response to mitotane treatment in dogs with pituitary-dependent hyperadrenocorticism (PDH)., Design: Case series., Animals: 51 clinically normal dogs and 21 dogs with PDH., Procedure: The reference range for the UCCR was determined by measuring the ratio in 51 clinically normal dogs. The usefulness of measuring UCCR in evaluating response of 21 dogs with PDH to treatment with mitotane was evaluated by comparing ACTH-stimulated blood cortisol concentrations with UCCR at the end of the induction phase of treatment (13 dogs) and during the maintenance phase of treatment (21)., Results: UCCR was not useful for identifying dogs with inadequate adrenal reserves at the end of the induction phase of treatment or during the maintenance phase. The UCCR was useful for identifying dogs in which control of cortisol secretion was not adequate., Clinical Implications: UCCR should not be used for evaluation of dogs during the induction phase of treatment, because the potential consequences of not identifying dogs with inadequate adrenal reserves are great. The UCCR may be useful as an adjunct means of monitoring treatment response during the maintenance phase of treatment. However, the ACTH stimulation test remains a necessary component when monitoring response to treatment in dogs with PDH receiving mitotane.

Objective: To investigate whether urinary urea nitrogen (UUN) content can be used to accurately estimate total urinary nitrogen content in hospitalized dogs., Design: Prospective, cohort study., Animals: 24 client-owned dogs admitted to an intensive care unit of a veterinary teaching hospital., Procedure: Indwelling urinary catheters and closed collection systems were placed for the purpose of monitoring urine output. Urine was collected during a 24-hour period from each dog. For each collection, the total volume was measured. Urine was analyzed for urea nitrogen content at an in-house laboratory, using standard methods for determination of BUN content. Total urinary nitrogen content was determined by another laboratory, using Kjeldahl's method. Correlation between UUN content and total urinary nitrogen content was evaluated by use of linear regression analysis., Results: Total urinary nitrogen content adjusted for metabolic body weight ranged from 0.21 to 2.21 g/ kg0.75/d (mean +/- SD, 0.81 +/- 0.46 g/kg0.75/d). Adjusted UUN content ranged from 0.05 to 1.50 g/kg0.75/d (0.54 +/- 0.38 g/kg0.75/d). Total urinary nitrogen content was highly correlated with UUN content (R2, 0.88; P < 0.001)., Clinical Implications: Measurement of UUN content can be used to estimate total urinary nitrogen content in a clinical setting. Furthermore, critical illness in dogs is associated with substantial catabolism of endogenous proteins.

Objective: To determine prevalence and severity of systemic arterial hypertension and proteinuria in dogs with naturally developing hyperadrenocorticism and to determine whether these abnormalities resolve with adequate management of the disease., Design: Case series and cohort study., Animals: 77 dogs with naturally developing hyper-adrenocorticism examined once; 15 dogs examined before and after treatment., Results: Among dogs examined only once, hypertension was diagnosed in 21 of 26 dogs with untreated pituitary-dependent hyperadrenocorticism (PDH), 17 of 21 with inadequately controlled PDH, 8 of 16 with well-controlled PDH, 10 of 10 with an untreated adrenocortical tumor, and 0 of 4 that had undergone adrenalectomy because of an adrenocortical tumor. Untreated dogs and dogs with inadequately controlled PDH had significantly higher blood pressures than did other dogs. Proteinuria was documented in 12 of 26 dogs with untreated PDH, 5 of 16 with inadequately controlled PDH, 3 of 14 with well-controlled PDH, 5 of 8 with an untreated adrenocortical tumor, and 1 of 3 that had undergone adrenalectomy. Dogs with untreated PDH and dogs with an untreated adrenocortical tumor had higher urine protein/creatinine ratios than did dogs with well-controlled PDH. Among dogs evaluated before and after treatment, blood pressure and urine protein/creatinine ratio did not change in 8 dogs with inadequately controlled hyperadrenocorticism, but decreased in 7 dogs with well-controlled disease., Clinical Implications: Results suggest that systemic hypertension and proteinuria are common in dogs with untreated hyperadrenocorticism and that successful treatment of hyperadrenocorticism will result in resolution of these abnormalities in many, but not all, dogs.

The purpose of the study reported here was to assess 3 commonly used screening tests for hyperadrenocorticism (low-dose dexamethasone suppression test, ACTH stimulation test, and urinary cortisol:creatinine ratio) in dogs with various diseases other than those of the adrenal glands (nonadrenal diseases). A group of 100 dogs was studied: 59 dogs with nonadrenal disease, 21 clinically normal dogs, and 20 dogs with pituitary-dependent hyperadrenocorticism. Of 59 dogs with nonadrenal disease, 20 (34%) had high baseline cortisol concentration (greater than reference range limits), and 22 (38%) and 33 (56%) had inadequate serum cortisol suppression at 4 and 8 hours, respectively, after administration of a low dose of dexamethasone. Compared with clinically normal dogs, dogs with nonadrenal disease had significantly (P < 0.05) higher mean serum cortisol concentration at 4 and 8 hours after administration of a low dose of dexamethasone; however, significant differences were not detected between the mean cortisol concentration at 8 hours after administration for dogs with nonadrenal disease and for dogs with hyperadrenocorticism. After ACTH stimulation, only 8 of 59 (14%) dogs with nonadrenal disease had high serum cortisol concentrations. Significant differences did not exist after ACTH stimulation between mean cortisol concentration of clinically normal dogs and that of dogs with nonadrenal disease. Of 59 dogs with nonadrenal disease, 45 (76%) had a high urinary cortisol:creatinine ratio. When compared with clinically normal dogs, dogs with nonadrenal disease had a significantly higher mean urinary cortisol:creatinine ratio, but significant differences did not exist between the mean urinary cortisol:creatinine ratio of dogs with nonadrenal disease and that of dogs with hyperadrenocorticism.(ABSTRACT TRUNCATED AT 250 WORDS)

A 2-year-old spayed female Shetland Sheepdog had recurrent episodes of discolored urine. Treatments administered for presumed urinary tract infection did not prevent recurrence. Episodes of pigmenturia appeared to correlate with stressful situations or excessive activity. Examination of urine sediment consistently revealed that RBC were not evident, despite a positive result for blood on urinalysis. This was suggestive of hemoglobinuria, and diagnostic testing was instituted to determine the underlying cause. Results of alkaline and osmotic fragility tests were useful in determining that an increase in erythrocyte fragility was the underlying cause of the recurrent pigmenturia. Erythrocyte fragility testing should be considered in animals that do not respond to appropriate treatments for pigmenturia.

A urine cortisol:creatinine (c:c) ratio, determined from a free-catch morning sample, was evaluated in each of 83 dogs as a screening test for hyper-adrenocorticism. The dogs evaluated were allotted to 3 groups, including 20 healthy dogs, 40 dogs with confirmed hyperadrenocorticism (HAC), and 23 dogs with polyuria and polydipsia not attributable to HAC (polyuria/polydipsia group; PU/PD). Overlap in the urine c:c ratios (mean +/- SEM), comparing results from the healthy dogs (5.7 x 10(-6) +/- 0.9) with those from the HAC dogs (337.7 x 10(-6) +/- 72.0) was not found. However, 11 (64%) of the 18 values from the PU/PD dogs (42.6 x 10(-6) +/- 9.4) were above the lowest ratio in the HAC group and 50% of the HAC group had a urine c:c ratio below the highest value in the PU/PD group. When the mean urine c:c ratio (+/- 2 SD) for the group of healthy dogs was used as a reference range, 100% of the HAC dogs and 18 (77%) of 23 dogs in the PU/PD group had abnormal urine c:c ratios. The sensitivity of the urine c:c ratio to discriminate dogs with HAC was 100%. The specificity of the urine c:c ratio was 22% and its diagnostic accuracy was 76%. On the basis of our findings, a urine c:c ratio within the reference range provides strong evidence to rule out HAC. However, abnormal urine c:c ratios are obtained from dogs with clinical diseases other than HAC. Therefore, measurement of a urine c:c ratio should not be used as the sole screening test to confirm a diagnosis of HAC.

A retrospective survey of complete urinalyses performed on dogs and cats hospitalized at the University of Minnesota Veterinary Teaching Hospital was performed to determine the frequency of abnormal findings in urine sediment, compared with normal and abnormal macroscopic findings. One thousand consecutive urine samples collected from dogs and 1,000 consecutive urine samples collected from cats were studied. Results indicated that failure to examine urine sediment of macroscopically normal samples would have yielded false-negative results in 16.5% of the canine patients and 5.7% of the feline patients. Microscopic findings in macroscopically normal canine samples consisted primarily of pyuria and bacteriuria, whereas in cats they consisted of hematuria and bacteriuria. Microscopic abnormalities were detected in almost 50% of the canine and feline samples with macroscopic abnormalities. The results of this evaluation confirm the value of routine microscopic examination of urine sediment as a component of complete urinalysis.

A commercially available leukocyte esterase assay was evaluated for application in analyzing canine urine for the detection of pyuria. In 229 urine samples, the leukocyte esterase activity was compared with leukocyte concentrations, as assessed by microscopic sediment analysis and chamber cell counts. The leukocyte esterase assay was specific (93.2%) for canine pyuria, but was poorly sensitive (46.0%) and did not appear to be applicable to analysis of canine urine samples.

Azotemic dogs receiving prednisone and azathioprine to enhance renal allograft survival had higher blood urea nitrogen (BUN):serum creatinine (SC) ratios, when compared with nontreated dogs with induced azotemia. The difference in ratios probably was attributable to increased BUN content secondary to the catabolic effects of the drugs used. However, dogs with naturally occurring renal failure had BUN:SC ratios that were similar to those for dogs receiving the catabolic drugs. It was concluded that even though catabolic drugs may influence BUN:SC ratios, the multiplicity of other factors affecting BUN and SC may interact to cause a wide range of BUN:SC ratios under conditions of naturally occurring primary renal failure in the dog.

Idiopathic hematuria of unilateral renal origin was diagnosed in a 3-month-old male Weimaraner. The hematuria had been visible grossly for 6 weeks. Extensive clinicopathologic, radiographic, and histologic evaluations localized the source of the hematuria to the right kidney, but could not identify a cause. Nephrectomy of the right kidney resolved the problem. This case report supports a previous article comparing canine idiopathic hematuria of renal origin with benign essential hematuria of human beings.

The 24-hour urine protein/creatinine (U[P/C]) ratio was examined in 19 healthy dogs and in 38 dogs with protein-losing nephropathies. A positive correlation existed between the U(P/C) ratio and the 24-hour urine protein output per kilogram of body weight. The U(P/C) ratio in 18 of 19 healthy dogs was less than 0.2; one dog had a ratio of 0.38. The median U(P/C) ratio in dogs with glomerulonephritis (n = 26) and amyloidosis (n = 6) was 5.73 and 22.50, respectively. The median U(P/C) ratio in dogs with chronic interstitial nephritis (n = 6) was 2.89. In the presence of hypoalbuminemia (albumin less than or equal to 1.5 g/dl), a U/(P/C) ratio greater than 1 indicated a nephrotic syndrome. Severe protein-losing nephropathies (ie, severe glomerulonephritis and amyloidosis) were characterized by U(P/C) ratios greater than 10 and urine protein values exceeding 159 mg/kg/day. The 24-hour U/(P/C) may be more sensitive than the 24-hour urine protein output per kilogram of body weight in the detection of mild glomerular disease. Abnormal U(P/C) ratios were present in 5 dogs, 2 with glomerulonephritis and 3 with chronic interstitial nephritis; that had normal or mildly increased 24-hour urine protein output.

The clinical problems and results of urinalyses of 500 dogs were reviewed and summarized to compare the sensitivities for detection of abnormalities indicative of urinary system disease among qualitative (sulfosalicylic acid [SSA]), quantitative (Coomassie brilliant blue [CBB]), and indexed (urinary protein/creatinine ratio [U(P/C)]) determinations of urinary protein loss vs microscopic examination of urine sediment. False-negative rates for the detection of microscopically abnormal urine specimens were 5.4% for SSA greater than or equal to 1+, 8.5% for CBB greater than or equal to 1.0 mg/ml, 9.7% for U(P/C) greater than or equal to 1.0, and 7.7% for CBB + U(P/C). A discriminatory U(P/C) value of 2.0 would have excluded dogs with clinically relevant proteinuria in the lower ranges. Proteinuria was not detected in 4.4% (22/500) of the specimens in which important numbers of leukocytes or bacteria were observed. False-negative rates for combined interpretation of quantitative protein concentration and U(P/C) were not significantly different (P greater than 0.10) from SSA alone. Degrees of azotemia were higher (high serum creatinine concentration, P greater than 0.10 and high serum urea nitrogen concentration, P less than 0.05) and prevalence of chronically diseased dogs was greater (P less than 0.005) in dog categories with higher U(P/C) values. More quantitative determinations of urinary protein loss as a screening test offer potential labor-saving and diagnostic advantages in the identification of urinary disease over more qualitative routine screening methods.

Effective treatment and prevention of urolithiasis depends on accurate determination of the chemical nature of the uroliths. A widely used qualitative chemical procedure was compared with quantitative crystallographic analysis of 272 canine uroliths. Agreement between the 2 methods was 78%. Qualitative analysis failed to detect 62% of calcium-containing uroliths and 83% of carbonate apatite uroliths. Qualitative analysis gave false-positive results for urates in 55% of cystine uroliths. Mixed uroliths comprising 6% of the total could not be classified without quantitative analysis. Silicate, cystine, and urate uroliths generally were of pure composition. Crystallographic analysis indicated the following distribution of major types: struvite, 69%; calcium oxalate, 10%; urate, 7%; silicate, 3.5%; cystine, 3.2%; calcium phosphate, 1%; and mixed, 6%. Among dogs with struvite uroliths, 66% had positive results of bacterial culturing from the urinary bladder. Six breeds (Miniature Schnauzer, Welsh Corgi, Lhasa Apso, Yorkshire Terrier, Pekingese, and Pug) had a significantly higher risk for urolithiasis, compared with other breeds. The German Shepherd Dog had a significantly lowered risk, compared with other breeds. Two breeds had significant relationship to a specific type of urolith: Miniature Schnauzer for oxalate, and Dalmatian for urate (P less than 0.001). It was concluded that quantitative analysis, using crystallography, was superior for the detection of calcium oxalate, carbonate apatite, cystine, urate, and mixed uroliths.

Hyponatremia with simultaneous renal sodium loss was associated with the inappropriate secretion of antidiuretic hormone in a dog with heartworm disease. Antidiuresis caused expansion of extracellular fluid volume, which induced renal salt wasting and a negative sodium balance. The combination of water retention, salt wasting, and inactivation of intracellular solute contributes to the decrease in serum sodium concentration. Water intoxication due to hypotonicity of body gluids induced anorexia, depression, weakness, and incoordination.

Clinical and histopathologic findings in 21 dogs with glomerular disease were reviewed. Diagnoses included amyloidosis, glomerulonephritis, and secondary glomerular atrophy. Dogs with amyloidosis excreted the largest amount of urinary protein per day, and 5 of 6 so affected had clinical signs of advanced renal disease at the time of examination. Dogs with glomerulonephritis excreted significantly less urinary protein per day, and none had clinical signs of advanced renal disease at the time of examination. The magnitude of proteinuria was correlated more with the nature of the glomerular lesion than with the stage of renal disease.

Renal tubular carcinoma was believed responsible for hematuria and extreme leukocytosis in a dog. Other paraneoplastic syndromes possibly associated with this neoplasm included fever, thoracolumbar hyperesthesia, and anemia attributable to myelophthisis. All clinical and clinicopathologic abnormalities resolved after unilateral nephrectomy. Neutrophil cytochemical stains were used to differentiate leukemoid reaction from myelocytic leukemia as the cause of the leukocytosis. The extreme leukocytosis in this dog may have been leukemoid reaction caused by production of colony-stimulating factor by the renal tubular carcinoma.

The daily excretion of urinary protein was evaluated in 8 conditioned research dogs and in 10 hospitalized, proteinuric dogs, using 24-hour urine collections. Concurrent with each 24-hour urine collection, a 5- to 10-ml urine specimen was obtained during midday. The ratio of urine protein to urine creatinine concentration was determined from the single urine specimen for each dog. Linear regression analysis was used to calculate the correlation between that ratio and the 24-hour urinary protein loss (mg/kg of body weight). The coefficient of determination was significant (r2 = 0.95, P less than 0.0001). Determination of the protein-to-creatinine ratio in a single urine specimen was found to be a sensitive, rapid, and dependable diagnostic technique for detection and quantitative estimation of proteinuria.

A modified water-deprivation test was performed on 12 polyuric and 4 clinically normal dogs. Immediately after maximal urine osmolality had been achieved with water deprivation, antidiuretic hormone was injected to test further renal concentrating ability. The test provided accurate diagnosis of severe hypothalamic-neurohypophyseal diabetes insipidus in 3 dogs, partial diabetes insipidus in 2 dogs, and primary (psychogenic) polydipsia in 2 dogs. Five polyuric dogs with hyperadreno corticism had a response to the modified water-deprivation test similar to that of dogs with partial diabetes indipidus.

The initial physical signs, clinical problems, and results of 1,000 consecutive urinalyses of canine patients at the Colorado State University Veterinary Teaching Hospital were reviewed and summarized to compare microscopic and physicochemical examinations of urine. Physicochemical examination alone would have resulted in an 11.4% (64/562) false-negative rate for detection of abnormal urine specimens without consideration of patient risk for genitourinary disease. The effects of a discriminative diagnostic algorithm on macroscopic examination sensitivity were determined. Fifty-one macronegative/micropositive and 85 macro- and micronegative specimens were obtained from higher-risk patients with history, physical signs, clinical problems, or serum biochemical analysis results indicative of predisposition to genitourinary disease, which would have warranted complete urinalyses regardless of physicochemical findings. Exclusion of these patients from evaluation of physicochemical examination sensitivity in order to consider such methodology's impact as a screening procedure only for those patients whose genitourinary disease was not already suspect resulted in a significantly (P less than 0.001) lower false-negative rate of 3.05% (13/426).