Last one unless there are questions (bet you're all glad and going 'shut up' lol). It includes Urinalysis and Anemia
Urinalysis
A physical, microscopic, or chemical examination of urine. The sample is physically examined for color, turbidity, and specific gravity.
Turbidity: a condition of light scattering in a liquid resulting from the presence of suspended particles. In other words, cloudy or obscured in appearance. Turbidity increases with the concentration of particles and depends on their shapes and sizes.
After being physically examined (ever wonder why they don’t just say ‘looked at’?) it is spun in a centrifuge to allow collection of a small amount of sediment, which is examined under a microscope for blood cells, casts, crystals, pus, and bacteria. Chemical analysis may also be performed to measure the pH and to identify and measure the levels of ketones, sugar, protein, blood components, and many other substances.
Now to what these things are. Blood, glucose, bilirubin, and protein have been covered. Most don’t know what pH, ketones and the like are, though, or whether they should be there, or what. So on to definitions.
Specific gravity (sp.gr.): is the ratio of the density of a substance to the density of another substance accepted as a standard. The usual standard for liquids and solids is water. Thus, a liquid or solid with a specific gravity of 4 is four times as dense as water at the same temperature.
PH –abbreviation for potential hydrogen, a scale representing the relative acidity (or alkalinity) of a solution, in which a value of 7.0 is neutral. Below 7.0 is acid, above 7.0 is alkaline.
Urinary sediment: solid matter that settles to the bottom of a urine sample that has been allowed to stand for several hours.
Urinary casts-cells or particles excreted in the urine having the shape of renal-collecting tubule cells.
Urinary crystals: such as calcium phosphate, tri phosphate, etc. They can occur with a UTI , and frequently accompany an alkaline pH.
Ketones: are an organic chemical compound characterized by having in it’s structure a carbonyl, or keto, group attached to two alkyl groups. It is produced by oxidation of secondary alcohols.
What do the numbers on the urinalysis mean? Here are some answers-NOTE that it is not all of them, and abnormal readings could indicate other things as well. That’s why we have vets.
Color: Normal…amber yellow. Abnormal…red indicates hematuria (possibly urinary obstruction, renal calculi, tumor, renal failure, cystitis)
Clarity: Normal…clear. Abnormal…cloudy; debris, bacterial sediment (urinary infection)
pH: Normal…according to my vet about 6.0-7.5. Abnormal…1. alkaline on standing or with urinary tract infection. 2. increased acidity with renal tubular acidosis.
Specific gravity: normal…in humans it’s 1.010 – 1.026—Chronos was 1.034..I don’t know what is normal for a glider. Abnormal: Usually reflects fluid intake: the less fluid intake, the higher the specific gravity. If specific gravity remains low (1.010-1.014 in Humans), renal disease or pituitary disease (deficit of ADH) is suspected.
Protein: normal-do not know for glider. 0-8mg/dl for Humans. Abnormal…Proteinuria may occur with high protein diet and exercise (particularly prolonged). Seen in Renal disease.
Sugar: Normal…0 Abnormal…Glycosuria occurs after a high intake of sugar or with diabetes mellitus.
Ketones: Normal…0 Abnormal…ketonuria occurs with starvation and diabetic ketoacidosis.
RBCs (red blood cells) Normal…0-4 (Human) Abnormal…Injury to kidney tissue (see color above)
WBCs (white blood cells) Normal…0-5 (Human) Abnormal…Urinary tract infection
Casts: Normal…0 Abnormal…Urinary tract infection, renal disease
There are other things that may be tested for as well, but these are the most common a glider owner will see.
There are also tests for Thyroid function, with names like T1, T3, free T4, that are specific and necessary for diagnosing thyroid issues. I do not know if they’ve ever been done on a glider or if any kind of normal values are known or estimated.
Anemia
(and note that most ‘symptoms’ would be almost impossible to see on a glider-which is what makes testing to find the cause so important)
Anemia is a decrease in hemoglobin in the blood levels to below the normal range. Anemia may be caused by a decrease in red cell production, an increase in red cell destruction, or a loss of blood.
Depending on severity, anemia may be accompanied by clinical findings that come from the lessened oxygen carrying capacity of the blood. Signs and symptoms include fatigue, exertional dyspnea (a distressful sensation of uncomfortable breathing that may be caused by certain heart conditions, strenuous exercise, or anxiety), dizziness, headache, insomnia, and pallor (ie pale nose/gums). Signs may also include confusion or disorientation. Anorexia (NOT the eating disorder. It is: lack or loss of appetite resulting in the inability to eat. The condition may result from poorly prepared or unattractive food or surroundings, unfavorable company, or various physical and psychological causes.), dyspepsia (a vague feeling of epigastric discomfort after eating-an uncomfortable feeling of fullness, heartburn, bloating, and nausea), HEART: palpitations , tachycardia, cardiac dilation, and systolic murmurs also may occur. Iron deficiency is the most common causative factor. Additional lab studies may be required to establish the less common forms of anemia.
The therapeutic response to anemia (treatment for) is variable and depends on the causative factors. Moderate to severe anemia, with hemoglobin levels that are below (in Humans) 7-8 g/dL, may require transfusion of one or more units of blood (packed blood cells), especially if the condition is acute and specific clinical signs are present. Depending on the kind of anemia, treatment includes providing supplements of the deficient component, eliminating the cause of the blood loss, or alleviating the hemolytic component. Alleviating the hemolytic component may involve administration (or dosing) of adrenal corticosteroids or splenectomy—which would not be viable on a glider. Neither would a transfusion.
Appropriate lab tests are repeated at intervals to monitor the response and need for continued therapy. Erythropoietin injections may be used to stimulate red cell production when anemia is secondary to chronic renal (kidney) failure, or the anemia of chronic disease.
There are many kinds of anemia-caused by things from kidney infections, parasites, dietary iron deficiency, processing issues, etc. A parasite that travels through the bloodstream, such as trichinosis, may also trigger a white cell response in the host as if there were a bacterial infection. Because a glider will not show most symptoms, or be able to tell a vet “I feel…” or “It hurts here…” testing is the only conclusive way we have to confirm a problem that may not be straightforward, and ensure the right treatment in a timely manner, since usually with gliders by the time we know there’s a problem at all it’s late in the game.
I’ve talked to Chris about subq’s both before and after his blood draw, considering his weight, to make it easier on him, with the backup and professional advice of another GC member on that. I am also going to quote part of the PM (hope that’s okay!) in additional info she’s added for our understanding and education, and in an attempt to help Chris and her vet (the neat thing is that after recent studies and typing all this, I have no problem understanding what she said, as well as agreeing):
Re parasites-he is on flagyl so the fecal float and smear may be neg. when repeated. In people the equivalent is the "ova and parasite" test-pretty much the same thing other than volume of specimen. We request 3 specimens collected on different days. If we got 6 specimens the test at that point is only 90% accurate. Parasites are often not detected in every specimen collected. Therefor specimen quality is critical. Is it possible for Chris to bring a specimen to the vet? Also, same with UA-can it be collected in a urine cup before she leaves and kept on ice?
Also, it only takes less that a drop to do a manual diff. Some machines do an automatic diff. I think this is a worthwhile test either way. You count the first 100 wbc's you see and report the results as as percentage. It is useful in that a "shift" of too many neut. would indicate poss. bacterial infection. Immature neut. are called bands. They are present when you have a bacterial infection and the older neuts. are "used up". Monos are the garbage eaters-they can mean infection,parasites,and also stress. Too many lymphs can mean a viral infection, but usually you have a low WBC count. You can also learn a lot about a patient's anemia with this test by looking at the rbc's. RBC's that are too big or too small are indicative of different types of anemia. You get a lot of info per drop of blood when a diff is performed!
If any lab work is sent to a reference lab, the vet should make sure to note what his priorities are as far as what tests are most important to him and that they need to take special care with the specimen as it was not easily obtained and cannot be recollected.