General physical examination

1. Urine output

Dogs 20-40ml/kg/day, cats 22-30ml/kg/day abnormal urine output: 1. Polyuria is more common in the following diseases (1) Endocrine diseases: such as diabetes, primary thyroid disease Hyperparathyroidism and primary aldosteronism, etc. (2) Kidney diseases: such as chronic pyelonephritis, hypertensive nephropathy, chronic renal tubular failure, etc. (3) Psychogenic polyuria: mostly caused by mental factors, such as tension, excessive work pressure, etc. 2. Oliguria or anuria is common in the following diseases (1) Kidney diseases: such as acute glomerulonephritis, acute attack of chronic nephritis, acute renal failure, etc. (2) Shock, severe dehydration or electrolyte imbalance caused by various reasons, or urinary tract obstruction caused by various reasons.

2. Color

Normal fresh urine in dogs is light yellow and in cats it is yellow and transparent liquid. After being left for a period of time, trace amounts of flocculent precipitates can be seen. The color of urine is often related to food, drugs and urine output. Common types of abnormally colored urine include the following - 1. Red. When the urine contains a certain amount of red blood cells, the urine turns red, which is medically called hematuria. Commonly seen in renal tuberculosis, renal tumors, kidney or urinary tract stones, acute glomerulonephritis, pyelonephritis, cystitis, etc. It can also be seen in bleeding disorders, such as thrombocytopenic purpura, hemophilia, etc. Note: Taking dyes, drugs, etc. can also cause red urine, so you need to distinguish carefully. 2. Soy sauce or strong brown color is common in favismosis, black urine fever, acute hepatitis, paroxysmal nocturnal hemoglobinuria and blood transfusion reactions with incompatible blood types. 3. Milky white: common in filariasis, tuberculosis, tumors, chest and abdominal trauma, or obstruction of lymphatic circulation around the kidneys due to certain reasons. In addition, when patients suffer from urinary system infections, such as cystitis, pyelonephritis, etc., white cloudy precipitates can be seen after urine is placed. Note: Normal urine may also appear milky white if it contains a large amount of phosphate, especially in winter when the temperature is low. 4. Yellow color is common in obstructive jaundice and hepatocellular jaundice. This is caused by the large amount of conjugated bilirubin in the urine. It can also be seen after taking certain drugs, such as riboflavin, berberine, metronidazole, etc. 5. Blue-green color is more common after using methylene blue, indomethacin, triamterene and other drugs.

3. Smell

After normal urine is left for a long time, the decomposition of urea will produce an ammonia smell. If there is an odor of ammonia in the urine, you often suffer from chronic cystitis or chronic urinary retention. If the urine smells like apples, it's more common in people with diabetic ketoacidosis. In addition, eating some foods, such as garlic and onions, can also make urine have a special smell.

2. Routine urine examination

1. Urobilinogen

Normal reference value: positive

The amount of urobilinogen in urine is only trace under physiological conditions. It increases slightly when hungry, after meals, exercise, etc. However, if the urine is diluted more than 4 times and is still positive, it means that urobilinogen has increased, which is pathological. indications.

Increased urobilinogen in urine is common in the following diseases - Impaired liver function, such as liver disease, heart failure, etc.

People with excessive bilirubin production in the body and unobstructed bile ducts are more common in patients with internal bleeding or various hemolytic diseases.

The amount of urobilinogen reabsorbed from the intestine increases, which is more common in patients with refractory constipation and intestinal obstruction.

Negative, seen in obstructive jaundice.

2. Urinary bilirubin

Normal reference value:

Negative (-)

Clinical significance: Urinary bilirubin examination is an important examination to show liver cell damage and distinguish jaundice. Positive: Found in obstructive jaundice caused by cholelithiasis, biliary tract tumors, biliary roundworms, and pancreatic head cancer, and hepatocellular jaundice caused by liver cancer, cirrhosis, acute and chronic hepatitis, and hepatocellular necrosis. Negative: negative reaction in hemolytic jaundice. When hepatic and obstructive jaundice are combined with severe renal damage, urinary bilirubin will be negative.

3. Ketone bodies

Normal reference value: Negative (-) Clinical significance: Positive, seen in diabetes, acidosis, vomiting during pregnancy, eclampsia, diarrhea, poisoning, typhoid, measles, scarlet fever, pneumonia, septicemia, acute rheumatic fever, acute Miliary pneumonia, convulsions, etc., besides starvation. Eating too much fat and protein after childbirth can also be a positive.

4. Occult blood

Normal reference value: negative

5. Protein

Normal reference value: negative

Positive clinical significance: seen in various acute and chronic glomerulonephritis, acute pyelonephritis, multiple myeloma, renal transplantation, nephrotic syndrome caused by various reasons, etc.;

Urinary system infection: such as pyelonephritis, cystitis or renal tuberculosis;

Other diseases: such as cardiac insufficiency, hypertensive nephropathy, diabetic nephropathy, hyperthyroidism, systemic lupus erythematosus, sepsis, leukemia, etc.

In addition, damage to renal tubular epithelial cells caused by drug, mercury, drug poisoning, etc. can also be positive.

6. Nitrate

Normal reference value: negative

Clinical significance: Positive, seen in urinary system infections such as cystitis and pyelonephritis.

7. White blood cells Normal reference value: negative

Clinical significance: increased: seen in acute glomerulonephritis, pyelonephritis, cystitis, urethritis, urethral tuberculosis, etc.

8. GlucoseNormal reference value: negative

Clinical significance: Positive, seen in diabetes, hyperthyroidism, anterior pituitary hyperfunction, pheochromocytoma, pancreatitis, pancreatic cancer, severe renal insufficiency, etc., craniocerebral trauma, cerebrovascular accident, brain Stress-induced diabetes may also occur. lConcussion, acute myocardial infarction, etc. Excessive intake of high sugar can also cause temporary increases in blood sugar and urine sugar positivity.

9. Proportion

The urine specific gravity of infants and young children is low, and the urine specific gravity is affected by age, water intake and sweating. The level of urine specific gravity mainly depends on the concentration function of the kidneys, so measuring urine specific gravity can be used as one of the kidney function tests. Normal reference values: dogs 1.015-1.045, cats 1.015-1.060 Clinical significance:

Reduced urine specific gravity: Common in chronic pyelonephritis, diabetes insipidus, chronic glomerulonephritis, polyuria phase of acute renal failure, etc.

Increased urine specific gravity: More common in diabetes, high fever, vomiting, diarrhea, dehydration, shock, acute glomerulonephritis, and heart failure.

10.PH

Normal reference value: The pH value (acidity and alkalinity) of dog and cat urine is between 5.0-7.0, usually around 6.0. Normal urine is weakly acidic, or it can be neutral or weakly alkaline. The pH of urine depends to a large extent on the type of diet, medications taken and the type of disease. Clinical significance: Urinary pH value is lower than the normal value: common in acidosis, diabetes, gout, leukemia, or taking acidic drugs (such as ammonium chloride); Urinary pH value is greater than the normal value: common in alkalosis, cystitis, or taking sodium bicarbonate Alkaline drugs, etc.

11. Vitamin C

Normal reference value: negative

Clinical significance: Vitamin C is affected by food. If your food is high in vitamin C, your urine may be higher than normal. it `s just normal. Vitamin C is an antioxidant that acts like a "reducing agent" in chemical reactions. Therefore, as long as there is a "redox reaction" process in any laboratory examination, vitamin C may be involved, which will affect the test results. The most common one is the impact of urinalysis - large intakes of vitamin C can lead to false negative results in occult blood, urine sugar, urine ketone and nitrite testing items (originally there is a problem, but it is not detected), which may cause doctors to Wrong diagnosis of D. Ises. Therefore, urine routine vitamin C+3 will not directly affect the body.

Urine indicators can be roughly divided into four categories: kidney disease, diabetes, urinary infection and other diseases.

1. Kidney disease indicators: pH, specific gravity (SG), occult blood or red blood cells (BLD, ERY), protein (PRO) and color (COL). The normal reference values ​​are: 4.6~8.0, 1.005~1.030, positive, negative, light yellow to dark yellow. Changes in these indicators may indicate renal damage.

2. Diabetes indicators: pH, protein, specific gravity, sugar (GLU) and ketone bodies (KET). The detection of these indicators can help diagnose related complications and whether some organs of the body are damaged, such as whether ketonemia occurs. Under normal circumstances, urine glucose and ketone bodies are negative.

3. White blood cells, occult blood or red blood cells, nitrite (NIT), color and turbidity (TUR) are indicators of urinary tract infection. When the urinary system becomes infected with bacteria, white blood cells and red blood cells often appear in the urine. The color or turbidity of the urine may also change. Nitrite is sometimes positive. Chemical detection of urinary white blood cells and occult blood or red blood cells only serves a screening purpose, and clinical diagnosis is based on microscopic examination results.

4. Other disease indicators, mainly pH, specific gravity, bilirubin (BIL), urobilinogen (URO), color and other indicators. Bilirubin and urobilinogen are two indicators that reflect the liver's ability and quantity to metabolize heme. Under normal circumstances, urinary bilirubin is negative and urobilinogen is weakly positive. When the above indicators increase, it often reminds you of jaundice, and the urine color turns yellow-green.

Reminder: "1+" or "3+"... or +, +++ appears after some items on the urine routine analysis test sheet, which means the superficial test result is positive; on the contrary, if it is "-", it means the test The result was negative. When reading the report, you must analyze the report objectively, because there are many interfering factors that affect the accuracy of the test results, such as dietary factors, some interfering substances in urine, etc. When abnormalities appear in routine urine tests, please do not be too nervous or worried; similarly, when test results inconsistent with clinical manifestations appear, do not be blindly optimistic. It is necessary to cooperate with the clinician for further examination and analysis to avoid delaying the diagnosis of the disease.