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Urinalysis: erythrocytes

ISSN 2398-2985

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Synonym(s): Red blood cells

Overview

  • Presence of erythrocytes in urine (hematuria) occurs with various urinary tract conditions, including inflammation, infection, calculi and neoplasia.
  • Hematuria may be seen in cases of:
    • Cystitis Cystitis and urolithiasis.
    • Urolithiasis.
    • Renal infarcts.
    • Pyelonephritis.
    • Septicemia.
    • Disseminated intravascular coagulation (DIC).
    • Uterine disease in intact females.

Uses

Alone

  • Red or red-tinged urine may be due to blood or blood products, eg hemoglobin, in the urine.

In combination

  • If erythrocytes are detected in urine, further investigative tests are necessary to identify their origin and the etiology.
  • Other tests that may be useful in disease investigation include:

Sampling

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Tests

Methodologies

  • Chemical reagent test strip: semi-quantitative testing, result as negative or as positive in range to 1+ to 4+.
  • Microscopic examination of urine sediment:
    • To obtain sediment, centrifuge on low speed for 5 min and decant supernatant Urinalysis: centrifuged deposit. Take a drop of sediment onto a clean microscope slide and add a coverslip to examine as a wet preparation.
    • Examine under a low (x10) and high power (x40 dry): erythrocytes are seen as uniform sized pale red-brown to yellow cells, sometimes with a visible biconcave shape. Erythrocyte casts may be present from renal hemorrhage.

Availability

  • Urine test strips are cheap and readily available.
  • Equipment for microscopy includes centrifuge and light microscope; both are available in most veterinary practices.

Validity

Sensitivity

  • Good.

Specificity

Predictive value

  • Confirmation of presence of erythrocytes is only possible using microscopy.

Technique intrinsic limitations

  • Equipment is required for microscopic urine examination: centrifuge to spin sample and light microscope to examine sediment.
  • Optimal sampling technique for urine analysis is cystocentesis; however, this will require heavy sedation or general anesthesia.
  • If using a dipstick for testing, consider significance of result in conjunction with urine specific gravity as more dilute urine will affect the cellular concentration.
  • Conversely, microscopy may give a false-negative result if erythrocytes in urine lyze before analysis. In this case, the dipstick reading will be positive (for hemoglobin).
  • Hyposthenuric urine may cause hypotonic lysis of erythrocytes, interfering with microscopic detection of the cells.

Technician extrinsic limitations

  • If using a dipstick interpret test strip at specified time interval.

Result Data

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Lloyd M (2002) Veterinary care of ferrets: 1. Clinical examination and routine procedures. In Practice 24 (2), 90-95

Other sources of information

  • Chitty J (2009) Ferrets: physical examination and emergency care. In: BSAVA Manual of Ferrets and Rodents. Eds: Keeble E & Meredith A. British Small Animal Veterinary Association, UK. pp 205-218.
  • Fisher P G (2009) Ferrets: urogenital and reproductive system disorders. In: BSAVA Manual of Ferrets and Rodents. Eds: Keeble E & Meredith A. British Small Animal Veterinary Association, UK. pp 291-302.