Image Gallery: Urinalysis in Small

Animals
Maxey Wellman, DVM, MS, PhD, DACVP (Clinical Pathology)
M. Judith Radin, DVM, PhD, DACVP (Clinical Pathology), The Ohio State University

UROLOGY & NEPHROLOGY | MAY 2015 | WEB-EXCLUSIVE

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Urinalysis, which can easily be performed in-house, is helpful in establishing baseline data,
especially for comparison with ongoing clinicopathologic data for dogs and cats with clinical
signs of urinary tract disease. Preferred collection methods include free-catch, cystocentesis,
and catheterization. Ideally, urine should be examined within 30 minutes of collection. If
analysis is delayed, containers should be protected from exposure to UV light and tightly capped.
Urine can be stored in the refrigerator for up to 24 hours, but refrigerated samples should reach
room temperature prior to analysis.

Related Article: Struvite Crystalluria: Three Cases

Color and turbidity of urine should be evaluated before centrifugation. Specific gravity can be
measured by refractometry on a turbid sample with or without centrifugation, but turbid urine
should be centrifuged prior to chemical analysis with commercial reagent strips.

Complete urinalysis includes microscopic examination of urine sediment, prepared by

centrifuging a standard volume of urine (10mL) at 1500 rpm for 5 min, decanting the
supernatant, and resuspending the sediment by gently tapping on the tube. The sediment can be
evaluated with or without staining. Using freshly collected urine and precipitate-free stain
results in fewer artifacts. A drop of the sediment is placed on a glass slide and covered with a
coverslip. Improved contrast of the sediment is achieved by lowering the condenser and partially
closing the iris diaphragm. Low-power (100×) magnification is used to identify casts, crystals,
cells, sperm, mucus, and lipid droplets. High-power (400×) magnification is used to identify
erythrocytes, leukocytes, epithelial cells, microorganisms, and crystals. Results are recorded as
number of elements per low-power field (/lpf ) or per high-power field (/hpf ). 

Related Article: Atypical Transitional Epithelial Cells

Figure 1 (A and B). 

Squamous epithelial cells (400×, Sedi-Stain). 

Squamous epithelial cells originate from the urethra, vagina, or

prepuce and have no clinical significance. Their numbers
typically are higher in samples obtained by catheterization as
compared with free-catch samples; squamous epithelial cells
normally are not present in samples obtained by cystocentesis.
Squamous epithelial cells are large polygonal cells that either
are anucleate (A) or have small nuclei (B). 
Figure 2. 

Transitional epithelial cells (400×, Sedi-Stain).

Normal transitional epithelial cells, which line the renal pelvis,

ureters, bladder, and proximal urethra, occur as single cells or in
clusters or sheets. They are smaller than squamous epithelial
cells and are round, oval, elongate, or caudate. The nuclei are
round, with moderately condensed chromatin. Normal
transitional epithelial cells have minimal-to-moderate variation
in cell size, nuclear size, and nuclear:cytoplasmic ratio.

Figure 3 (A and B).

Transitional cell carcinoma in a dog (A 400×, Sedi-Stain; B
1000× Wright-Giemsa stain).

Atypical transitional epithelial cells can be seen in samples

obtained from animals with transitional cell carcinoma or from
animals with marked urinary tract inflammation. The distinction
between hyperplasia and neoplasia can be difficult, especially if
cell preservation is poor. If neoplasia is suspected, make several
unstained, air-dried direct smears of the sediment to send with
the urine sample to the reference laboratory.

This cluster of neoplastic transitional epithelial cells (A) is

characterized by multiple nucleoli as well as moderate-to-
marked variation in cell size, nuclear size, and
nuclear:cytoplasmic ratio. It is difficult to see the binucleated
cells (double arrow). There are several erythrocytes (arrows)
and lipid droplets (arrowheads). Preparation of air-dried
sediment smears stained with a Romanowsky-type stain (B) may
aid in differentiation between neoplastic and hyperplastic
transitional epithelial cells, especially if inflammation is
present. 

Figure 4. 

Erythrocytes and sperm (400×, Sedi-Stain).

Occasional erythrocytes and leukocytes can be found in urine
from normal dogs and cats. There may be 0–8 RBCs and
WBCs/hpf in a voided sample, 0–5 RBCs and WBCs/hpf in a
sample collected by catheterization, or 0–3 RBCs and WBCs/hpf
in a sample collected by cystocentesis. Higher numbers of
erythrocytes can be detected in samples collected by traumatic
catheterization or cystocentesis or if there is hemorrhage.
Erythrocytes may lyse in very dilute urine or may shrink
(crenate) in highly concentrated urine. (Photo courtesy of Dr. L.
Millward) 

Figure 5. 

Leukocytes and bacteria (400×, Sedi-Stain).

Increased numbers of leukocytes (pyuria) indicates

inflammation and often is associated with infection. This
sediment shows numerous leukocytes (>10 WBCs/hpf) and
large, rod-shaped bacteria. Although bacteria are easy to see in
the image, they sometimes are more readily detected on an air-
dried preparation stained with a Romanowsky-type stain. In
unstained sediment smears, small particulate matter can
resemble bacteria and in stained sediment smears, stain
precipitate can resemble bacteria. Culture may be helpful if
there is clinical concern for bacterial infection but no bacteria
are noted. When bacteria are present in urine, cell morphology
can deteriorate quickly and can impair cytologic evaluation if
processing is delayed. 

Figure 6. 

Hyaline cast (400×, Sedi-Stain).

Casts consist of protein and typically form in the distal renal

tubules. Although the presence of casts localizes problems to
the kidneys, the number of casts does not reflect disease
severity. A few hyaline casts (0–2/lpf) can be normal. Increased
numbers of hyaline casts can occur with increased protein
leakage or tubular protein secretion. Hyaline casts appear
homogenous and colorless and are difficult to see, especially in
unstained urine samples. With stain, hyaline casts are pale pink
or purple. These casts may dissolve in dilute or alkaline urine.
Figure 7.

Cellular and granular casts (400×, Sedi-Stain).

Cellular casts contain cells that have been trapped within the
protein matrix (arrow). Leukocyte casts indicate inflammation
within the kidney, as in this example. Granular casts can be
coarsely or finely granular and result from degeneration of
cellular casts. A finely granular cast is shown in the lower right
(arrowhead).

Figure 8. 

Fatty cast (400×, Sedi-Stain).

Fatty casts are uncommon but can occur in patients with
diabetes mellitus or other disorders associated with lipid
metabolism.

Figure 9.

Waxy cast (400×, unstained urine). Waxy casts are the result of
continual degeneration of granular casts and may indicate the
presence of a chronic renal lesion. Waxy casts are smooth with
blunt ends and folds or cracks. They usually are broader than
hyaline casts, and in stained sediment, they appear darker than
hyaline casts. (Photo courtesy of Dr. S. Corn)
Figure 10.

Struvite crystals (400×, Sedi-Stain).

Crystals form or dissolve in urine, depending on pH,

concentration, and temperature. Crystalluria often has no
clinical significance but may be associated with risk for
urolithiasis, may indicate abnormal metabolism, or may be in
response to diet or medication. Struvite (magnesium
ammonium phosphate) crystals are commonly found in urine of
normal dogs and occasionally of normal cats. Struvite crystals
form in alkaline urine and typically appear as rectangular or
square prisms of variable size.

Figure 11.

Bilirubin crystals (400×, Sedi-Stain).

Bilirubin crystals can form in concentrated urine obtained from

normal dogs or in animals with bilirubinuria resulting from
either hemolysis or cholestasis. They appear as orange spicules
and often form groups of crystals. Note that several leukocytes
are also in this field.
Figure 12.

Calcium oxalate crystals (400×, Sedi-Stain).

The dihydrate form of calcium oxalate crystals form in acidic

urine and can occur in urine obtained from normal animals.
These crystals appear as relatively small colorless squares with a
Maltese cross or envelope pattern (arrow). The monohydrate
form of calcium oxalate has a hemp seed (arrowhead) or picket
fence appearance and can be seen in the acute stage of ethylene
glycol toxicity.

Figure 13.
Ammonium biurate crystals (400×, Sedi-Stain).

Ammonium biurate and other urate crystals occur in some dogs

with liver disease, especially those with portosystemic shunts,
and in Dalmatians or English bulldogs with an inherited error of
metabolism. These crystals are yellowish-brown spheres that
either are smooth or have irregular projections.

Figure 14.

Cystine crystals (400×, Sedi-Stain).

Cystine crystals are uncommon but can be seen in dogs and cats
with defective tubular transport of amino acids. They have a
characteristic hexagonal shape. (Photo courtesy of Dr. N. Zitzer)
 Figure 15 (A and B).

Capillaria (syn Pearsonema) plica and Dioctophyme renale

(400×, Sedi-Stain).

C plica (A) is a bladder worm of dogs and cats. Eggs are laid in
the bladder lumen and can be seen in urine sediment of infected
animals. The eggs measure 65 × 25 microns and have
asymmetric bipolar plugs and a rough surface. Adult D renale (B)
nematodes develop in the kidneys of dogs and release eggs into
the renal pelvis. The barrel-shaped eggs measure 60–80 × 40–46
microns and have indistinct bipolar plugs and a pitted surface.
(Photo courtesy of Dr. D. Schaefer)

Dr. Wellman is a professor in the Department of Veterinary Biosciences at The Ohio State
University College of Veterinary Medicine. She is a recipient of the Carl Norden-Pfizer
Distinguished Teacher Award and the Dean’s Creativity in Teaching Award. Dr. Wellman has
given numerous hematology and cytology CE presentations, including a cytology workshop at
NAVC Conference. She is past president of the American Society of Veterinary Clinical Pathologists
and past president of the American College of Veterinary Pathologists. In addition, Dr. Wellman is
the cytology/surgical pathology section editor for Veterinary Clinical Pathology. Her clinical areas
of interest are hematology, cytology, and the scholarship of teaching, and her current area of
collaborative research is regenerative medicine.
Dr. Radin is a Professor in the Department of Veterinary Biosciences at The Ohio State University
College of Veterinary Medicine. She is the Section Editor for Invited Reviews for Veterinary Clinical
Pathology and on the journal’s editorial board. She is past president of the American Society for
Veterinary Clinical Pathologists. She has served on and chaired the board certifying examination
committee for the American College of Veterinary Pathologists. Her clinical areas of interest are
chemistry, cytology, hematology, and coagulation. She is a member of the Dorothy M. Davis Heart
& Lung Institute and Center for Clinical and Translational Research where she studies cytokine
and eicosanoid mediators of hypertension and cardiovascular disease.

REFERENCES
Suggested Reading
Clinical chemistry, serology and urinalysis. Radin MJ, Wellman ML. In Mccurnin’s
Clinical Textbook for Veterinary Technicians, 7th ed—Philadelphia: Elsevier, 2013, pp
430-437.
Interpretation of canine and feline urinalysis. Chew DJ, DiBartola SP. In Nestlé-Purina
Clinical Handbook Series—Wilmington, DE: The Gloyd Group, 1998.
Laboratory evaluation of renal function. Fettman MJ, Rebar A. Veterinary Hematology
and Clinical Chemistry—Philadelphia: Lippincott Williams & Wilkins, 2004, pp 314-326.
Urinalysis: A Clinical Guide to Compassionate Patient Care. Osborne CA, Stevens JB
—Whippany, NJ: Bayer North America, 1999.

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