Case Study 1: Indicanuria in a Dog

Case Summary:

A 5-year-old male German Shepherd was presented with a history of chronic diarrhea,
vomiting, and weight loss. The owner reported occasional blood streaks in the stool. A
urinalysis was performed.

Urine Analysis Findings:

• Color: Dark yellow

• Odor: Strong
• pH: Slightly acidic
• Indican Test (Obermayer’s Reagent): Positive (blue color in chloroform layer)
• Microscopic Examination:
o Moderate leukocytes
o Few erythrocytes
o No casts observed
o No bacteria detected

Diagnosis & Interpretation:

The positive indican test suggests excessive protein putrefaction in the intestines. This could
be associated with intestinal obstruction, enteritis, or malabsorption syndrome. The presence
of leukocytes suggests mild urinary tract inflammation.

Possible Conditions:

• Chronic enteritis
• Intestinal malabsorption
• Intestinal obstruction (e.g., foreign body, volvulus, or intussusception)

Recommended Diagnostic Tests:

• Abdominal radiographs & ultrasound (to check for obstruction)

• Fecal examination (for parasites or bacterial overgrowth)
• Serum chemistry panel (to assess protein levels)

Treatment Plan:

• Fluid therapy for dehydration

• Broad-spectrum antibiotics if bacterial overgrowth is suspected
• Dietary modification (highly digestible food)
• Exploratory surgery if an obstruction is confirmed
Case Study 2: Urinary Crystals in a Horse
Case Summary:

A 7-year-old mare was presented with signs of frequent urination, mild colic, and discomfort
during urination. The urine was cloudy and had visible sediment.

Urine Analysis Findings:

• Color: Yellow, cloudy

• pH: Alkaline
• Microscopic Examination:
o Numerous calcium carbonate crystals
o Mucous threads present
o No bacteria observed
o No casts detected

Diagnosis & Interpretation:

The presence of calcium carbonate crystals and mucous threads is normal in horses due to
their high calcium excretion in urine. However, the cloudy urine and discomfort suggest
mild urinary irritation.

Possible Conditions:

• Dietary excess of calcium-rich feeds (e.g., alfalfa hay)

• Mild cystitis (bladder inflammation)
• Urinary sludge accumulation

Recommended Diagnostic Tests:

• Urinary pH and biochemical tests

• Ultrasound of the bladder (to check for sludge or stones)

Treatment Plan:

• Increase water intake

• Adjust diet (reduce high-calcium feed like alfalfa)
• Monitor for signs of UTI
Case Study 3: Bacterial Urinary Tract Infection in a Cat
Case Summary:

A 4-year-old female Persian cat was brought to the clinic with frequent urination, straining,
and occasional blood in the urine.

Urine Analysis Findings:

• Color: Light red (hematuria)

• pH: Slightly acidic
• Microscopic Examination:
o Numerous bacteria
o Moderate leukocytes
o Few erythrocytes
o No casts detected

Diagnosis & Interpretation:

The presence of bacteria and leukocytes suggests a urinary tract infection (UTI). The
hematuria (blood in urine) may indicate cystitis or bladder irritation.

Possible Conditions:

• Bacterial cystitis
• Feline lower urinary tract disease (FLUTD)

Recommended Diagnostic Tests:

• Urine culture and sensitivity test

• Ultrasound to check for bladder stones

Treatment Plan:

• Antibiotic therapy (based on culture results)

• Increase water intake
• Urinary acidifiers if required
Case 1: Urine Collection & Contamination
Case Summary:

A 6-year-old female Labrador Retriever was brought to the clinic for excessive thirst and
frequent urination. A free-catch urine sample was collected at home by the owner and
submitted for analysis.

Urinalysis Findings:

• Color: Slightly cloudy

• pH: Neutral
• Microscopic Examination:
o Numerous squamous epithelial cells
o Few bacteria
o No casts or crystals
o Mild leukocytes

Diagnosis & Interpretation:

The presence of numerous squamous epithelial cells suggests contamination from the lower
urinary tract or external genitalia. The bacteria detected may not be significant, as
contamination is possible in a free-catch sample.

Management:

• Repeat urinalysis with a sterile cystocentesis sample

• Educate the owner about proper urine collection techniques
• If infection suspected, perform urine culture

Case 2: Concentration of Urinary Sediment

Case Summary:

A 10-year-old mixed-breed dog was presented with lethargy and dark-colored urine. A urine
sample was collected via catheterization.

Urinalysis Findings:

• Color: Brownish-red
• pH: Slightly acidic
• Centrifuged Sediment Analysis:
o Numerous erythrocytes (RBCs) in sediment
o Moderate leukocytes
 o No bacteria detected

Diagnosis & Interpretation:

The brownish-red color and high RBC count in sediment suggest hematuria (blood in
urine). Possible causes include urinary tract trauma, infection, or neoplasia.

Recommended Tests:

• Urine culture and sensitivity

• Abdominal ultrasound to rule out bladder tumors or stones

Management:

• Fluid therapy for hydration

• Antibiotics if infection is confirmed
• Pain management if necessary

Case 3: Supernatant & Microscopic Dilution

Case Summary:

A 2-year-old male Persian cat was presented with difficulty urinating. A urine sample was
collected via cystocentesis.

Urinalysis Findings:

• Color: Pale yellow

• pH: Acidic
• Microscopic Examination:
o Excessive amounts of sediment
o Numerous struvite crystals
o Few leukocytes
o Supernatant urine was clear

Diagnosis & Interpretation:

Since sediment was excessive, supernatant urine was used to dilute the sample, ensuring a single
layer of elements under the microscope. The presence of struvite crystals suggests Feline
Lower Urinary Tract Disease (FLUTD) or urolithiasis.
Management:

• Urinary acidification therapy

• Dietary modification (low magnesium diet)

• Monitor for recurrence

Case 4: Proper Microscopic Examination & Illumination

Case Summary:

A 4-year-old male Thoroughbred horse was evaluated for mild colic and dark urine. A urine
sample was examined microscopically under improper illumination.

Urinalysis Findings (After Correcting Illumination):

• Color: Dark brown

• pH: Alkaline
• Microscopic Examination:
o Numerous granular casts
o Moderate erythrocytes
o Few calcium carbonate crystals

Diagnosis & Interpretation:

Initially, granular casts were not visible due to improper illumination. Adjusting the
microscope’s light intensity allowed for better identification. The presence of granular casts
suggests renal tubular damage.

Management:

• IV fluid therapy
• Monitor kidney function
• Avoid nephrotoxic drugs

Case 5: Staining of Urine Sediment

Case Summary:

A 7-year-old female goat with suspected bacterial cystitis was evaluated. The veterinarian
used new methylene blue stain for better visualization of cells.
Urinalysis Findings (After Staining):

• Color: Yellow
• pH: Neutral
• Microscopic Examination (Stained):
o Numerous neutrophils
o Cocci-shaped bacteria
o Few transitional epithelial cells

Diagnosis & Interpretation:

Staining with new methylene blue helped in clearly identifying neutrophils and bacteria,
confirming bacterial cystitis.

Management:

• Antibiotic therapy based on culture results

• Increase water intake

Case 6: Urine Specific Gravity & Kidney Function

Case Summary:

A 9-year-old male German Shepherd was presented with weight loss, excessive drinking
(polydipsia), and frequent urination (polyuria). A mid-stream urine sample was collected.

Urinalysis Findings:

• Color: Clear
• Specific Gravity (SG): 1.008 (low)
• Protein: Trace
• Microscopic Examination:
o No significant abnormalities

Diagnosis & Interpretation:

A low specific gravity (1.008) indicates isosthenuria, which is a sign of chronic kidney
disease (CKD) or diabetes insipidus. The kidneys are unable to concentrate urine properly.

Management:

• Blood tests (BUN, Creatinine) to confirm CKD

• Monitor hydration status
 • Dietary management (low protein & phosphorus diet)

Case 7: Proteinuria in Urine

Case Summary:

A 5-year-old female Holstein cow was presented with edema (swelling) and reduced milk
production. Urine was collected via catheterization.

Urinalysis Findings:

• Color: Yellow
• Specific Gravity: 1.020
• Protein: 3+ (high)
• Microscopic Examination:
o Granular casts
o Few leukocytes
o No bacteria detected

Diagnosis & Interpretation:

The presence of high protein levels (3+) and granular casts indicates glomerulonephritis or
amyloidosis.

Management:

• Monitor kidney function

• Reduce protein intake
• Supportive therapy (fluids, electrolytes)

Case 8: Hemoglobinuria vs. Hematuria

Case Summary:

A 3-year-old Thoroughbred horse was presented with red-colored urine after strenuous
exercise. A cystocentesis urine sample was examined.

Urinalysis Findings:

• Color: Dark red

• pH: Neutral
• Dipstick Test:
o Blood: Positive
 o RBCs (Microscopy): Absent

Diagnosis & Interpretation:

The absence of RBCs in microscopy, despite a positive blood test, suggests hemoglobinuria
(due to muscle damage or hemolysis) rather than hematuria (blood in urine).

Management:

• Check serum CK & AST for muscle damage (myopathy)

• Monitor hydration & electrolyte balance

Case 9: Crystals in Urine & Urolithiasis

Case Summary:

A 2-year-old male Dalmatian dog was presented with straining to urinate (dysuria) and
blood in urine (hematuria). A mid-stream urine sample was collected.

Urinalysis Findings:

• Color: Red-tinged
• pH: Acidic
• Microscopic Examination:
o Excessive urate crystals
o Few RBCs
o No bacteria detected

Diagnosis & Interpretation:

Dalmatian dogs have a genetic predisposition to forming urate crystals, leading to urinary
stones (urolithiasis).

Management:

• Increase water intake

• Dietary modification (low purine diet)

• Possible surgical removal of stones

Case 10: Bacteriuria & Urinary Tract Infection (UTI)
Case Summary:

A 4-year-old female cat was brought to the clinic due to frequent urination (pollakiuria) and
pain while urinating. A sterile cystocentesis urine sample was submitted.

Urinalysis Findings:

• Color: Cloudy
• pH: Alkaline
• Microscopic Examination:
o Numerous bacteria
o Moderate leukocytes
o Few transitional epithelial cells

Diagnosis & Interpretation:

The presence of numerous bacteria and leukocytes indicates a urinary tract infection (UTI).

Management:

• Urine culture & antibiotic sensitivity test

• Start broad-spectrum antibiotics
• Encourage increased water intake

Case 11: Urinary Casts & Kidney Damage

Case Summary:

A 6-year-old male German Shepherd was presented with lethargy, weight loss, and
increased thirst. Urine was collected via catheterization.

Urinalysis Findings:

• Color: Pale yellow

• Specific Gravity: 1.012
• Microscopic Examination:
o Numerous granular casts
o Few waxy casts
o No bacteria
Diagnosis & Interpretation:

Granular and waxy casts suggest chronic kidney disease (CKD) or acute tubular necrosis.

Management:

• Bloodwork (BUN, creatinine) for kidney function

• Fluid therapy to support kidney function

Case 12: Lipiduria in Urine

Case Summary:

A 3-year-old female Persian cat was presented for obesity and recent weight loss. A urine
sample was examined under a microscope.

Urinalysis Findings:

• Color: Clear
• pH: Neutral
• Microscopic Examination:
o Numerous fat droplets
o No crystals or casts

Diagnosis & Interpretation:

Lipiduria (fat in urine) is commonly seen in cats with obesity, diabetes, or liver disease.

Management:

• Check for diabetes or hepatic lipidosis

• Weight management plan

Case 13: Acid-Base Disturbance in Urine pH

Case Summary:

A 4-year-old male Rottweiler was presented with vomiting, weakness, and dehydration. A
mid-stream urine sample was collected.
Urinalysis Findings:

• Color: Light yellow

• Specific Gravity: 1.030
• pH: 8.5 (alkaline)
• Microscopic Examination:
o Few epithelial cells
o No crystals or bacteria

Diagnosis & Interpretation:

An alkaline urine pH (8.5) suggests metabolic alkalosis, which can occur due to chronic
vomiting (loss of stomach acid) or a urinary tract infection (UTI).

Management:

• Check blood gas analysis for acid-base status

• Correct dehydration with IV fluids
• Investigate underlying cause of vomiting

Case 14: Myoglobinuria vs. Hemoglobinuria

Case Summary:

A 7-year-old racehorse was presented after a strenuous workout, showing signs of muscle
stiffness and dark-colored urine.

Urinalysis Findings:

• Color: Brownish-red
• Specific Gravity: 1.025
• Dipstick Test:
o Blood: Positive
o RBCs (Microscopy): Absent

Diagnosis & Interpretation:

The presence of positive blood test but no RBCs suggests myoglobinuria (muscle breakdown
due to exertional rhabdomyolysis) rather than hematuria (blood in urine).

Management:

• Check serum CK & AST (muscle damage markers)

 • Fluid therapy to prevent kidney damage
• Rest and muscle relaxants

Case 15: Glucosuria & Diabetes Mellitus

Case Summary:

A 6-year-old overweight Labrador Retriever was presented with increased thirst, excessive
urination, and weight loss.

Urinalysis Findings:

• Color: Pale yellow

• Specific Gravity: 1.010
• Glucose: 4+ (high)
• Ketones: Moderate
• Microscopic Examination:
o No significant abnormalities

Diagnosis & Interpretation:

The presence of high glucose (glucosuria) and ketones indicates diabetes mellitus.

Management:

• Check blood glucose levels

• Start insulin therapy
• Monitor diet and weight

Case 16: Bilirubinuria & Liver Disease

Case Summary:

A 5-year-old male Persian cat was presented with jaundice (yellowish gums and eyes),
lethargy, and poor appetite.

Urinalysis Findings:

• Color: Dark orange

• Specific Gravity: 1.020
• Bilirubin: 3+ (high)
• Urobilinogen: Increased
Diagnosis & Interpretation:

The presence of high bilirubin in urine (bilirubinuria) indicates liver disease, bile duct
obstruction, or hemolysis.

Management:

• Check liver function tests (ALT, ALP, Bilirubin levels)

• Ultrasound to check for bile duct obstruction
• Supportive therapy with hepatoprotective drugs

Case 17: Pyuria & Bacterial Infection

Case Summary:

A 2-year-old female Poodle was presented with frequent urination, pain while urinating, and
cloudy urine.

Urinalysis Findings:

• Color: Cloudy
• pH: 8.0 (alkaline)
• Leukocytes (WBCs): Numerous
• Bacteria: Present

Diagnosis & Interpretation:

The presence of numerous WBCs (pyuria) and bacteria suggests a urinary tract infection
(UTI).

Management:

• Urine culture & sensitivity test

• Start broad-spectrum antibiotics
• Encourage increased water intake

Case 18: Hyaline Casts & Early Kidney Disease

Case Summary:

A 9-year-old male Golden Retriever was presented for a routine health check-up with mild
lethargy.
Urinalysis Findings:

• Color: Pale yellow

• Specific Gravity: 1.015
• Protein: Trace
• Microscopic Examination:
o Hyaline casts
o No bacteria or crystals

Diagnosis & Interpretation:

The presence of hyaline casts suggests early-stage kidney disease or dehydration.

Management:

• Monitor kidney function (BUN, Creatinine)

• Ensure adequate hydration
• Dietary management for kidney support

Case 19: Ammonium Biurate Crystals in Liver Disease

Case Summary:

A 4-year-old Dalmatian dog was presented with lethargy, vomiting, and increased thirst.

Urinalysis Findings:

• Color: Yellow
• pH: Acidic
• Microscopic Examination:
o Numerous ammonium biurate crystals

Diagnosis & Interpretation:

The presence of ammonium biurate crystals suggests liver disease (e.g., portosystemic
shunt).

Management:

• Liver function tests (Bile acids, ALT, ALP)

• Ultrasound for liver shunt
• Special low-protein diet
Case 20: Squamous Epithelial Cells in Contaminated Urine
Case Summary:

A 6-year-old female Labrador Retriever was presented with cloudy urine.

Urinalysis Findings:

• Color: Cloudy
• Microscopic Examination:
o Numerous squamous epithelial cells
o No bacteria detected

Diagnosis & Interpretation:

A high number of squamous epithelial cells suggests contamination from the lower urinary
tract (e.g., poor sample collection technique).

Management:

• Repeat urinalysis with a properly collected sample

• Check for underlying infections

Final Notes:

• These cases cover all critical topics of urinalysis.

• Each case is written according to the principles of Duncan & Prasse’s Veterinary
Laboratory Medicine.
• You can use these cases for clinical practice, exam preparation, and practical
applications.