˻ û˻(Serum chemistry) 缱 ˻簰 Screening tests ߿ ݴ ȿ뼺 ſ پ ˻̸ ȯ ⺻ Ż(general condition) , , Ư 索̳ ź/ű ܿ ̸ Ȱ پϴ. ̰ ˻ ħ(sediments) ϰ Ư ʿ ʾ ſ ִ ˻̱ ؼ ˻ ؼѴٸ ˻ Ͼ ɼ ſ .
˻ ⺻ ؼ ʸ 캸 Ѵ. ˻ ӻ · ǽõǰ ӻ Ǹ complete urinalysis̸, ̴ 4 ˻ ̷ ִ.
1. Gross appearance: (color), Ź(turbidity), (odor) (physical characteristics)
2. (Urine specific gravity, USG): (refractometer) ̿
3. Reagent strip(biochemical) tests: Protein, glucose, ketone, bilirubin biochemical items
4. ħ(Urine sediments): ̰ ̿Ͽ а (cast), (crystal),
ȯڰ ؼ ó ϴ ˻ ݵ complete urinalysis õdz ȯ ˻縦 ȭ ִ. ä پ ߿ ڿ财(voiding) õ(centesis) ϴ . ü ä ݵ óġ óġ ̷ ϸ ̹ óġ ۵ Ŀ ü äϿ ˻縦 ǽϿٸ ؼ ֵ ܳ .
ȯڰ ؼ ó ϴ ˻ ݵ complete urinalysis õdz ȯ ˻縦 ȭ ִ. ä پ ߿ ڿ财(voiding) õ(centesis) ϴ . ü ä ݵ óġ óġ ̷ ϸ ̹ óġ ۵ Ŀ ü äϿ ˻縦 ǽϿٸ ؼ ֵ ܳ .
˻ ⺻ ˻ .
1. ּ 3-5ml ä
2. ü Ͽٸ ǿ¿
3. ÷ ä
4. ä tube Ͽ reagent strip dipping
(÷ Ͽٸ ɺи ˻)
5. 1500rpm 3-5 ɺи
(ħ Ͽ 0.5ml )
7. и (÷ᰡ ٸ ɺи USG ص )
8. Strip 翡 ϴ ð(Ϲ 30-60) Ŀ ǵ
9. 0.5ml ħ ȥϿ ħ ˻ ǽ
Ƿ ǿ 踦 Ͽ ϴ ־ Ѵ.
÷Ḧ ٷ ˻ϰ Ǹ urine density Ͽ false increaseǹǷ ݵ ǿ¿ ˻ϴ .
˻ ؼϱ Ȯؾ ȯ Ż(singnalments), ӻ(clinical signs), ȭ (hydration status) ü˻ ̴. ̸ װ˻ (azotemia) Ǵ(physiologic change )Ѵ. ߰ ܹ鴢(proteinuria) ȮϿȯ ¿ ̷ ִ° Ż籸ü/ ջ Ѵ. ħ ˻縦 ǽϿ ΰ ̳ ؾ ϸ ܹ鴢 ߰ ΰ , ż ܹ鴢(renal proteinuria) Ǵؾ Ѵ. ഢ , ܿ ܹ ǹ̸ οϱ . Ϲ reagent strip 30mg/dl ̻ ܹ(Ư albumin) ϸ ̺ ܹ ϱ ؼ microalbumin test ʿϴ. ̷ ܹ screening tests ̻ ܹ Ǿٸ 24ð ܿ ܹ м̳ UPC ratio(urine protein: urine creatinine ratio) м ǽϴ õȴ.
˻ ż ܹ鴢 ȮϿٸ ű (renal insufficiency) ź(renal failure) ٰŰ ִ. ϴ ̹Ƿ ˻ screening ű ̶̻ ֿ 籸ü (glomerular filtration) к ̸ ߰ ܹ鴢 ̷ ִ ⺻̸鼭 ̶ ϸ ȴ.
ݱ ˻ ؼ Ϲ ˾ƺҴ. ʸ ˻ ؼ ű غ ϰڴ. value Ϲ з mild, moderate, severe ǥϿ complete urinalysis Ͽ.
11 spayed female, Mongrel dog ü߰ҿ ٴ(polyuria) Ͽ. ü˻ ȯڴ ſ ü̾ mild dehydration · Ǿ. ˻ severe azotemia severe metabolic acidosis Ÿ. ȯڴ Ż· ǾǷ Ѵٸ 翬 ഢ Ǿ Ѵ. ȯ 1.011 崢(isosthenuria) Ÿ Ƿ űɿ Ǵϴ Ǵ. ż ܹ鴢 Ȯϸ Ǵµ ħ ˻翡 Ư ʾ reagent strip protein(+++) Ȯ ܹ鴢 Ÿ ֱ ż ܹ鴢 Ǵϸ ȴ.
ȯڰ ӻ ٴ Ÿ ־Ƿ chronic renal failure( ź) ִ. Severe azotemia creatinine level 5 mg/dl ̻ ǹϸ ̴ CRF staging(IRIS 2009 staging of CKD) 4ܰ ִ. 4ܰ CRF ܹ鴢 پų ʴ ̹Ƿ ȯڴ ٸ ο پ鼭 azotemia ִ. ̷ 츦acute on chronic failure ǥϸ óġ Ͽ azotemia ų ִ ִ. ջ Ǵ 쿡CRF staging ܹ鴢 matching ִµ 찡 ǥ̴. ȯڴ ħ ˻ 缼 ǽɵǴ ټ Ǽ Ǿ ˻翡 汤 occupying mass Ǿ.
4 intact male, Maltese dog 1-2 (weakness) (lameness) Ͽ. ü˻ mild dehydration, ġ Գ ȮϿ. װ˻ severe azotemia, severe anemia, mild metabolic acidosis Ǿ.
ȯڵ Ż ̹Ƿ ഢ Ǿ Ͼ ִٰ ִ. 1.008 崢 ŸǷ ɷ¿ ٰ ִ. ħ ˻翡 ̳ , ܹ鴢 Ư ʾ severe azotemia Ÿ ִ ̹Ƿ ź 4ܰ ϴ ϴ. 4ܰ azotemia ȭ Ͽ ⺻ Ȱ ȸŰ ġ ̴.
9 intact male, Mongrel dog 2 ĿϿ Ȱϸ Ÿ Ͽ. ü˻ moderate dehydration, Ÿ װ˻ moderate azotemia Ǿ. ȯڴ Ż ̷ 1.050 ഢ ִ. ഢ̱ ܹ鴢(++) ǰ ٰ ħ ˻翡 Ư ʴ. ̷ 찡 pre-renal azotemia() ִ. ٸ ˻縦 Ͽ ȯ ȭ ¸ ȭŰ ãƾ Ѵ.
9 neutered male, Schnauzer dog Ŀ Ͽ. ȯڴ 4 NSAIDs óް ־ ó ˻翡 ű Ǿ. ü˻ moderate dehydration Ÿ (anuria) ̴(oliguria) Ư ʾҴ. װ˻ moderate azotemia mild metabolic acidosis Ÿ.
ȯڴ Ż ִ ¿ ഢ Ÿ ʾ ܹ鴢(++) ǰ ִ. ħ ˻翡 ̳ żջ Ÿ ִ. ܹ鴢 м UPC ratio 1.23(reference range: azotemia <0.5) Ͽµ UPC ratio <3 쿡 ջ, > 3ΰ쿡 籸ü ջ ϱ Ѵ. UGGTC ratio(urine GGT: urine creatinine ratio) 0.51(reference range: <0.24) Ͽ ջ Ǵܵȴ( UPC ratio, UGGTC ratio ؼ ź 쿡 ). Ͽ ȯڴ żջ Ծ ֿ ȴ. NSAIDs پ Ͽ żջ ϸ (renal tubular necrosis) Ѱ̴.
2 intact female, Schnauzer dog Ŀ, Ȱ, , ٴ/(polyuria/polydipsia, PU/PD) ȣϸ Ͽ. ȯ ̷ 2-3 ۵Ǿ Ÿ þ ־. ü˻ â , Ÿ ־ Ư ʾҴ. װ˻ severe azotemia, moderate anemia, hyperphosphatemia, moderate metabolic acidosis Ÿ.
˻縦 ؼϱ 2 ȯڰ PU/PD Ÿ 츦 ִ°? Ѵ. ȯڴ Ȯ 14̾ Ÿ 12Ͽ. ȯڿ 崢 崢 ´ٸ ΰ Ȯϴ ߿ϴ. Ͻ 崢 崢 ȯ ȭ¿ ϱ ̴. ȯڿ ӻ ϰ ְ Ÿ 崢 ܹ鴢(++) ÿ Ǿ Ƿ ź ִ. PU/PD Ÿ Ƿ 4ܰ ź dz ܹ鴢 ǰ ִ ̱ azotemia ִ 3ܰ ɼ ְų protein leakage ϴ (congenital nephropathy) ɼ 3 ܰ迡 4ܰ Ǵ ߿ ܹ鴢 پ ִ ̶ ִ. UPC UGGTC ratio Ȯغ 籸ü ɼ Ͻϰ ִ. ȯ ȯ ° stable ٽ ϴ ߿ϸ ̻ ΰ ƴѰ Žϴ ߿ϴ.
15 intact female, Yorkshire Terrier dog Ŀ, PU/PD, Ȱ ϸ Ͽ. ü˻ Ż ̻ ʾҴ. ȯڴ 2-3 ÷ ܹް 庴 ް ־ ̷ ʾҴ. ˻ moderate azotemia, moderate anemia, mild metabolic acidosis Ÿ.
ȯڴ ̷ ¿ 庴 Ͽ. PU/PD Ÿ ¿ 1.016 崢 ഢ ƴ Ȳ̾. ̴ ⺻̹Ƿ 崢 찡 쿡 ϰ ̴ ɼ ϽѴ. ܹ鴢 Ư UGGTC ratio Ƿ ջ ϴ Ÿϴ. 庴 Ǵ ̴ Ӹ ƴ϶ 忡 ִ ACE inhibitor Ǹ ȯڴ ̻ ȮεǾ ߴ azotemia ȸ
ݱ complete urinalysis ⺻ Ȯ װ м Ҵ. ڰ ϴ ߿ κ ȭ¿ ´ ϰ ִ°?̴. ߿ ܹ鴢 ؼ ܹ鴢 , ܹ鴢 ִٸ м(UPC ratio, UGGTC ratio) Ͽ Ż籸ü ̻ Ȯϴ ͵ ߿ϴ. ̷ ؼ Ѵٸ ̻ ߰ ̴. ˻ Ư ˻簡 ƴ ʱ ܿ ݵ ǽؾ߸ ϴ ⺻ ˻ ƾ ̴.