1. Fecals and Zoonotic Diseases in Urine and Fecals
Michael Lavoie
Middlesex Community College
Veterinary Assistant Program
12/10/12

2. Gross Examination Things to consider
Color and consistency
Mucus
Blood
Undigested food
Parasites
Foreign materials or debris
All will lead to a proper and accurate diagnoses to the problem

3. What is giardiasis?
Giardiasis is a diarrheal disease caused by the microscopic parasite called Giardia
A parasite is an organism that feeds off another organism to survive
Once a person or animal (for example, cats, dogs, cattle, deer etc.) has been infected with giardia, the parasite lives in the intestines and is passed in feces
Once outside the body, Giardia can sometimes survive for months or weeks.
Giardia can be found within every region of the United States and around the world

4. How do you get giardiasis and how is it spread?
Can be spread by:
Swallowing Giardia picked up from surfaces (such as bathroom handles, changing tables, diaper pails, or toys) that can contain stool from an affected person or animal
Drinking water or using ice made from water sources where Giardia may live (for example, untreated or improperly treated water from lakes, streams, or wells.)

5. Spreading continued
Swallowing water while swimming or playing in eater where Giardia live, especially in streams, lakes and rivers.
Eating uncooked foods that contain Giardia organisms
Having contact with someone who is sick with giardiasis
Traveling to countries where Giardia is common

6. What are the symptoms of giardiasis?
Giardia infection can have a variety of intestinal symptoms, which include:
Diarrhea
Gas or flatulence
Greasy stool that can float
Stomach or abdominal cramps
Upset stomach or nausea
Dehydration
These symptoms can also lead to weight loss.
Some people with Giardia infection show no symptoms at all.

7. Who is at the most risk of getting giardiasis?
Though giardiasis is commonly thought of as a camping or back-packing related disease and is sometimes called “Beaver-fever,” anyone can get it
People more likely to become infected are:
Children in child care settings, especially diaper-aged children
Close contacts (for example, people living in the same household) or people who care for those sick with giardiasis

8. Getting giardiasis continued
People who drink water or use ice made from places where Giardia may live (for example, untreated or improperly treated water from lakes, streams, or wells)
Backpackers, hikers, and campers, who drink unsafe water, or who do not practice good hygiene
People who swallow water while swimming and playing in recreational water where Giardia may live.
International travelers

9. Giardia

10. Giardia cyst

11. Giardia Life Cycle

12. Whipworms (Trichuris vulpis)
Common internal parasite, found mostly in dogs
Get name from whiplike shape of the adult parasite
Live in the large intestine of the infected animal
Live inside and can cause intestinal disease

13. Infestation Infect host through contaminated food or drinking water
Hatch and in three months adults will attach to the large intestine and feed on blood
Lay eggs that are passed in feces

14. Whipworm transmission and diagnosis
A dog or cat becomes infected by ingesting food or water contaminated with whipworm eggs
Eggs are swallowed, hatch and a little less than three months, the larve mature into adults in the cecum and large intestine where they burrow their mouths and feed off blood
Adult worms lay eggs that are passed in the feces
Eggs must remain in the soil for about a month to mature and be capable of causing infection

15. What are signs of whipworm infection?
Signs of infection may vary with the number of worms in the intestines
Small numbers of worms cause no signs, but larger numbers can result in inflammation of the intestinal wall
Large amounts of mucous can be produced by the inflammed intestine
Sometimes hemorrhage into the intestine occurs, and anemia can result
Animals may have weight loss and diarrhea

16. How to control and prevent whipworm?
Whipworm eggs are very resistant and can live in soil for years, even resisiting freezing.
Because of this, animals should be restricted from contaminated areas
There is no effective method for killing whipworm eggs in the soil
The only alternative is to replace the soil with new soil, gravel, and pavement
To prevent exposure, any feces in the yard should be picked up on a daily basis.

17. Prevention continued
Floors in kennels and dog runs should be impervious so they are easier to clean
Kennels, runs, and litter boxes should be cleaned thoroughly, and if possible, be allowed to dry in direct sunlight.
Routine fecal examinations and deworming can help control this widespread parasite
Because of the possible zoonotic potential of T. vulpris, care should be taken when cleaning, and people should wear gloves and wash their hands well after these duties.

18. Whipworm egg

19. Whipworm Adult

20. Whipworm life cycle

21. Coccidia
Common protozoan internal parasite that is a simple one celled organism that occurs in all mammals
Most infections occur by Isopora canis, although several species of coccidia occur
Animals with coccidia will shed oocysts
Some animals will show no signs of an infection

22. Signs of infection Symptoms include: Chronic diarrhea Blood and mucous
Poor body condition
May look shaggy and unkempt

23. Diagnosis Sometimes hard to find on fecal samples
Protozoa are so small that they can be passed by as a debris or something else in the cell
Are small and circular

24. Contamination
Most animals become infected by contaminated food, water or soil sources
Bird droppings are also a carrier for coccidia

25. Coccidia

27. Leptosporosis Transmission
Leptosporosis is transmitted between animals through contact with infected urine; veneral and placental transfer; bite wounds; or the ingestion of infected tissue
Crowding, as found in the kennel, can increase the spread of the disease
Indirect transmission occurs through exposure of susceptible animals to contaminated water sources, food, or even bedding.

28. Transmission continued
Stagnant or slow moving water provides a good habitat for Leptospira
As a result the disease outbreaks often increase during periods of flooding.
In dry area, infections are more common around ground water sources
Freezing greatly reduces the survival of the organism in the environment

29. Transmission continued
This explains why infections are more common in the summer and fall and why the infection is more common in temperate areas

30. Infection
Leptospira bacteria penetrate the mucous membranes or abraded skin and multiply rapidly upon entering the blood system
From there, they spread to other tissues including the kidneys, liver, spleen, nervous system, eyes and genital tract
As the body fights the infection, the organism is cleared from most organs, but they may persist in the kidneys and be shed for weeks to months in the urine

31. Infection continued
The amount of damage done to the internal organs is variable depending on the host it infects
After 7-8 days of infection, the animal will begin to recover, if the damage to the liver and kidneys hasn’t been too much
Infections in dogs with the serovars canicola and grippotyphosa have been associated with kidney infections with minimal liver involvement

32. Infection
Whereas, the serovars pomona and icterohaemorrhagiae produce liver disease.
Dogs younger than 6 months tend to develop more cases of liver disease regardless of the serovar.

33. Symptoms
In acute infections, a fever of , shivering, and muscle tenderness are the first signs
Then vomiting and rapid dehydration may develop
Severely infected dogs may develop hypothermia and become depressed and die before kidney or liver failure has a chance to develop.

34. Symptoms
In subacute infection, the animal usually develops a fever, anorexia, vomiting, dehydration, and increased thirst
The dog may be reluctant to move due to muscle or kidney pain
Animals with liver involvement may become icteric

35. Symptoms
Those who develop kidney or liver involvement may begin to show improvement in organ function after 2-3 weeks or they may develop chronic kidney failure.
The possibility of severe infection an death, the majority of leptospiral infections in dogs are chronic or subclinical
Dogs that become chronically infected may show no outward signs, but may intermittently shed bacteria in the urine for months or years

36. Diagnosis
A positive diagnosis can be made through a blood test, or urine test
A blood sample of the suspected animal is drawn and sent to the laboratory where a microscopic agglutination test is performed
This can test for the individual serovars (strains) and the level of antibody (titer) against these strains

37. Diagnosis
Depending on the level of titer, a positive diagnosis to the specific serovar can be made
Titers may be negative in the first 10 days after initial infection, so may times additional samples must be drawn and tested to get a positive diagnosis.

38. Diagnosis
Previous vaccination can give an elevated titer and this must be taken into consideration when interpretating the titers
Acutely infected, or chronically infected dogs will most likely be shedding leptosporosis organisms in their urine
It is possible to culture a urine sample and get a positive diagnosis
However, because of intermittent shedding and bacteria contamination this is not always the best way to diagnose the disease.

39. Treatment
Consists of antibiotics, fluid replacement, and controlling the vomiting and the problems associated with the corresponding kidney or liver infections
Penicillin, or one of its derivatives is the antibiotic of choice for treating the initial infection

40. Treatment
After the initial infection is under control, doxycycline is often used to cure and prevent a potential long-term carrier state
Intravenous or subcutaneous fluids are often given to correct dehydration while the corresponding liver or kidney problems are treated.

41. Leptosporosis

42. Life Cycle

43. Questions?

44. Urinalysis Collection and Interpretation
Michael Lavoie
Middlesex Community College
Veterinary Assistant Program
5/21/12

45. Introduction
Urinalysis is an important tool in disease detection, as well as monitoring and screening animal health.
Complete urinalysis involves both macroscopic and microscopic assessment.

46. The Dipstick Test
This is typically performed by gross visual assessment of the urine, microscopic examination, and chemical evaluation.
Several chemical parameters can be measured using a commercially available in house dipstick test.
This test is relatively inexpensive, and takes less than 5 minutes to complete.

47. Urine Testing
Typical dipstick strips include the following tests: bilirubin, blood, glucose, ketones, pH, protein specific gravity, and urobilinogen.
Some dipsticks also include leukocytes and nitrite analyses.

48. Why Urine Test?
Abnormalities can be indicative of diseases of the urinary system as well as other organ systems, including liver function, acid-base status, and carbohydrate metabolism.

49. Sample Collection
Urine should be collected in a clean, dry container that is free of any disinfecting or cleaning chemicals.
Samples may be collected by free catch of voided sample, manual bladder expression, catheterization, or cystocentesis

50. Voided Samples
Voided samples are the easiest and least invasive samples to collect
However, voided samples may have contaminants that include bacteria, epithelial cells, and white blood cells.

51. Tips Red blood cells should not be found in normal voided samples.
Voided samples should be collected midstream to lessen contaminants from the vagina or prepuce
Collection of samples from surfaces such as floors, cages, and litter boxes should be avoided, since these will introduce environmental contaminants.

52. What you need to collect a voided sample?
Sterile collection cup
Rubber glove
syringe

53. Manual Expression of the Bladder
In this method, the patient’s bladder is gently squeezed until urine is expressed
This technique may lead to bladder trauma resulting in hematuria, and in some instances (such as urethral obstruction) may result in a ruptured bladder

54. Catherization
Catheterization is performed by placing a small hollow tube into the urethra to the level of the bladder.
Urine is then withdrawn from the bladder using a syringe.
Catheterized samples have less contamination from the distal urogenital tract; however, contamination from the urethra may still occur.
Poor catheterization technique may lead to trauma or, less commonly, infection.

55. Cystocentesis
Cystocentesis samples are collected by inserting a sterile needle through the body wall into the bladder.
Urine is withdrawn from the bladder using a syringe.
A lateral or ventral approach to the bladder may be made without causing severe trauma to any vital region of the bladder.

56. Cystocentesis
Clipping or surgical preparation of the area along the body wall is not necessary prior to sample collection.
Often a 1 inch or 1.5 inch 22 gauge needle is used attached to a 6 or 12 cc syringe.
The bladder is manually immobilized and the needle is inserted through the abdominal wall into the bladder, and the urine is withdrawn.

57. Cystocentesis
It is important to stop aspirating prior to withdrawing the needle as this may lead to aspiration of blood cells or epithelium from the bladder wall.
Animals often tolerate cystocentesis very well and little restraint is needed.

58. Sample Handling
In order to obtain accurate results, the urine collection, storage and handling must be sterile and follow standard procedures.
The dipstick analysis should be performed as soon after collection as possible (ideally within 30 minutes of collection) and the sample should be well mixed prior to testing.

59. Sample Handling
If for some reason the test cannot be performed immediately, the sample may be covered and refrigerated.
It should be allowed to return to room temperature prior to testing.

60. Testing Methods
Dipsticks may be removed from the air tight, light sealed containers.
It is important not to touch the reagent areas of the strip as this may alter test results.
Each reagent area should be immersed in urine by dipping.

61. Testing Methods
The excess urine should be removed to prevent dilution of reagents or mixing of reagents between pads.
This can be achieved by tilting the strip and allowing the urine to run off the edges

62. Testing Methods
The reagent pads should be read at the specified times. These times are different for each test and also vary between dipstick manufacturers.
Compare the blocks to the corresponding color chart provided by the test strip's manufacturer.

63. Testing Methods
Urine discoloration may create difficulty in visually interpreting the test results.
Color changes may be masked, or read as false positive test results.
If the urine is noticeably discolored, the sample may be centrifuged and the supernatant used for analysis.

64. Interpretation on test results
Dipsticks commonly include tests for specific gravity, pH, glucose, protein, blood, bilirubin, ketones, urobilinogen, nitrite, and leukocytes.

65. Specific Gravity
Urine specific gravity is based on the ratio of weight of urine to weight of an equivalent volume of pure water.
Although dipstick strips do have a method of approximating specific gravity, this measurement is best made with a refractometer.
Normal specific gravity in dog or cat is:

66. Urine pH
This number is a reading of how acidic or alkaline the urine is. On a pH scale of 1-14, 7 is considered neutral, meaning neither acid nor alkaline.
A number less than 7 indicates acidity, while a number greater than 7 indicates alkalinity.
Normal pH is

67. Protein
Healthy animals will usually not have any protein in their urine, although in some cases small, trace amounts may be normal.
The significance of any protein in the urine is dependent upon the specific gravity of the sample.
Small amounts of protein are more significant in dilute or unconcentrated urine.

68. Glucose
If the glucose (sugar) in the blood is significantly higher than normal, (for example, in diabetes) some of the excess will be found in the urine.
Normal dog and cat urine should be negative for glucose on a dipstick.

69. Ketones
Ketones are substances formed in the body during the breakdown of lipids (fat).
When excess amounts of ketones are formed, their level rises in the blood, and in turn, the urine.
The condition of excess ketones in the urine is termed "ketonuria."
Normal pet urine should have no Ketones.

70. Bilirubin
Bilirubin is a pigment made by the liver from dead or dying red blood cells.
Small amounts of bilirubin may sometimes be found in the urine of healthy dogs.
Bilirubin in the urine of a cat is a concern and calls for further investigation.
Can signify liver disease, a bile duct blockage, or hemolysis

71. Urobilinogen
This is a compound formed from bilirubin by intestinal bacteria.
Normal cats and dogs have small amounts of urobilinogen in their urine.
This is a common test that is included on many dipsticks, but the results are not considered very accurate in pets, and are difficult to interpret.

72. Blood
Healthy pets may have a few red blood cells in their urine, but greater than normal amounts indicate a problem.
Blood in the urine (hematuria) can be due to a number of causes, including trauma, urinary tract infection, bladder stones, and blood clotting problems.

73. Nitrites
Nitrites may be produced by the bacteria present in some infections.
However, this test often shows false negative results, and is considered inaccurate in pets.

74. White Blood Cells
Urine sediment should be examined for the presence of white blood cells.
Larger than normal numbers of white blood cells may indicate inflammation from a bladder or kidney infection.
Bladder stones can also cause inflammation.
However, white blood cells can also enter the urine from the prepuce or vagina during sample collection.

75. Bacteria
Urine sediment should be examined for the presence of bacteria.
Small amounts of bacteria in a urine sample may be from contamination during sample collection.
Large amounts of bacteria usually indicate a bladder infection, especially if an uncontaminated sample was obtained via cystocentesis.

76. QUESTIONS?