Lab tests can be one of the more expensive aspects of veterinary care. It’s frustrating for both veterinarian and owner when lab results are impacted by a problem with the sample. Dr. Buzby wants to ensure that you get the most out of your dog’s diagnostic tests by helping to ensure ideal samples are tested in the first place.
In this week’s episode, Dr. Buzby provides seven simple tips that might not save you money, but will maximize the value you and your dog get out of every lab test. Listen now to learn:
1. The importance of interpreting blood work and urine together
2. The advantage of testing a first-morning urine sample
3. Why a “fasted” sample is best
4. Why refrigeration is preferable
5. How much do you need
6. Tips for sample collection
7. What to put samples in
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Speaker 1: (00:16)
Welcome to the Buzby Dog podcast, where our passion and focus is proactive care and longer, healthier, happier lives for our dogs. Here’s your host integrative veterinarian, Dr. Julie Buzby.
Dr. Buzby: (00:32)
Welcome to this week’s episode of the Buzby Dog podcast, which is inspired by my dear friend, Wayne. He called me yesterday and he said, Julie, my dog’s drinking a lot and urinating more. And I was just on the phone and he was nuzzling my arm, which isn’t unusual. We play a lot of ball in the backyard and all of a sudden there was a huge puddle by the front door. So what could be causing this? And I thought, well, there’s certainly a lot of things and he was absolutely making an appointment with the vet, but in the meantime, in the hours it took to get there, his mind was racing. He was worried. So he called me and I was happy to walk through some concerns with him, but most importantly, and I didn’t even really think about it, I gave him some tips for collecting lab work, and I thought, you know what?
Dr. Buzby: (01:17)
This is something that is really important to me as a veterinarian. I like my clients to have this baseline information because it helps me interpret the labs. Lab work’s not cheap as I’m sure, you know, when you have to run tests on your dogs, it tends to add up fast. It’s one of the more expensive things that we do in veterinary medicine. And so I thought, wait a second, this may really be helpful to all of my friends who listen to the Buzby Dog podcast to know how they can get really the most bang for their buck when they have to run lab tests. So I’ve got seven tips for you. Seven tips for getting the most out of your dog’s lab work. Tip number 1 is it’s really important to compare blood work and urine together. It’s called a urinalysis.
Dr. Buzby: (02:00)
That’s the analysis of urine. We look for a lot of different things. We look under a microscope at the specific cells. We look for red cells and white cells and bacteria. We also do what’s called a dip stick. It’s done in human medicine as well. Where we look at the pH of the urine. We check for protein. We check for what’s called ketones. We check the urine sugar level, which should be zero. And it’s very, very, very important to compare those together, namely, because of something called specific gravity. I want to know in light of the blood work, how well the kidneys are concentrating and that’s shown in a number called the urine specific gravity. So if you’re having blood work done, I’m sure your vet will bring it up, but I just want to prepare you that most commonly we’re doing blood work. Now, of course, if it’s something simple, like a heartworm test, this doesn’t apply, but if you’re doing diagnostic blood work, it’s very, very valuable to check that in light of a urinalysis and run the two as a pair.
Dr. Buzby: (02:58)
Number two, I think it’s really valuable to do a urine sample and if you’re going to do a urinalysis to do it on the first morning sample. And here’s why, because often we’re looking for information on the kidneys, in a urinalysis and how well that urine is concentrated. How well the dog’s kidneys can take the bodily fluid levels and concentrate them in the urine output tells us a lot about how the kidneys are functioning. If urine is very, very dilute and you know that probably by looking at it and seeing it just look almost white. I mean, just almost clear that may not be a problem. You know, maybe the dog just drank a lot and that dilutes the urine. But it may be a huge problem if the dog’s blood work shows that there’s some renal kidney insufficiency, and we have dilute urine to go along with that, that can be a really big clue.
Dr. Buzby: (03:52)
So the day that you’re taking your dog in for lab tests, I would recommend that you collect the first morning sample and bring that along. Why is the first morning sample so important? Well, because theoretically your dog hasn’t been drinking a lot of water overnight. I mean, typically dogs go to bed with us, wake up first thing go to the bathroom. They really haven’t been spending time with the water bowl in that amount of time. And so it’s really going to show us the best concentrating ability, of those kidneys. So your vet may choose not to run it. They may want a very fresh sample. And there’s times where freshness matters. We want a sample that’s collected right away. And if that’s the case and you can collect that right at the veterinary hospital, the vet can actually collect it directly through a process called cystocentesis.
Dr. Buzby: (04:41)
It’s basically like an amniocentesis for the bladder where a needle goes right into the bladder, removes some urine sterilely. It sounds horrible. Sounds like a torture chamber, but it’s done very commonly is super safe. And we do that if we need a sterile sample, that’s really the only way to get it. Now, if we don’t need a sterile sample, because we’re, we’re going to culture, it let’s say we would want a sterile sample so that if there’s any bacteria, we knew that it came right from the bladder and wasn’t a contaminant from the outflow tract, the lower urinary tract. And don’t fool yourself. I know in human medicine, they’ll send you into the bathroom with the cup and the little iodine wipe. And they might culture that sample, but we don’t in dogs. There’s just too much of a factor of them squatting in the bushes and hair and hair trapping bacteria.
Dr. Buzby: (05:29)
So we really never culture a sample that’s been collected as what we call a free catch. But again, the vet may want a very fresh sample. One of the reasons would be if we’re monitoring for crystals in the urine, crystals are going to change fast. So if that urine wasn’t collected and analyzed in probably 20 to 30 minutes, max, the crystals are not necessarily going to be accurate. So if you collected a first morning sample, the vet took it, didn’t analyze it in the office because we do that. We can do tests right in the office with our own lab and equipment and microscope. Sometimes they’re sent off to the laboratory. And of course that takes time often they’re going on an airplane to some other part of the country, to the lab. Let’s say all that happens in your vet says, okay, we saw crystals in the urine.
Dr. Buzby: (06:14)
Well, I don’t put a lot of credence in that. Because crystals, like I said, change fast in a max of 20 to 30 minutes. So if we are looking for crystals, if I have a patient I’m concerned about crystal crystals in the urine, I’m going to want to catch this sample in my parking lot. I don’t necessarily need it to be sterile, but I want to catch it in my parking lot. And I’m going to have the technicians analyze it, you know, within 10 minutes, I want those results because different situations required different testing parameters. But my point to you is just to be on the safe side, collect that first morning urine on the day that you’re going in. And at least you have it. You can present it to the vet and say, “Hey, I brought a first morning urine sample if you need it.”
Dr. Buzby: (06:56)
And then the vet can decide what to do with it from there. Number three, if you’re having blood work done on your dog. And again, I’m not talking about a simple heartworm test or something that we just requires like three drops of blood and it’s a simple in-office test. I’m talking about diagnostic blood tests, where we’re looking for liver values, we’re looking kidney values, we’re looking at electrolytes. In that case, fasted blood work is best. So my preference would be that you have a first morning appointment that you’re being seen at the office between eight and 10:00 AM for the sake of your dog, because, I’m sure, like all dogs or most dogs they’re in their routine and they love breakfast and they don’t want to miss that meal. So your night routine, the night before would be very normal. No change the next morning, it’s fine to offer water to keep the water bowl out.
Dr. Buzby: (07:47)
You don’t need to restrict that, but don’t feed breakfast, take the dog in, let them draw the blood in the office. And as soon as the blood draw’s over, I mean, whether it be right in the, in the exam room while youre are waiting or out in the parking lot or in your vehicle, you’re welcome to feed your dog then. But the blood work really should be drawn first. And here’s why there’s times where we get a phenomenon called lipemia where the blood actually has fat in it from food being digested and fat going into the bloodstream being absorbed. And that messes up some of the values. So we’ll actually get an index of plus one or plus two or plus three lipemia. The lipemia, the fat in the blood, actually causes the blood cells sometimes to break open and that’s called hemolysis and we get a one plus two plus or three plus on that.
Dr. Buzby: (08:34)
And it actually affects our ability to interpret the results. It may cause results that we say, I don’t know if I can believe these, is this a problem because of the lipemia or is this an issue that I need to pay attention to? How much do I need to pay attention to it? So again, you’re spending a fair amount of money on having the test done. You might as well get the best results possible. So fasted blood work is best. And just double check with your vet. When you schedule the appointment, ask the receptionist, does the veterinarian want me to fast my dog for this blood test? And they’re certainly the ultimate authority for your dog. You have the relationship with them, but I can tell you that for almost all of my patients, unless it would be a diabetic dog or puppies, for example, I wouldn’t fast a young dog, very, very young dog for my average dog.
Dr. Buzby: (09:17)
who’s getting blood work I am recommending fasted sample. All right, number four, refrigeration is your friend. So whether it be that first morning urine that you collected or a fecal sample that you picked up out of the yard for taking in for your annual exam to have the dog stool sample tested for internal parasites, it’s fine to put it in the refrigerator. Of course your significant other and children may not think so when they open it up for a ham sandwich and find a stool sample in Tupperware, but really refrigeration is preferable to leaving it out between the time that you collect it and taking it to the vet. All right, next number five. How much do we need? So Wayne asked me how much urine do you need? And we take these things for granted. You know, I’ve done 2 billion urine samples, have seen 2 billion urine samples come across my desk.
Dr. Buzby: (10:05)
So we take these things for granted, but it was a really good question. And the answer for urine is not very much, but definitely better to err on the side of having too much than too little. So one tablespoon is really plenty. If you can get several tablespoons, that’s great for feces, I would say the size of a bullion cube or bigger, certainly the fresher, the better. And it doesn’t hurt to have more, but they don’t actually need a lot for the stool sample. I think the more you bring in the more accurate the results are but if you go to the vet and you don’t have a stool sample, the vet may take a gloved finger into your dog’s rectum and collect a sample for analysis without having you bring one in. And I would strongly recommend both for the sake of your dog.
Dr. Buzby: (10:54)
Not that it’s harmful per se, but wants to have that done. So both for the sake of your dog and just for quality of results, go ahead and bring your stool sample when you are told to do so. Bring it from home, from the yard. Number six is tips for collection. So this can be really tricky, just like if you’re in that bathroom in your doctor’s office, and they’ve got that laminated sheet of paper on the door with the instructions on how to collect a urinalysis. I’m sure it says collect a clean midstream sample. So what does that mean? Well, clean just means be as clean as you possibly can. And midstream means let a little bit come out before you try to catch it because it’ll actually sort of cleanse the outside of, the vulva, the outside of the outflow tract.
Dr. Buzby: (11:42)
And so you’ll just kind of get a little bit washed past before you start to collect the sample and ideally it would make it a little bit more, more clean. Some dogs are very private and they do not want you back there catching anything. For these dogs, you’ve got one chance once they figure out that you’re trying to collect something from their hind end, they are done. So you want to be very efficient in round one. Some things that have worked for me is having something very flat with a low lip. So like a Tupperware lid or for bigger dogs, maybe a pie tin and you can tape it to something like a yard stick or a ruler to get it under there without being right on top of your dog and making them nervous about the process. Taking it away after you’ve actually collected the sample may be the hardest part because you’re trying to keep the whole thing flat and not spill it.
Dr. Buzby: (12:30)
You’re trying to keep it out of the leaves. You’re trying to keep your dog from stepping in it. So just do the best you can. It’s now this precious substance that you’ve got to get to the vet and for some dogs, especially male dogs, it’s really no big deal at all, but do your best to get a good sample. Be clean, be careful as I said, it won’t be sterile, but if you present it to the vet without leaves in it it’s much a precious sample and we can get better results. All right. Finally, tip number seven. What do you put this in? What do you put your fecal sample in? Well, believe it or not. We see all kinds of things. I mean, we’ve got people who bring in their fecal sample in a Pandora jewelry bag all the way to their prized crystal jar.
Dr. Buzby: (13:14)
I mean, it’s really cracks me up when a client brings us a fecal or urine sample and then asks for their container back. I would highly recommend that you use something disposable because we’re assuming that if your dog’s pee and poop was in it, that you don’t want it back. So something disposable is better for urine, anything, glass or plastic is fine. You obviously want a good sealing lid for feces. Really, anything is fine. You can just use a Ziploc bag for that matter, but any sort of disposable plastic container is fine. You just want, in any case you want both of them to be clean and dry before you would put any of your dog samples into them. All right? And so the other thing to remember is your veterinarian may be able to provide you with free supplies for collection and we get these free from the lab.
Dr. Buzby: (14:02)
We’re happy to give them out to you. So if you know, in advance that your dog’s needing a stool sample checked, or you need to take in a urine sample and it’s convenient for you to stop by your vet or you’re at an appointment, and know this is an upcoming procedure, ask your vet, “Do you have a container for me to put the urine in? Or do you have a container that you want me to bring the stool in?” And probably they do. And it’s very neat, tidy and efficient, and everybody’s happy. So there you go. There are your seven tips for getting the most out of your dog’s lab work. Certainly if your vet tells you something different default to them as they are the expert on your dog. If you have questions about this, leave a blog comment. I’d love to hear from you all in all. I hope this information helps you keep your dog as happy and healthy as possible. I’ll see you next time on the Buzby dog podcast,
Speaker 3: (14:58)
And now a message from Dr. Buzby’s mailbag. The ToeGrips are working out perfectly, the medium fits great. And Charlie does not seem to even know they are on. She is so much more confident and is smiling. Again. We recently took her out of town to visit family, and usually we have to take runners with us to put on the hardwood floor this time she was able to navigate without them. She is also attempting steps again for a tripod that is a really big deal. Thank you for such a great product ~ Chris Mcever. For more info, or to help your dog get a grip, go to toegrips.com
Speaker 1: (15:39)
Thanks for listening to the Buzby dog podcast. Don’t forget to subscribe in iTunes or Google play. So you don’t miss a single episode. We invite you to check out the Buzby Bark and our innovative products at toegrips.com.