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Comparison of urine dipstick, sulfosalicylic acid, urine protein-to-creatinine ratio, and species-specific ELISA methods for detection of albumin in urine samples of cats and dogs

Shane D. Lyon DVM1, Michael W. Sanderson DVM, MS, DACVPM2, Shelly L. Vaden DVM, PhD, DACVIM3, Michael R. Lappin DVM, PhD, DACVIM4, Wayne A. Jensen DVM, PhD5, and Gregory F. Grauer DVM, MS, DACVIM6
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  • 1 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 4 Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80525.
  • | 5 Heska Corporation, 3760 Rocky Mountain Ave, Loveland, CO 80538.
  • | 6 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

Abstract

Objective—To evaluate the use of dipstick, sulfosalicylic acid (SSA), and urine protein-tocreatinine ratio (UP:C) methods for use in detection of canine and feline albuminuria.

Design—Evaluation study.

Sample Population—599 canine and 347 feline urine samples.

Procedures—Urine was analyzed by use of dipstick, SSA, and UP:C methods; results were compared with those for a species-specific ELISA to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value, and positive and negative likelihood ratios.

Results—Positive results for dipstick and SSA tests (trace reaction or greater) in canine urine had moderate specificity (dipstick, 81.2%; SSA, 73.3%) and poor PPV (dipstick, 34.0%; SSA, 41.8%). Values improved when stronger positive results (≥ 2+) for the dipstick and SSA tests were compared with ELISA results (specificity, 98.9% and 99.0% for the urine dipstick and SSA tests, respectively; PPV, 90.7% and 90.2% for the dipstick and SSA tests, respectively). Data obtained for cats revealed poor specificity (dipstick, 11.0%; SSA, 25.4%) and PPV (dipstick, 55.6%; SSA, 46.9%). Values improved slightly when stronger positive test results (≥ 2+) were used (specificity, 80.0% and 94.2% for the dipstick and SSA tests, respectively; PPV, 63.5% and 65.2% for the dipstick and SSA tests, respectively). The UP:C had high specificity for albuminuria in dogs and cats (99.7% and 99.2%, respectively) but low sensitivity (28.7% and 2.0%, respectively).

Conclusions and Clinical Relevance—Caution should be used when interpreting a positive test result of a dipstick or SSA test for canine or feline albuminuria.

Abstract

Objective—To evaluate the use of dipstick, sulfosalicylic acid (SSA), and urine protein-tocreatinine ratio (UP:C) methods for use in detection of canine and feline albuminuria.

Design—Evaluation study.

Sample Population—599 canine and 347 feline urine samples.

Procedures—Urine was analyzed by use of dipstick, SSA, and UP:C methods; results were compared with those for a species-specific ELISA to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value, and positive and negative likelihood ratios.

Results—Positive results for dipstick and SSA tests (trace reaction or greater) in canine urine had moderate specificity (dipstick, 81.2%; SSA, 73.3%) and poor PPV (dipstick, 34.0%; SSA, 41.8%). Values improved when stronger positive results (≥ 2+) for the dipstick and SSA tests were compared with ELISA results (specificity, 98.9% and 99.0% for the urine dipstick and SSA tests, respectively; PPV, 90.7% and 90.2% for the dipstick and SSA tests, respectively). Data obtained for cats revealed poor specificity (dipstick, 11.0%; SSA, 25.4%) and PPV (dipstick, 55.6%; SSA, 46.9%). Values improved slightly when stronger positive test results (≥ 2+) were used (specificity, 80.0% and 94.2% for the dipstick and SSA tests, respectively; PPV, 63.5% and 65.2% for the dipstick and SSA tests, respectively). The UP:C had high specificity for albuminuria in dogs and cats (99.7% and 99.2%, respectively) but low sensitivity (28.7% and 2.0%, respectively).

Conclusions and Clinical Relevance—Caution should be used when interpreting a positive test result of a dipstick or SSA test for canine or feline albuminuria.

Contributor Notes

Dr. Lyon's present address is Las Vegas Veterinary Referral Center, 8650 W Tropicana Ave, Ste B-107, Las Vegas, NV 89147.

Dr. Jensen's present address is Morris Animal Foundation, 10200 E Girard Ave, Ste B430, Denver, CO 80231.

Supported by Heska Corporation.

Presented in part at the American College of Veterinary Internal Medicine Conference, Minneapolis, June 2004.

Address correspondence to Dr. Grauer (ggrauer@vet.ksu.edu).