Today and yesterday morning Ryan’s urine analysis showed the exact same result. It was negative for leukocytes (white blood cells). This is good. However, it picked up nitrites. This is not good. So, for the time being it will continue to be closely monitored to see if this develops into a full-blown urinary tract infection (UTI).
A urine analysis (the one we have) captures ten measurements. In the case of a UTI, I’m primarily concerned with nitrites and leukocytes. Here’s a brief definition.
Nitrites. Bacteria that cause a UTI make an enzyme that changes urinary nitrates to nitrites.
Leukocyte (WBC). WBCs in the urine may mean a UTI is present.
Other clinical signs I’m looking at are the odor and clarity of the urine. Urine typically doesn’t have a strong odor, but a UTI will make it smell quite foul. For clarity, I want it a clear, pale yellow (straw-colored). A UTI will produce a “cloudy” appearance. Often the urine will have debris floating in it. At this time, Ryan is absent of these symptoms. Still, these usually don’t show up until the UTI grabs hold.
One area I am going to investigate is to see if Ryan is retaining urine (not completely purging). There are a few ways to check this. One, which is quite invasive, involves inserting a catheter in his penis until it enters the bladder. I would do this immediately after he urinates to see if not everything came out.
The second is completely non-invasive and is checked through ultrasound. Dr. Rodriguez is in agreement that we should go this route and will be submitting a letter of medical necessity for a bladder scanner (see photo on left). It’s really a simple piece of equipment to use.
I am quite familiar with using it too. While at Kessler, I requested access to one at all times (it mostly just stayed in his room) while we moved Ryan from an indwelling catheter to a condom catheter. It was a time when we had to retrain his bladder to work again. I remember waiting until Ryan was retaining 500ml of urine and then messaging his bladder to stimulate urination. Ahhhh, good times…