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Relationship of cerebrospinal fluid protein concentration determined by dye-binding and urinary dipstick methodologies.

Aroutine cerebrospinal fluid (CSF) examination i ncludes determination of the protein concentration and erythrocyte, nucleated, and differential cell counts. For many central nervous system (CNS) diseases, the nucleated cell count and protein concentration increase together. However, an increased protein concentration suggests CNS disease even if the nucleated and differential cell counts are normal. Therefore, determination of CSF protein concentration is important in the diagnosis, prognosis, and treatment of CNS disease. Since quantitative methods for determination of CSF protein concentrations are not always readily available, alternative screening or semiquantitative methods are used. The Pandy test, which involves mixing CSF with phenol, is one such test. The sensitivity and correlation of the Pandy test with other analytical tests are quite good (1), but the Pandy test may not detect small increases in protein concentration with accuracy and precision. Recently, the urinary dipstick has been used to estimate CSF protein concentration (2). These data, comparing protein concentrations determined using urinary dipsticks and a quantitative dye-binding technique, showed a trace reaction in normal dogs (protein concentration < 0.25 g/L), and 1+, 2 +, and 3 + reactions corresponding to CSF protein concentrations between 0.28 and 0.75, 1.15 and 2.40, and 4.70 and 5.90 g/L, respectively (2). Most veterinary hospitals have urinary dipsticks; therefore, the dipstick technique would be a convenient procedure for estimating CSF protein concentration. Since CSF protein concentration determination is an important test in the characterization of CNS disease, and the preliminary study used only a small sample size, we examined a larger number of samples of canine CSF, comparing dye-binding and dipstick methodologies. One hundred samples of canine CSF were obtained from two referral practices (Veterinary Teaching Hospital, University of Guelph; Veterinary Referral Clinic of Mississauga) over a six-month period. The protein concentrations in fresh samples were determined by the trichloroacetic acid(TCA)-Ponceau S dyebinding method (3) using human albumin standards (American Dade, Aguada, Puerto Rico) and by urinary