CS: Urolithiasis Flashcards
1
Q
Are rate stones radiopaque?
A
Not really
2
Q
Tx urate stones
A
- dietary protein restriction
- allopurinol (NB: pdf xanthine uroliths)
- alkalinise urine (7.1-7.7) sodium bicarb/pottasium citrate
- ^ water intake
3
Q
Monitoring when resolving urate stones?
A
- rads/ultrasound q 4w
- serial biochem (if urea v then hows owners are sticking to diet)
- urinalysis for pH and crystals??
- avoid catheterisation (pdf UTI)
4
Q
Which type of stones are associated with UTIs and why?
A
- Struvite (mg and ph)
- UTI bacteria ^ pH of urine
- alkali urine pdf struvite
> in cats often sterile - can be dissolved in 2w
- preventative tx more useful in these cases (diets etc.)
5
Q
Best tx struvite stones?
A
> medical
- ABx most important!!! Tx UTI! to 1 month after resolution
- also responds well to diet changes
- monitor for calcium oxalate crystals as may form years dow n the line
- ^ water or Na consumption
- v protein , Mg and Ph
6
Q
How do struvite stones appear radiographically?
A
- radiopaque
- big >1cm (always suspect struvite)
- pyramidal
- smooth edges
7
Q
Monitoring for struvite stone resolution? Prevention?
A
- In dogs no indication for preventative diet (cats more reason to)
- re-radiograph at 1 month
- continue diet for 1 month after radiographic resolution of stones then no need to remain on it
- prevent UTIs
8
Q
Are stones commonly missed at surgery?
A
yes 20% - warn patient before surgery!
9
Q
Outline the genetics behind dalmatians having lack of uric acid enzyme transporter
A
- ALL dalmations homozygous recessive for the trait causing a problem
- 3 Heterozygotes recently imported after being backcrossed with a pointer several generations ago
- KC people being idiots about this saying not a real dalmatian but have been forced to accept it
