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SAMS > Urinary Calculi > Flashcards

Urinary Calculi Flashcards

1
Q

Uroliths

A

Polycrystalline concentrations located within the urinary tract
- >90% weight is composed of inorganic/organic crystalloid, with remainder consisting of organic matrix

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2
Q

Canine bladder uroliths are commonly _______

A

Struvite!

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3
Q

Most common stone is seen in the _____

A

Bladder

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4
Q

Most common bladder stones are seen in _____

A

Female dogs

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5
Q

Most female bladder stones are ______

A

Struvite

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6
Q

_____ stones are common in dogs that eat sand

A

Silica

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7
Q

Most common stone in cats is ______

A

Oxalate

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8
Q

Urolith matrix

A
  • matrix substance A
  • tamm-horsfall mucoprotein
  • uromucoid
  • albumin
  • globulins
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9
Q

Initiation phase

A

Formation of a crystal nidus (nucleation) in the presence of urine supersaturation with calculogenic crystalloids

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10
Q

Growth phase

A

Continued circumferential crystal deposition around the crystal nidus

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11
Q

Do stones form in the ureters/urethra?

A

NO

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12
Q

Urolith formation is influenced by

A
  • urine supersaturation
  • organic matrix
  • urine pH
  • crystal transit time
  • crystallisation inhibitors or promoters
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13
Q

Which stones form in acidic urine?

A

Oxalate

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14
Q

Which stones form in alkaline urine?

A

Struvite

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15
Q

Citrate in urine is a stone _____

A

Inhibitor

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16
Q

Urine analysis

A

Urine sediment, collect by cystocentesis!

  • crystalluria
  • bacteriuria
  • pyruia
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17
Q

Crystalluria

A

Presence of crystals in urine

  • limited diagnostic meaning, some crystals are found in normal urine
  • nature of crystalluria does not always reflect type of calculus!
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18
Q

Struvite crystals

A

House roofs

19
Q

Calcium oxalate dihydrate crystals

A

Square envelopes

20
Q

Calcium oxalate monohydrate crystals

A

Double ended picket fences

  • do not form stones!
  • end point of ethelene glycol toxicity
21
Q

Urate crystals

A

Brown, spiky

  • not normally seen in urine, except Dalmations
  • usually sign of severe liver dysfunction
  • not benign
22
Q

Cystine stones

A

6 sided

  • hereditary, common in bulldogs
  • not normal in other breeds
  • prone to cystine stones
23
Q

Imaging techniques

A
  • plain radiography
  • contrast radiography
  • ultrasonography
24
Q

_____ and _____ are the same density on radiographs

A

Bladder and urine

25
Q

Radiopacity of uroliths

A

From radiodense to radiolucent:

- phosphate –> oxalate –> cystine –> uric acid/urate

26
Q

Every stone shows up on _______

A

Ultrasound!

- may miss stones in the urethra

27
Q

A renal calculus is also known as a _____

A

Nephrolith

28
Q

Severe hydronephrosis

A

End stage kidney dz secondary to ureter obstruction due to a stone that did not pass

29
Q

Stone analysis

A
  • chemical or physical

- surgery is often the only means of obtaining a stone for analysis

30
Q

With a mixed stone, you would treat based on the type of stone in the ______

A

Middle

- the nidus

31
Q

Which stones are dissolvable?

A

Struvite and urate

32
Q

Which stones are resistant to dissolution?

A
  • oxalate
  • silica
  • cystine
  • calcium phosphate
33
Q

Non-surgical alternatives

A
  • voiding urohydropropulsion
  • ureteral stents
  • lithotripsy: intracorporeal and exttracorporeal
34
Q

Struvite

A

Magnesium ammonium phosphate hexahydrate

- most common in dog, relatively common in cat

35
Q

Infection induced struvite

A

Most commonly associated with urinary tract infection with urease-producing organisms
- staph, proteus, ureaplasmas

36
Q

Sterile struvites

A

Struvite calculi may (less commonly) occur in the absence of infection

37
Q

Medical management of struvite

A
  • antibiotics
  • calculolytic diet
  • urinary acidifiers
    (bottom 2 are for sterile stones)
38
Q

Calcium oxalate

A

Most common in cats, most common nephrolith

39
Q

Calcium oxalate contributing factors

A
  • hypercalciuria
  • hypocitraturia
  • hyperoxaluria
  • decreased inhibitors
40
Q

Can you medically get rid of calcium oxalate stones?

A

No

  • surgical removal
  • voiding urohydropropulsion
  • lithotripsy
41
Q

Medical management of calcium oxalate to prevent recurrence

A
  • find/correct hypercalcemia
  • dietary modification
  • urinary alkalinization
  • thiazide diuretics
42
Q

Dalmation urate urolith formation

A

Excrete excessive uric acid in urine due to defective uric acid metabolism, and are prone to urate stones

43
Q

Can you see urate stones on x ray?

A

NO

44
Q

Urate urolith in dalmations - medical management

A
  • calculolytic diet
  • urinary alkalinisers
  • xanthine oxidase inhibitors (allopurinol)

SAMS (13 decks)

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