Urolithiasis Flashcards
1
Q
Medical management to remove stones is possible for most stones with the notable exception of _______________.
A
Calcium oxalate - can’t be treated medically (need surgery for this type of stone)
2
Q
An alkalising diet should be used for ___(1)__ and ____(2)____ stones. Whereas acidification should be used for _____(3)____.
A
- Cysteine
- Urate
- Struvite
3
Q
What are the two radiolucent stones?
A
- Cysteine
- Urate
4
Q
What are the three general principles of management for all types of uroliths?
A
- Increase urine volume
- Reduce the quantities of crystal forming substances in urine
- Increase crystal solubility by changing pH (acidify for struvite, alkaline for others) - with exception of Ca Oxalate that can only ever be removed surgically
5
Q
For struvite stones (magnesium ammonium phosphate):
- Describe the dietary management
- Any other additional management strategies that would be recommended
A
- Reduce magnesium in diet, reduce ammonium by feeding high quality protein, phosphate reduced in diet
- Acidify the diet + use Ab’s to neutralise urease positive microbes
6
Q
Describe how the diet can be used to prevent the development of Calcium oxalate crystals:
A
- Usually require surgery
- However can use dietary management to prevent the recurrence of them: Avoid - excessive protein, calcium, oxalate, Vit D BUT provide adequate phosphorous (prevent Vit D activation)
7
Q
For cysteine:
- Provide an example of a breed that is predisposed
- Describe how you would manage it
A
- Bulldogs
- Use an alkaliniser and 2-MPG (binds to cysteine to make a more soluble compound)
8
Q
For urate:
- State the breed predisposed
- Describe the dietary management
A
- Dalmatian
- Alkaliniser and allopurinol
9
Q
What is the problem with giving allopurinol without reducing protein in the diet?
A
- Has the potential to cause xanthine crystals
