Urolithiasis Flashcards
Name some risk factors for urolith development
Urine supersaturation with calculogenic substances
Favorable urine pH
Reduced crystal inhibitors
Retention of crystals in urinary tract
Struvite uroliths occur in urine with _________pH
Alkaline
Can struvite be dissolved with nutritional and/or medical management?
Yes!
A female dog with a history of recurrent UTIs presents with LUT signs (pollakiuria, hematuria, stranguria). You want to rule out the presence of ________ stones, so you take radiographs.
Struvite
Key nutritional factors for prevention and dissolution of sterile struvite uroliths
Water!
Limit dietary precursors (Mg, protein, P)
Enhance NaCl (enhances water, keeps bladder flushed)
Acidify the urine!
T/F: A patient that presents with a UTI and struvite crystals should be placed on a dissolution diet long-term.
False - if this is the first episode, dissolution/prevention diets may NOT be needed
Treat the UTI
When do you stop a dissolution diet for struvite?
Continue diet 1 month after negative imaging
What component of cranberry extract may be helpful in managing chronic UTIs? Why?
Proanthocyanidins
Reduce microbial adherence to
Like proanthocyanidins, __________ reduces microbial adherence and can be used in patients with chronic, recurring UTIs
D-Mannose powder
Calcium oxalate uroliths form in _________ urine
Acidic
T/F: Calcium oxalate uroliths can be managed with dietary/medical management
No - require lithotripsy or cystotomy
How can calcium oxalate be PREVENTED nutritionally?
- Limit dietary precursors (Ca, Oxalate)
- Limit protein (Protein promotes urinary citrate excretion and citrate is beneficial againse Ca oxalate)
- Enhance inhibitors (Citrate, Mg)
T/F: some breeds are predisposed to developing calcium oxalate uroliths
True - Mini schnauzers (calciuria) and others
Purine uroliths form in ________ urine
Acidic
Can purine uroliths be dissolved with nutritional and/or medical management?
Yes
What is the representative breed for purine uroliths? What is a common concurrent disease?
Yorkies
PSS
Why can switching to a vegetarian diet limit purine uroliths?
Alkalinizes the urine by limiting high purine containing animal proteins
T/F: Urate dissolution protocols are available for both dogs and cats
False - not available for cats
How are cystine uroliths managed?
Similar to purine (low animal protein or vegetarian)
Potassium citrate
Target urine pH for struvite prevention/dissolution
Dissolution: 5.9-6.1
Prevention: 6.0-6.5
Target urine pH for Ca oxalate
6.5-8.0
Target urine pH for urate and cystine
7.0-7.5
Monitoring uroliths
BW, BCS, MCS
Appetite, behavior
Urine every 3-6 months
Culture
Radiographs (q2-4 weeks during dissolution of struvite, purine)
