Urolithiasis Flashcards
what chemicals are likely to precipitate?
Mg+
NH4+
PO4-
Ca
Ox
are feline uroliths indications of disease?
no
what do feline uroliths indicate?
supersaturation of urine
often will not develop uroliths
what are urate uroliths associated with?
portosystemic shunts
are feline struvite uroliths usually sterile?
yes
how can you treat felines for hypercalcemia?
high fiber diet
avoid acidifying diets
prednisone
biphosphonates
chia seeds
what should you screen cats with calcium oxalate uroliths for?
hypercalcemia
how can you tell a cat has hypercalcemia of malignancy?
mild to severe elevations in total calcium
ionized calcium elevations
PTH 0
PTHrp measurable
what can cause hypercalcemia of malignancy?
lymphoma
squamous cell carcinoma
others
what are feline calcium oxalate uroliths often due to?
idiopathic hypercalcemia
what are the treatment options for feline calcium oxalate uroliths?
surgery
percutaneous cystolithotomy
urohydropulsion
what should urine specific gravity be for cats with calcium oxalate uroliths?
less than 1.030
how can you diagnose feline uroliths?
abdominal radiographs
abdominal ultrasound
percutaneous antegrade pyelography
diuretic renal scintigraphy
fluoroscopy
what are the options for medical management of feline uroliths?
intravenous fluids
alpha antagonists
amitriptyline
glucagon
diuretics
why should you go to surgery sooner for a ureterolith?
better return to kidney function the earlier you go
what are the majority of feline ureteroliths?
calcium oxalate
what are the signs of a canine urolith in the kidney?
signs of uremia
signs of pyelonephritis
no clinical signs
what does treatment of canine uroliths depend on?
urolith location
clinical presentation
what are the options for canine nephroliths and cystic calculi?
surgical removal
medical dissolution
voiding hydropropulsion
percutaneous antegrade pyelography
how does lithotripsy work?
high frequency sound waves “shatter” uroliths
what are some inhibitors of precipitation?
citrate
glycosaminoglycans
what urolith types are common in cats?
struvite- calcium ammonium phosphate
calcium-oxalate
what diets are for dissolution of struvite uroliths?
low-magnesium
urine acidifying
what is usually elevated in idiopathic hypercalcemia?
total calcium
ionized calcium
PTH
how can you treat hypercalcemia in a diet?
high fiber
avoid acidifying diets- mobilize calcium
chia seeds
how can you identify hypercalcemia of malignancy?
elevated total calcium
elevated ionized calcium
PTHrP measurable
PTH 0
what does primary hyperparathyroidism cause on bloodwork?
elevated total calcium
elevated ionized calcium
high PTH
what can be found on physical exam with ureteroliths?
unequal kidney size
pain on kidney or spinal palpation
hematuria
what are the options for medical management of ureteroliths?
intravenous fluid therapy
alpha-antagonists
amitriptyline
glucagon
diuretics
what should you do to stabilize the patient prior to surgery for ureteroliths?
correct hyperkalemia
surgery and place sub
fluids
what are the majority of feline ureteroliths?
calcium oxalate
what nephroliths and cystic calculi can be dissolved?
struvite
urate
cystine?
how long should you continue diagnostic imaging for canine stones?
uroliths not visible for 30 days
uroliths stable for 60 days
>6 months
how can you treat ureteroliths in dogs?
diuresis
smooth muscle relaxants
anti-inflammatory medication
analgesics
surgery
difficult to manage
how can you dissolve urate stones?
restrict protein
monitor urine pH and alkalinize if needed
allopurinol
how can you dissolve struvite stones in dogs?
treat infection
acidify urine if needed
how can you treat cystine stones in dogs?
reduce protein
alkalinize urine if needed
reduce cystinuria
neuter
