Urolithiasis Flashcards
Can you have uroliths without crystals?
Yes. You can have either without the other and even have crystals of one type and uroliths of another
Do you get clinical signs from crystals?
no
What’s the clinical name for bladder stones?
Cystoliths
What’s the clinical name for Kidney stones?
Nephroliths
What’s the clinical name for Urethra stones?
Urethroliths
How are uroliths formed?
Crystals form when urine is supersaturated
What is the start of the process of stone forming called?
Nucleation
How does the body protect itself against stone formation?
There are precipitate inhibitors in urine that prevent precipitation and therefore allow the excretion of calcium oxalate
What are the common symptoms of cystoliths?
dysuria, pollakiuria, haematuria, and inappropriate urination
What are the common symptoms of urethroliths?
Abdominal discomfort, poor or no urine stream, licking of genital area, azotaemia, and enlarged painful bladder
How can radiographs aid you in diagnosis?
You can see uroliths and whether they show up radiolucent or radio- opaque
Is quantitative or qualitative analysis more useful in diagnosing stone type?
Quantitative but takes a few weeks
What are the 5 main treatment options for renal stones?
Surgical removal, Urinary bipass, lithotripsy, dietary dissolution or benign neglect
What is lithotripsy?
Use of shock waves to break up stones
Why might you choose benign neglect?
If the stone isn’t causing clinical signs then it can be left. Especially if it is in the kidney as the surgery is very invasive and cause loss of renal function
What’s the most common stone found in the kidney?
Calcium oxolate
What are the main treatment options for bladder stones?
Medical dissolution, voiding urohydropropulsion, surgery
What are the main treatment options for urethra stones?
Retrograde flush into bladder or surgery
How would you go about returning a urethral stone to the bladder?
Anesthetize patient, push catheter in till just before stone. Have assistant insert finger rectally and block stone. Then flush fluid into space, walls of urethra should stretch. When you let go of stone it should flush back into bladder
What stone formations are more amenable to dissolution?
Struvite, cystine and urate
How do you perform urohydropulstion?
Fill bladder with saline.
Position so urethra is vertical.
agitate.
initiate voiding under high pressure and repeat if necessary
What after treatment is required after urohydropulsion treatment?
3 days of antobiotics
What are struvite stones strongly associated with in dogs?
UTI
What Urine PH will you see in an animal with a struvite stone?
alkaline
How would you treat a struvite stone?
Change diet to reduce PH of urine and increase fluid intake
How would treatment differ between a dog and a cat?
A dog would need constant antibiotics, the entire time of treatment
Are diets any use in prevention of struvite stones?
Not really, especially in dogs as the main cause of struvite stones are bacterial infections and diet has no effect on this
What unwanted effect can struvite preventative diets have?
They can make the urine acidic which actually encourages the formation of calcium oxalate stones
What’s the second most common stone in dogs?
calcium oxalate
What sex is more predisposed to calcium oxolate crystals in the dog?
Male
What’s the one dietary change that actually helps animals with calcium oxalate stones?
Increased water intake
What breed of dog are ammonium urate stones most common in?
Dalmations
How can you manage ammonium urate stones?
Reduce protein available in the diet but also drugs are available
How can allopurinol help ammonium urate stones?
Competetively inhibits x.oxidase, reducing uric acid but this can result in xanthine stores if protein not restricted
Whats the main cause of cystine stones?
renal tubular defect in which excess cystine enters urine
What preventative treatment can be taken for cystine stones?
castration in male dogs
What are the two surgical options?
Open the viscus and remove the calculi or provide urine diversion
What should you place before bladder surgery?
a urinary catheter
What 2 layers do you have to cut through to gain access to the bladder?
detrusor muscle layer and urothelial layer
