Urolithiasis Flashcards
What is required for the formation of uroliths?
Supersaturation Inhibitors of crystal formation Precipitation of a nucleus Crystal growth or aggregation Calculus retention
T/F: crystalluria does not mean urolithiasis
True
T/F: crystalluria does mean the urine has been supersaturated
True
What clinical signs are associated with urolithiasis ?
Dysuria Pollakiuria Incontience Stranguria Hematuria
You have a history of dysuria, pollakiuria, hematuria, and stranguria..
You think this might be due to a urolith.. what diagnostics might you do to confirm?
Bladder palpation
UA and culture
Imaging
- > radiographs
- > US
What type of uroliths will usually show up on a radiograph??
Struvite
Ca oxalate
What type of uroliths do not show up on radiographs?
Urate
Cystine
What are possible therapies for a urothiliais?
Diet Urohydropulsion Cystocospy (with baskets) Cystotomy Lithotripsy (endoscopy/extracorproal)
What is urohydropropulsion? And what patients would you consider doing this in??
You insert a catheter into bladder, position dog so all stones will fall to the ureteral opening of bladder, put pressure onto the bladder and remove catheter.. flushing stones out
Female dogs
Stones < 5-15mm
What are the types of uroliths??
Struvite Ca oxalate Cystine Urate Silicate
Mixed/compound
What breeds of dogs are predisposed to struvite stones??
Miniature schnauzer Shih tzus Bichons Miniature poodle Cocker spaniel Lhasa Apso
Struvite crystals are AKA??
Magnesium ammonium phosphate hexahydrate
Struvites in cats are usually related to ?
Diet
Struvites in dogs are usually associated with??
UTI
- urease producing bacteria
- urine pH high
T/F: Ca oxalate crystals are usually large and struvite crystals are usually small
False
Ca oxalate - small
Struvite - large
What is the therapy for struvite uroliths?
Dietary (make urine more acidic) Increase water (decrease USG)
Hills s/d (3months)
Treatment of infection if present
What type of urolith to you risk inducing when putting an animal on a preventative diet for struvites?
Ca oxalate
What breeds are prone to Ca oxalate uroliths?
Miniature schnauzer Lhaso apso Miniature poodle Yourkshire terrier Shih tsu Bichon
What are causes of Ca oxlatate uroliths?
More common in males
Acidifying diets
Obesity
Hypercalicuria (intestinal, renal , bone)
Breed
What is the appearance of a Ca oxalate crystal
Spiny
Small
Very radiodense for size
What is the therapy for Ca oxalate uroliths?
Hypercalcemia treatment
Surgical/lithotripsy/cystoscopy
Prevention
How can Ca oxalate uroliths be prevented??
Diet plus water
- hills U/D contains potassium citrate
- Walthams S/O
Thiazides diuretics -> hydrochlorothiazide
Potassium citrate
Avoid Vit C (acidifying) and Vit D (hyperCa)
What breeds are prone to ammonium urate and xanthine uroliths??
Dalmatian
Black Russian terrier
English bulldog
What disease can lead to ammonium urate/xanthine uroliths?
Hepatic dz (PSS, cirrhosis) -> decreased uptake of uric acid from haptocytes to form allantoin
Genetic tubular defects
Acidic urine
What drug therapy can result in xanthine stones?
Allopurinol
What therapy can be used for urate stones??
Diet
- low protein
- increased pH (potassium citrate/ bicarb)
Xanthine oxidase inhibitors (only for Dalmatians)
Supportive care for hepatic dysfunction
What breeds are prone to cystine calculi?
Australian cattle dogs
Dashunds
Newfoundland
Bulldogs
Cystine calculi are usually treated by alkalinizing urine and low protein diets. But this can put large breed dogs at risk of what?
Dilated cardiomyopathy
Calcium phosphate uroliths are usually secondary to??
Primary hyperparathyroidism (hypercalcemia)
What type of uroliths result from poor diets that are rick in rice, soybean husks, and devoid of proper protein??
Silica
