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Renal > Urolithiasis in Small Animals > Flashcards

Urolithiasis in Small Animals Flashcards

1
Q

How do uroliths and crystals differ?

A

U - Can see with the naked eye, causes clinical signs

C - Need microscope to see, can be incidental or indicative of uroliths

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2
Q

How are uroliths formed? Can they disappear without treatment?

A

Urine becomes supersaturated with solute > Crystals form > Crystals nucleate into uroliths

If the conc. of solute decreases sufficiently, the crystals can dissolve.

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3
Q

What are the clinical signs of nephroliths and utereroliths?

A

Asymptomatic
Pyelonephritis
Renal failure (if bilat)

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4
Q

What are the clinical signs of cysoliths?

A

Dysuria, pollakiruia
Haematuria
Inappropriate urination

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5
Q

What are the clinical signs of urethroliths?

A 
Abdo discomfort
Oliguria, anuria
Licking at gentials
Obstruction, azotaemia
Enlarged painful bladder
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6
Q

How are uroliths diagnosed?

A

History and PE
Radiography (+/- contrast)
US

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7
Q

What can we use to predict the type of uroliath present in a paitent?

A 
Sex, breed, age
Radiopaque/lucent
Urine pH
Hx of uroliths
UTI --> Struvite
Disease associated
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8
Q

How can renal and uretral uroliths be treated?

A 
Surgical removal
Urinary bypass
Lithotripsy
Dietary dissolution
Benign neglect
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9
Q

How are bladder stones treated?

A

Medical dissolution
Voiding urohydropropulsion
Cystotomy

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10
Q

How are urethra stones treated?

A

Retrograde flush into bladder
Urethrotomy
Urethrostomy

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11
Q

What are the conditions of using medical management to treat uroliths?

A

No obstruction
No contra-indications to diet
Struvite, cystine and urate uroliths

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12
Q

How does medical management of uroliths work?

A

Decrease solute conc in urine by increasing water intake

Decrease solute in diet or via drug therapy

Increase solubility of salts by altering pH of urine

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13
Q

Outline how urohydropropulsion is carried out…

A
  1. Anaesthetise animal
  2. Fill bladder with saline
  3. Position so urethra is vertical and agitate
  4. Allow stones to settle
  5. Initiate voiding, continue pressure to maintain urine flow
  6. 3d ABs
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14
Q

Which type of uroliths do UTIs most commonly occur with in dogs? How does this result in alkaline pH?

A

Struvite

Staph and Proteus infection produce urease which break urea down into ammonia and bicarbonate raising pH.

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15
Q

How are struvite uroliths treated?

A

Treat UTI for 3-4weeks after resolution

Reduce urinary magnesium, ammonium and phosphate

Maintain urine ph <6.4 with special diet

Increase voluntary water intake

Monitor progress with radiographs, urine pH, SG, sediment and culture

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16
Q

What is important to remember about using prescription diets in urolith treatment?

A

Diets are low in protein so are contraindicated in young, pregnant, lactating and animals with liver diease/pancreatitis

17
Q

Outline the signalment of calcium oxalate uroliths..

A 
Cats > dogs
Terriers, poodles, schnauzers
Burmese, himalayan, persian
M>F
Older animals
18
Q

How are calcium oxalate uroliths treated? What must owners be informed of?

A

Surgery
Urohydropropulsion
Ignore

60% recurrence within 3y

19
Q

How can calcium oxalate uroliths be prevented?

A 
Increase water intake
Sodium supplementation (PD)
Neutal/alkaline pH
20
Q

Which breeds are predisposed to ammonium urate uroliths? Outline why…

A

Dalmatians
Bulldogs

Increase levels of uric acid and defective transport of uric acid into hepatocytes out of urine

21
Q

What type of urolith can develop secondary to a PSS? How?

A

Ammonium urate

Due to increased excretion of ammonia and urea

22
Q

How are ammonium urate urolith treated/prevented?

A

Correct PSS
Treat any UTIS
Reduce purines via special diet (–>alkaline pH)
Allopurinol - inhibits xanthine oxidase to reduce levels of uric acid

23
Q

Which breeds are predisposed to cystine uroliths? Outline why…

A

Staffies and Bull mastiffs

Renal tubular defect –> excessive urine cystine –> poorly soluble

24
Q

Describe the radiopacity of cystine uroliths. How are they treated and prevented?

A

Radiolucent
Medical dissolution
Castration

25
Q

What type of urolith is associated with primary hyperparathyroidism?

A

Calcium phosphate

26
Q

What is the most common urolith in horses and rabbits?

A

Calcium carbonate

27
Q

What are the indications for surgical removal of uroliths?

A 
UT obstruction
Unknown urolith composition
Medical treatment failure
UT abnormalities
Immature animal
Owner preference
Cost
28
Q

What should be done before surgical removal of uroliths?

A

Stabilise hyperkalaemia and azotaemia
Known number and location of calculi
Place in urinary catheter and empty bladder

29
Q

What should be done at the end of a surgical removal of uroliths?

A

Check all calculi/fragments are removed

Submit calculi for analysis

30
Q

What suture material is used to close the bladder in cystotomy?

A

Synthetic absorbable e.g. monocryl

Renal (12 decks)

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