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VMS 2006 > Uroliths and Nutrition > Flashcards

Uroliths and Nutrition Flashcards

1
Q

Where do oxalates come from?

A
  1. A combination of dietary sources
  2. endogenous synthesis from precursors such as ascorbate and various amino acids
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2
Q

What percentage of kidney stones are composed primarily of calcium oxalate

A

75%

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3
Q

What are almost all struvite uroliths a consequence of?

A
  • infection of the urinary tract with urease producing microbes (e.g staphylococci)
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4
Q

What are 95% of struvite uroliths linked to in cats?

A
  • Urinary excretion of excessive quantities of dietary minerals
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5
Q

What does acidic urine cause the precipitation of?

A
  • Calcium oxalates
  • Uric acid
  • Cystine uroliths
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6
Q

What does alkaline urine cause precipitation of?

A
  • Struvite
  • Calcium carbonate
  • Calcium phosphate
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7
Q

How is calcum oxalate ususally formed?

A

Over-saturation of urine with calcium and oxalate

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8
Q

Why should you not recommend reducing dietary calcium?

A
  • Reduced complexes with oxalate formed
  • Increased intestinal absorption of oxalate
  • increased renal excretion of oxalate
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9
Q

What may a low dietary intake of phosphorus be linked to?

A

Increased urinary calcium excretion
* lower binding of calcium by phosphate ions in the GIT

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10
Q

What can excessive levels of phosphorus in the GIT mean?

A
  • They act as scavengers for calcium
  • increase the availability of oxalate uptake in the intestine
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11
Q

What are some of the risk factors for calcium oxalate stones in dogs?

A
  • Dogs under 7
  • males
  • neutured
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12
Q

What is the link between obesity and urolithiasis?

A

Glucose load increases urinary oxalate excretion

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13
Q

What is the function of Oxalobacter formigenes?

A

Gram-Negative anaerobic bacterium
degrades oxalate in the intestinal tract

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14
Q

What is the link between high phosphorus diets and kidney disease?

A

cats with chronic kidney disease have signficantly higher phosphorus and protein intakes

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15
Q

What is the function of magnesium in the GIT?

A
  • Directly interacts with oxalate to form an insoluble complex
  • this lowers the free oxalate concentration in the GIT
  • reduction in the absorption of oxalate, less oxalate for excretion via the kidneys
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16
Q

How can you reduce the risk of urolithiasis in cats?

A
  • Increase water intake
  • Increase the urinary input
  • dilutes the urine
  • reduces the risk of CaOx crystallisation in the urinary tract
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17
Q

What is the link between high protein diet and urine?

A
  • Increased protein diet
  • acompanied by increased water consumption
  • increased urine volume in cats
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18
Q

What is the main risk factor of struvites?

A
  • alkaline urine and increased levels of magnesium, ammonium and phosphate in urine
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19
Q

What is the consequence of a diet low in magnesium?

A

Prevents struvite urolithiasis
* may also encourage the formation of calcium oxalate

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20
Q

How are struvites produced in the urine?

A
  • Urinary tract infection with urease producing bacteria
  • Urine with a high urea concentration (bacteria hydrolyse urea to ammonia)
  • Ammonium ions reduce the hydrogen concentration
  • Increased urine pH
21
Q

What increases the likelihood of ruminants getting struvites?

A
  • High grain diets
  • low calcium/ phosphorus ratio
  • ruminants also graze on silica-rich soil so are predisposed to silica uroliths
22
Q

How may you prevent struvite calculi?

A

Increase urinary chloride excretion
* decreases urine pH

23
Q

What are the common characteristics of diets fed to overweight horses?

A
  • Preserved forages
  • low moisture content
  • unbalanced mins
  • low dry matter intake
24
Q

What is a single crystal?

A

a single crystal is where 70% of the urolith is composed of one type of crystal

25
Q

What is a mixed urolith?

A

Less than 70% one crystal, there is no identifiable nidus or shell

26
Q

What is a compound urolith?

A

Identifiable nidus of one crystal with surrounding layers of another crystal

27
Q

What is a matrix urolith?

A

Matrix without an appreciable crystalloid

28
Q

What are the three ways that crystals form?

A
  • Growth = new crystals are added to the nucleus
  • Aggregation = crystals stick together, promoted by cementing substances or viscous bidning materials
  • Matrix= made up of lipids and proteins
29
Q

What does urinary saturation depend on?

A
  • Urinary pH
  • Ionic strength
  • Solute concentration
  • Complexation
30
Q

What is the main way that uroliths form?

A
  • Urine is full of colloids and crystalloids
  • dissolved in solution
  • Once saturated, the salt crystallises
  • Nucleation/ nidus
31
Q

What is the primary risk factor for calcium oxalate stones?

A

hyperoxaluria (urinary oxalate is a key determinant)

32
Q

What is the main consequence of infection of the urinary tract with urease producing microbes

A

Almost all struvite uroliths

33
Q

What are 95% of all cat struvite uroliths linked to?

A

Urinary excretion of excessive quantities of dietary minerals

34
Q

Where do calcium oxalate stones occur?

A

In both the upper and the lower urinary tract of dogs

35
Q

What is the effect of having a high dietary calcium?

A

Reduces oxalate absorption

36
Q

What is the effect of reduced dietary calcium?

A
  • reduces complexion with oxalate in the intestinal lumen
  • increases intestinal absorption of oxalate
  • Increased renal excretion of both exogenous calcium and oxalate
37
Q

Why is the aim to reduce oxalate absorption?

A
  • Keeps oxalate in the gut
  • Increased faecal excretion
38
Q

What percentage of uroliths are non-obstructive?

A

75% of UUT
* removal is not recommended unless they are in pain or any other complications

39
Q

What is the link between obesity and urolithiasis?

A

Glucose load increases the urinary oxalate excretion
* Greater mass load = increased urinary oxalate excretion

40
Q

What is insulin resistance associated with?

A

defects in the renal ammonium ion production

41
Q

What is the function of oxalobacter formigenes?

A
  • gram negative anaeroic bacterium
  • degrades oxalate in the intestinal tract
  • Antibiotic consumption = absence of O.formigenes
42
Q

What does a diet low in magnesium prevent in cats?

A

struvite urolithiasis
also encourages the formation of calcium oxalate

43
Q

What is one of the greatest diet related risk factors for the formation of oxalate calculi?

A

low-magnesium acidifying diets designed to prevent struvite calculi

44
Q

What causes struvite calcium oxalate infection?

A

Urease positive bacteria, i.e Staphylococcus, Streptococcus, Proteus

45
Q

What are ruminants most predisposed to?

A

Increased risk of developing struvite uroliths
* high grain diets
* low calcium/ phosphorys ratio
* ruminants graze on silica-rich soil

46
Q

How may you prevent struvite calculi?

A
  • increased urinary chloride excretion
  • decrease in urine pH
47
Q

How would you minimise urethral calculi?

A
  • add sodium chloride to the total ration
  • promote increased sodium and chloride
  • increase mineral solubility
48
Q

How could you reduce urolith formation in equines?

A
  • Decrease the time that urine stays in the bladder
  • Addition of 50-75g of salt to the daily ration to increase fluid intake
49
Q

What factors effect the incidence of urolithiasis in rabbits?

A
  • Decreased water supply
  • Decreased activity level
  • Low forage intake

VMS 2006 (23 decks)

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