Term
|
Definition
| -organized concretion found in urinary tract that contains organic & inorganic material |
|
|
Term
| True or False: The presence of crystalluria predisposes to stone formation. |
|
Definition
| -FALSE, the presence of crystalluria does NOT predispose to stone formation |
|
|
Term
| When does crystalluria require treatment? |
|
Definition
-assoc w/ a urolith
-assoc w/ a urethral plug |
|
|
Term
| Which uroliths are radiopaque? |
|
Definition
-Ca oxalate
-apatite
-struvite
-silica |
|
|
Term
| Which uroliths are radiolucent? |
|
Definition
|
|
Term
| How do we fix uroliths medically? |
|
Definition
-dissolution
-promote movement/expulsion
-voiding urohydropropulsion
- |
|
|
Term
| How do we fix uroliths surgically? |
|
Definition
-ureterotomy
-cystotomy
-urethrotomy
-ureteral stent placement
-subcutaneous ureteral bypass system
-extracorporeal shock wave litotripsy (ESWL)
-IR/IR: endoscope w/ basket +/- laser lithotripsy, uretral stent placement |
|
|
Term
| Which uroliths are amendable to dissolution? |
|
Definition
|
|
Term
| Which uroliths are refractory to dissolution? |
|
Definition
|
|
Term
| What strategies are used to promote movement/expulsion of uroliths? |
|
Definition
-fluid therapy
-diuretics
-pain meds |
|
|
Term
| For which uroliths do we use urohydropropulsion? |
|
Definition
|
|
Term
| In which animals can we urohydropropulse uroliths? |
|
Definition
-male & female dogs
-female cats |
|
|
Term
| For which uroliths can we use endoscopy for? |
|
Definition
-stones located in urethra or bladder
-good for few small stones |
|
|
Term
| How do we place a ureteral stent in dogs? Cats? |
|
Definition
-Dogs: retrograde fasion using fluoroscopic guidance
-Cats: surgically |
|
|
Term
| What are the advantages of ureteral stents? |
|
Definition
| -ensures patency from kidney to bladder and prevent further hydronephrosis |
|
|
Term
| What is the typical outcome of surgery to fix uroliths? |
|
Definition
-bladder: usually great outcome
-ureter: risk of complications is greatly increased |
|
|
Term
| What does a subcutaneous ureteral bypass system do to fix uroliths? |
|
Definition
| -essentially creates a enw ureter |
|
|
Term
| What are the two most common types of stones in dogs? |
|
Definition
-Ca oxalate
-struvite (MAP) |
|
|
Term
| What is the other name for struvite stones? |
|
Definition
| -magnesium ammonium phosphate |
|
|
Term
| Which bacteria are associated w/ UTIs due to struvite uroliths? |
|
Definition
|
|
Term
| Are males or females more affected by struvite uroliths? |
|
Definition
|
|
Term
| Describe the dietary therapy of struvite uroliths. |
|
Definition
-reduce protein, phosphorus, magnesium
-promote acidic urine
-high moisture food
-ideally USG < 1.020 |
|
|
Term
| How do we medically dissolve struvites? |
|
Definition
-CAN be medically dissolved
-100% of sterile struvite stones dissolved in 3-6w
-abx therapy MUST be continued until the stones are dissolved |
|
|
Term
| What are the risk factors for calcium oxalate? |
|
Definition
-hypercalciuria: hypercalcemia, met acidosis, high sodium consumption, vit D excess
-recommend analyzing serum ionized ca |
|
|
Term
| Describe the dietary therapy for calcium oxalate. |
|
Definition
-avoid Ca supplements
-avoid high Ca foods
-avoid high oxalate foods
-high moisture food
-USG < 1.020 |
|
|
Term
| How do we medically dissolve calcium oxalate? |
|
Definition
|
|
Term
| What meds do we use for calcium oxalate uroliths? |
|
Definition
-potassium citrate to alkalinize pH
-hydrochlorothiazide: do not used in patients w/ hypercalcemia |
|
|
Term
| What is the other name for purine stones? How common are they? |
|
Definition
-aka urate stones
-only account for around 5% total stones in dos |
|
|
Term
| What are some common risk factors for purine/urate stones? |
|
Definition
-hyperuricosuria: certain breeds, PSS
-acidic urine
-concentrated urine |
|
|
Term
| Which breeds are associated w/ hyperuricosuria due to purine uroliths? |
|
Definition
-Dalmation
-English Bulldogs
-Black Russian Terrier |
|
|
Term
| How do we manage purine stones? |
|
Definition
-correct PSS if present
-if no PSS or liver dz present: high moisture low purine diet, aim for slightly alkaline urine, close monitoring
-allopurinol: prevent or dissolve urate stones in animals w/out liver dz |
|
|
Term
| What are the two most common feline stones? |
|
Definition
|
|
Term
| What is the typical signalment of struvite stones in cats? Where do they most commonly occur? |
|
Definition
-cats 2-10y
-bladder most commonly |
|
|
Term
| What makes feline struvite stones different from canine struvite stones? |
|
Definition
| -they are sterile in cats |
|
|
Term
| What is our major concern w/ prolonged acidic urine in cats being treated for struvite stones? |
|
Definition
| -may leed to formation of Ca oxalate stoens |
|
|
Term
| What leads to development of Ca oxalate stones in cats? |
|
Definition
|
|
Term
| What are some risk factors that lead to Ca oxalate stones in cats? |
|
Definition
| -hypercalciuria: hhypercalcemia, met acidosis, inc Na consumption, vit D excess |
|
|
Term
| How do we dissolve Ca oxalate stones? |
|
Definition
| -medical dissolution is NOT an option |
|
|
Term
| Why do we try to dilute the urine to prevent uroliths? Give some examples of this strategy. |
|
Definition
-more dilute the urine the less likely that ions will meet & have an interaction
-ex: canned food, dry food w/ water added, multiple water bowls |
|
|
Term
| Do we acidify or alkalinize for struvite stones? What about Ca oxalate stones? |
|
Definition
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