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Uroliths Jill Jackson

Uroliths Jill Jackson. Cat or dog presents with owner complaining of... . Pollakiuria Dysuria Hematuria Stranguria Recurrent UTI Abdominal pain Urethral obstruction. Upon Physical examination you find. Large, distended painful bladder upon palpation.

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Uroliths Jill Jackson

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  1. Uroliths Jill Jackson

  2. Cat or dog presents with owner complaining of... • Pollakiuria • Dysuria • Hematuria • Stranguria • Recurrent UTI • Abdominal pain • Urethral obstruction

  3. Upon Physical examination you find... • Large, distended painful bladder upon palpation. • An empty bladder that feels like a bag of rocks. • No abnormalities- especially cats • Unable to express cats bladder.

  4. You are suspecting either a UTI or Uroliths - what next... • Cystocentesis for urine analysis and possible culture • Radiographs • Abdomen - Lat and VD • Butt shot. • Ultrasound of urinary tract

  5. Urinalysis • Red blood cells, white blood cells, bacteria, +/- • Crystals+/- • Urine pH

  6. Radiographs • If stones are radio opaque • + there are stones • location • Cannot identify type of stone

  7. Contrast Studies

  8. Is it a stone?

  9. Ultrasound • Allows visualization of all stones • Location • Size • Number • Doesn’t indicate • Radiodensity • Shape

  10. Nephrolith

  11. Cystic Calculi • Semicircular • Hyperechoic line with distal diverging acoustic shadowing

  12. How do they get these stones? • Supersaturation • Matrix nucleation • Loss of crystallization inhibition • Urine pH • Urine concentration

  13. Treatment- Removal • Medical or dietary treatment • Non invasive • Urohydropulsion • Shock wave lithotripsy • Surgical • Prevention and Avoidance

  14. Most Common uroliths • #1 Struvite • #2 Oxalate • #3 Mixed content • #4 Urate • #5 Calcium phosphate • #6 Cystine

  15. Struvite Female mixed breeds most common Pure breds --Shih tzu, Bichon frise, Minature Schnauzer Male cats- small diameter or urethra- urethral plugs- obstruction. Radiodense Infection induced Alkaline, concentrated urine, retention of urine Ad libitum food, low moisture content Bladder and kidney stones can be dissolved Dietary- Calculolytic diet- S/D magnesium restricted, acidifying - Canned- increased moisture, decreases urine concentration.

  16. Oxalate • Males most common • Miniature schnauzers, Lhasa apso, Yorkie, Burmese, Himalayan, Persian • >3 mm radiopaque and easily detectable. • Excess calcium, vitamin D, or protein, dry food • Acidic urine • Doesn't dissolve with dietary alone. • Hypercalcemia in cats without evidence of hyperparathyroid or malignancy- w/d • Dietary-X/D or W/D -reduced oxalate and protein doesnt promote acidity. • Additional water- canned.

  17. Urate • Dalmations • Radiolucent, need intravaneous pyelogram to see in kidneys, double contrast in bladder. • High purine intake, dogs with portosystemic shunts. • Acidic urine • Stones will dissolve with diet. • Dietary-low purine, alkalizing diet.

  18. Calcium phosphate • Greater % in kidneys than in bladder • Doesn’t dissolve with dietary treatment. • Primary hyperparathyroidism, excess dietary calcium and vitamin D • Alkaline urine, concentrated urine. • Dietary- U/D – reduces calcium,reduces formation of concentrated urine. • Canned- high moisture, more dilute urine.

  19. Cystine • Radiolucent • Acidic urine • Highly concentrated • Incomplete and infrequent urination • Dietary- U/D- alkaline urine and reduces concentration. • Treat also with N-glycine.

  20. Questions

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