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VET 409: Renal > Urolithiasis > Flashcards

Urolithiasis Flashcards

1
Q

signs of LUT uroliths

A

pollakiuria, stranguria, hematuria

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2
Q

signs of UUT uroliths

A

anorexia, malaise, sub lumbar pain, uremia, hematuria

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3
Q

relative supersaturation (RSS)

A

measures the risk of crystals forming in the urine; ratio of activity product to solubility constant

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4
Q

undersaturation

A

no crystallization
crystal dissolution

desired for urinary stone diets, urine state, etc for stone prevention and treatment

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5
Q

metastable supersaturation

A

no spontaneous crystallization
no crystal dissolution possible

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6
Q

labile supersaturation

A

spontaneous crystallization
crystal growth/aggregation

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7
Q

crystalluria

A

crystals in the urine

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8
Q

is crystalluria always a disease state

A

NO - can have crystals in health

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9
Q

what is a stone matrix

A

the material that gets incorporated into the stone lattice as it forms (protein, cell debris, foreign bodies, drug residues, etc)

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10
Q

if concurrent stones + crystalluria, is the stone type always the same as the crystal type

A

NO - can be, but not always

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11
Q

what stone types occur from genetic mutations in dogs

A

urate and cystine

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12
Q

what is the best diagnostic for stones

A

radiographs (for radio-dense stones)

ultrasound or cystourethrogram (for radio-lucent stones)

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13
Q

what stones are radio-dense

A

struvite
Ca oxalate or phosphate

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14
Q

what stones are radio-lucent

A

urate (purine) and cystine

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15
Q

what are other diagnostic options for stones

A

contrast studies (positive or double contrast), excretory urography, cystoscopy

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16
Q

what diagnostic is best for measuring stone size

A

radiographs

ultrasound OVERESTIMATES size (best option for radiolucent)

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17
Q

what are some methods of stone removal

A

cystotomy
dissolution
voiding urohydropropulsion
laser and basket retrieval

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18
Q

cystotomy

A

surgical removal of the stones

most common for all types

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19
Q

dissolution

A

dissolving the stones

only used for struvite and some urate/cystine stones

can NOT dissolve Ca stones

20
Q

voiding urohydropropulsion

A

infusing the bladder until full, positioning the patient upright, shake and remove catheter while expressing the bladder to void stones

repeat until empty

21
Q

laser and basket retrieval

A

laser the stone until it gets broken up; retrieve the largest piece with a basket then use VUH to empty remaining pieces

22
Q

primary uroliths in dogs

A

Ca oxalate
struvite
urate
Ca phosphate
cystine
silica

23
Q

primary uroliths in cats

A

struvite
Ca oxalate
urate
dried blood
Ca phosphate

24
Q

where is the main site of Ca oxalate stones

A

dogs: bladder
cats: ureters

25
Q

what pH do CaOx dihydrate stones form in

A

acidic

26
Q

what is the signalment for CaOx stones

A

middle aged males

some breed dispositions

27
Q

what is the best prevention for CaOx stones

A

serum Ca monitoring
high water intake

28
Q

where is the main site of struvite stones

A

lower urinary tract

(can be upper in dogs)

29
Q

what is the main cause of struvite stones in dogs

A

urease producing bacteria

always culture urine if struvite stones identified in dogs

30
Q

what pH do struvite stones form in

A

alkaline

31
Q

how do you treat struvite stones

A

cats: acidic diet

dogs: acidic diet + antibiotics

32
Q

can you prevent struvite stones in dogs

A

NO - need to prevent the UTI of urease producing bacteria in order to prevent struvite stones

33
Q

what enzyme converts hypoxanthine to xanthine in protein metabolism

A

xanthine oxidase

34
Q

what enzyme converts xanthine into uric acid in protein metabolism

A

xanthine oxidase

35
Q

where does uric acid travel to continue protein metabolism

A

the liver

36
Q

what enzyme converts uric acid to allantoin in protein metabolism

A

uricase

37
Q

what are the two ways of obtaining urate uroliths

A
  1. hyperuricosuria mutation
  2. portosystemic shunts
38
Q

hyperuricosuria mutation

A

defective transporters prevent uric acid from entering hepatocytes, preventing conversion of uric acid to allantoin –> uric acid accumulates in circulation –> kidneys can’t reabsorb –> accumulates in urine –> forms urate stones

common in Dalmatians

39
Q

how do portosystemic shunts cause urate stones

A

PSS causes blood to bypass the liver –> uric acid can’t reach hepatocytes –> unable to convert to allantoin –> uric acid accumulates –> forms urate stones

resolving PSS will resolve the urate stones

40
Q

what stones are most common in goats

A

Ca carbonate (alfalfa)
struvite (grain)

41
Q

what stones are most common in cows

A

struvite (grain)
silica (soil)

42
Q

what stones are most common in horses

A

Ca carbonate

caused by alkaline urine

43
Q

what stones are most common in chelonians

A

urate

caused by uric acid as final waste product

44
Q

what stones are most common in rodents

A

Ca carbonate

45
Q

what stones are most common in pigs

A

amorphous magnesium calcium phosphate (AMCP)

VET 409: Renal (21 decks)

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