Flashcards in CS: Urolithiasis Deck (9)
Are rate stones radiopaque?
Tx urate stones
- dietary protein restriction
- allopurinol (NB: pdf xanthine uroliths)
- alkalinise urine (7.1-7.7) sodium bicarb/pottasium citrate
- ^ water intake
Monitoring when resolving urate stones?
- rads/ultrasound q 4w
- serial biochem (if urea v then hows owners are sticking to diet)
- urinalysis for pH and crystals??
- avoid catheterisation (pdf UTI)
Which type of stones are associated with UTIs and why?
- Struvite (mg and ph)
- UTI bacteria ^ pH of urine
- alkali urine pdf struvite
> in cats often sterile
- can be dissolved in 2w
- preventative tx more useful in these cases (diets etc.)
Best tx struvite stones?
- ABx most important!!! Tx UTI! to 1 month after resolution
- also responds well to diet changes
- monitor for calcium oxalate crystals as may form years dow n the line
- ^ water or Na consumption
- v protein , Mg and Ph
How do struvite stones appear radiographically?
- big >1cm (always suspect struvite)
- smooth edges
Monitoring for struvite stone resolution? Prevention?
- In dogs no indication for preventative diet (cats more reason to)
- re-radiograph at 1 month
- continue diet for 1 month after radiographic resolution of stones then no need to remain on it
- prevent UTIs
Are stones commonly missed at surgery?
yes 20% - warn patient before surgery!