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12- SA- Urinary and endocrine disease > Urolithiasis > Flashcards

Urolithiasis Flashcards

(46 cards)

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1
Q

where do uroliths tend to occur in dogs and cats

A

normally lower urinary tract, i.e. bladder & urethra

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2
Q

what are struvite uroliths made of

A

Magnesium ammonium phosphate

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3
Q

what are struvite uroliths associated with in dogs

A

Usually associated with UTIs caused by urease producing bacteria

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4
Q

are males or females more prone to struvite uroliths

A

females
likely due to increased tendency of female dogs to develop UTIs

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5
Q

list the risk factors of struvite uroliths in dogs

A

abnormal retention of urine
Any condition that predisposes to UTI - e.g. diabetes mellitus, cushings
susceptible breeds- Miniature schnauzer, Shih Tzu, Bichon

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6
Q

what are struvite uroliths associated with in cats

A

90% are sterile – in contrast to dogs (infection-induced seen predominantly in cats > 10 yrs)

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7
Q

what are the risk factors of struvite uroliths in cats

A

abnormal retention of urine
formation of concentrated urine - moisture content of food, water intake
Urine-alkanising metabolites in diets

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8
Q

list the risk factors for formation of calcium oxalate uroliths

A

acidifying diets
Oral calcium supplements given outside of mealtimes
Excessive dietary protein
Formation of concentrated urine

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9
Q

what are urate uroliths made of

A

Composed of uric acid, sodium urate or ammonium urate

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10
Q

how are urate uroliths formed

A

Impaired conversion of uric acid to allantoin ——-> increased concentration of uric acid in serum and urine.

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11
Q

what breeds are predisposed to urate uroliths

A

Dalmations and Black Russian terriers

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12
Q

which urolith is associated with porto systemic shunt

A

urate

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13
Q

list 2 risk factors of urate uroliths

A

High Purine intake (glandular meat)
Persistent aciduria in a predisposed animal

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14
Q

how do cysteine uroliths form

A

inborn error of metabolism caused by defective tubular resorption of cysteine and other amino acids

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15
Q

which dogs are more affected by cysteine uroliths

A

Predominantly intact male dogs affected

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16
Q

list 3 risk factors of cysteine uroliths

A

Genetic predisposition to cystinuria
Acidic, concentrated urine
Urine retention

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17
Q

how do xanthine uroliths form

A

Impaired Xanthine oxidase activity leads to hyperxanthinaemia and xanthinuria
Familial or congenital defect e.g. CKCS

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18
Q

list 4 risk factors of xanthine uroliths

A

Genetic predisposition
Acid urine, highly concentrated urine
Urine retention
Allopurinol treatment

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19
Q

list 2 risk factors of calcium phosphate uroliths

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A

Excessive dietary calcium, primary hyperparathyroidism
UTI – with urease producing bacteria

20
Q

List the clinical signs of urolithiasis

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A

lower urinary tract signs- dysuria, haematuria, pollakiuria
+/- signs of urinary obstruction
urate- signs of PSS
Not that specific

21
Q

Describe how urinalysis can help diagnose uroliths

Study These Flashcards
A

Not really
pH useful- clue to urolith type - helps monitor dietary management later on
rules out UTI
crystals can be misleading

22
Q

What is most helpful when diagnosing uroliths

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A

imaging key
radiography or ultrasound

23
Q

list the uroliths that are radiopaque

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A

calcium oxalate
struvite
calcium phosphate

24
Q

list the uroliths that are radiolucent

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A

Xanthine

need contrast to see

25
what do struvite uroliths look like
usually round/faceted appear smooth
26
what do calcium oxalate uroliths look like
irregular shape
27
Why does it matter that we know what type of urolith it is?
A diagnosis of urolithiasis without knowing the composition makes it impossible to select effective management.
28
what do you see on ultrasound with uroliths
acoustic shadowing Remember gravity when deciding if mass or urolith
29
why can ultrasound be better than radiography when diagnosing uroliths
can be done conscious will pick up radiolucent uroliths
30
describe medical treatment of uroliths
analgesia- usually NSAID antibiotic if concurrent UTI - generally prolonged course if struvite (C and S)
31
What is a specific urolith treatment for urate
allopurinol - Xanthine Oxidase inhibitor – for dissolution – takes at least 4-6 weeks, sometimes required long term not effective if PSS
32
what diet is used to dissolution calcium oxalate uroliths
Not amenable to dissolution (dietary management is for prevention of recurrence)
33
what diet is used to dissolution struvite uroliths
Prescription struvite dissolution diet (acidifying)
34
what diet is used to dissolution urate uroliths
Low-purine, alkalinising diet (contraindicated if pregnant/lactating)
35
what diet is used to dissolution cysteine uroliths
Alkanising, lower methionine protein content
36
what diet is used to dissolution calcium phosphate uroliths
Not amenable to dissolution
37
what diet is used to dissolution xanthine uroliths
Low purine, alkalinising
38
which uroliths need surgical removal
Calcium Oxalate Calcium phosphate larger Struvite uroliths - depends on the dog and their clinical signs
39
if a animal is blocked with urolith what is a surgical option
try and push urolith(s) back into bladder by retrograde urohydropulsion
40
what do you need to warn owners about post op after urolith surgical removal
warn owner of likely haematuria need to monitor urine output watch for dysuria
41
Describe how to prevent calcium oxalate uroliths recurrance
High moisture alkalinising diet – but monitor for Struvite crystalluria Monitor – monthly urinalysis, aim for SG < 1.020 (dogs) & < 1.030 (cats) and pH >6.5 Correct any hypercalcaemia
42
Describe how to prevent struvite uroliths recurrance
High moisture acidifying diet – but care re CaOx crystalluria Monitor urine pH & SG (as for CaOx but want pH < 7 Ensure UTI fully resolved – repeat C & S at end of antibiotic course
43
Describe how to prevent urate uroliths recurrance
High moisture alkalinising diet Some dogs require long term Allopurinol
44
Describe how to prevent cysteine uroliths recurrance
High moisture alkalinising diet Dogs – consider castration, will reduce recurrence if have sex-linked genetic predisposition
45
Describe how to prevent calcium phosphate uroliths recurrence
High moisture diet; senior diets may be useful due to lower protein
46
Describe how to prevent xanthine uroliths recurrence
High moisture alkalinising diet

12- SA- Urinary and endocrine disease (20 decks)

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