Urolithiasis

Question 1

Can you have uroliths without crystals?

Answer 1

Yes. You can have either without the other and even have crystals of one type and uroliths of another

Question 2

Do you get clinical signs from crystals?

Answer 2

no

Question 3

What’s the clinical name for bladder stones?

Answer 3

Cystoliths

Question 4

What’s the clinical name for Kidney stones?

Answer 4

Nephroliths

Question 5

What’s the clinical name for Urethra stones?

Answer 5

Urethroliths

Question 6

How are uroliths formed?

Answer 6

Crystals form when urine is supersaturated

Question 7

What is the start of the process of stone forming called?

Answer 7

Nucleation

Question 8

How does the body protect itself against stone formation?

Answer 8

There are precipitate inhibitors in urine that prevent precipitation and therefore allow the excretion of calcium oxalate

Question 9

What are the common symptoms of cystoliths?

Answer 9

dysuria, pollakiuria, haematuria, and inappropriate urination

Question 10

What are the common symptoms of urethroliths?

Answer 10

Abdominal discomfort, poor or no urine stream, licking of genital area, azotaemia, and enlarged painful bladder

Question 11

How can radiographs aid you in diagnosis?

Answer 11

You can see uroliths and whether they show up radiolucent or radio- opaque

Question 12

Is quantitative or qualitative analysis more useful in diagnosing stone type?

Answer 12

Quantitative but takes a few weeks

Question 13

What are the 5 main treatment options for renal stones?

Answer 13

Surgical removal, Urinary bipass, lithotripsy, dietary dissolution or benign neglect

Question 14

What is lithotripsy?

Answer 14

Use of shock waves to break up stones

Question 15

Why might you choose benign neglect?

Answer 15

If the stone isn’t causing clinical signs then it can be left. Especially if it is in the kidney as the surgery is very invasive and cause loss of renal function

Question 16

What’s the most common stone found in the kidney?

Answer 16

Calcium oxolate

Question 17

What are the main treatment options for bladder stones?

Answer 17

Medical dissolution, voiding urohydropropulsion, surgery

Question 18

What are the main treatment options for urethra stones?

Answer 18

Retrograde flush into bladder or surgery

Question 19

How would you go about returning a urethral stone to the bladder?

Answer 19

Anesthetize patient, push catheter in till just before stone. Have assistant insert finger rectally and block stone. Then flush fluid into space, walls of urethra should stretch. When you let go of stone it should flush back into bladder

Question 20

What stone formations are more amenable to dissolution?

Answer 20

Struvite, cystine and urate

Question 21

How do you perform urohydropulstion?

Answer 21

Fill bladder with saline.
Position so urethra is vertical.
agitate.
initiate voiding under high pressure and repeat if necessary

Question 22

What after treatment is required after urohydropulsion treatment?

Answer 22

3 days of antobiotics

Question 23

What are struvite stones strongly associated with in dogs?

Answer 23

UTI

Question 24

What Urine PH will you see in an animal with a struvite stone?

Answer 24

alkaline

Question 25

How would you treat a struvite stone?

Answer 25

Change diet to reduce PH of urine and increase fluid intake

Question 26

How would treatment differ between a dog and a cat?

Answer 26

A dog would need constant antibiotics, the entire time of treatment

Question 27

Are diets any use in prevention of struvite stones?

Answer 27

Not really, especially in dogs as the main cause of struvite stones are bacterial infections and diet has no effect on this

Question 28

What unwanted effect can struvite preventative diets have?

Answer 28

They can make the urine acidic which actually encourages the formation of calcium oxalate stones

Question 29

What's the second most common stone in dogs?

Answer 29

calcium oxalate

Question 30

What sex is more predisposed to calcium oxolate crystals in the dog?

Answer 30

Male

Question 31

What's the one dietary change that actually helps animals with calcium oxalate stones?

Answer 31

Increased water intake

Question 32

What breed of dog are ammonium urate stones most common in?

Answer 32

Dalmations

Question 33

How can you manage ammonium urate stones?

Answer 33

Reduce protein available in the diet but also drugs are available

Question 34

How can allopurinol help ammonium urate stones?

Answer 34

Competetively inhibits x.oxidase, reducing uric acid but this can result in xanthine stores if protein not restricted

Question 35

Whats the main cause of cystine stones?

Answer 35

renal tubular defect in which excess cystine enters urine

Question 36

What preventative treatment can be taken for cystine stones?

Answer 36

castration in male dogs

Question 37

What are the two surgical options?

Answer 37

Open the viscus and remove the calculi or provide urine diversion

Question 38

What should you place before bladder surgery?

Answer 38

a urinary catheter

Question 39

What 2 layers do you have to cut through to gain access to the bladder?

Answer 39

detrusor muscle layer and urothelial layer