Urolithiasis in small animals Flashcards

Question

What is laser lithotripsy?

Answer 1

- guided by cystoscopy - fragments removed by VUH - BUT energy absorbed by water (effects only within 1-2mm fibre tip)

Answer 2

- 8% canine stones - DALMATIONS: reduced conversion of uric acid to allantoin, defective transport of uric acid into hepatocytes andout of urine - Hepatic dysfunction: PSS, increased excretion of ammonia and urea. - bulldogs and others

Answer 3

- tx underlying liver disease and PSS - otherwise dissolution - tx any UTI - reduce purine, neutral to alkalinepH (Hills u/d) - allopurinol (competitively inhibits xanthine oxidase, reducing uric acid this can result in xanthine stones if protein not restricted)

Answer 4

- 3% canine stones (breeds) - renal tubular defect resulting in excess urine cystine which is poorly soluble - typically middle aged, despite being a congenital problem - radiolucent - medical dissolution effective but v expensive - cystine excretion decreased by castration

Answer 5

- associated with primary hyperPTH - also mixed urolith - inerlaistion of blood clot

Answer 6

- commonest in horses and rabbits | - high {Ca2+] in ruine

Answer 7

- GSDs predisposed - rare - associated with poor diets

Answer 8

- UT obstruction - unknown or unpredictable urolith composition - failed medical tx - presence of other urinary tract abnormalities - immature dogs (d/t specific dietary requirements) - owner preference - cost

Answer 9

- open viscus and remove calculi (nephrotomy, pyelotomy, ureterotomy, cystotomy, urethrotomy) - provide urine diversion (create an artificial opening, usually permanent)

Answer 10

- stabilise hyperkalaemic and severely azotaemic animals pre-sx - ensure # and location of calculi are known immediately before sx - place indwelling urinary catheter (with extension set) and empty bladder - check all calculi / fragments of calculi are removed at end of sx - submit calculi for quantitative analysis

Answer 11

- place urinary catheter connected to an extension set prior to sx - caudal midline ventral celiotomy, care entering peritoneal lcavity - locate bladder and empty if necessary, place stay suture - prolene, in apex - pack of abdominal cavity - ventral midline cystotomy and use further stay sutures to aid manipulaiton - remove obvious calculi (forceps) - save for quantitative analysis and culture - flush urethra with sterile saline - non-sterile assistant to do until ALL calculi removed - close bladder using syntehtic absorbable material e.g. poliglecaprone = monocryl, single or double layer, continuous or interrupted, appositional or inverting, try and avoid placing stay suture in bladder lumen

Answer 12

- are all calculi removed - consider xray post-op - generally indwelling catheter not used - usual to keep on IVFT for 12-24 hours - need to be allowed to urinate frequently - analgesia - medical management (dependent on calculus)

Answer 13

- not removing all calculi -> CS recur - dehiscence of bladder --> uroperitoneum - blood clot --> outflow obstruction - CS: cystitis

Answer 14

moderately to markedly radiopaue

Answer 15

sharp projections, mulberry shaped or smooth round uroliths | - COD may be jackstone shaped

Answer 16

acidic to neutral

Answer 17

- COM crystals (dumbbell or picket fence shapes) | - COD (square envelopes)

Answer 18

None or secondary UTI with common uropathogens

Answer 19

- miniature schnauzer - lhasa apso - YT - bichon firse - pomeranian - shih tzu - birmese, himalayan, persian

Answer 20

often multiple small uroliths in bladder. multiple nephrolights is present. - males > females (dogs and cats)

Answer 21

mod to markedly radiopaque | - larger uroliths more radiopaque

Answer 22

SINGLE: smooth or speculated, may assume shape of bladder MULTIPLE: smooth surfaces where uroliths contact each other, often pyramidial

Answer 23

struvite or 'triple phosphate' crystals (coffin lid appearance)

Answer 24

urease producing organisms (staph,proteus, mycoplasma). | - sterile struvite uroliths in cocker spaniels and cats

Answer 25

- miniature schnauzer - shih tzu - bichon firse - miniature poodle - cocker spaniel - lhasa apso

Answer 26

- radiolucent to faintly radioopaque - multiple smooth uroliths - acidic urine - ammonium urate crystals (yellow-brown 'thornapple or spherical') or amoprhous urate crystals - no UTI or secondary UTI with common uropathogens. Rarely urease producing organisms - Dalmation, english bulldog,miniature schnauzer, shih tzu, YT - PSS or other liver dysfunction - yellow-green urolith colour, - DOGS: Males> females - CATS: equal b/w sexes

Answer 27

- radiolucent to moderately radioopaque - multiple smooth round uroliths in bladde/urethra - nephroliths staghorn shape - acidic urine - cystine crystalluria always abnormal - no UTI or seconday UTI with common uropathogens - mastiff, australian cattle dog, english bulldog, SBT, newfoundland, dachshund - positive urine-cyanide nitroprusside test - metabolic screening of urine available - DOGS: males>>>>females

Answer 28

- moderately to markedly radioopaque - SURFACE: hydroxyapatite (multiple small uroliths with variable shape) or brushite (multiple smooth round or pyramidal uroliths) - alkaline to neutralurine pH for hydroxyapaptite, acidic for brushite - crystalluria: amorphous phosphates or calcium phosphate crystals (thin prisms) - no UTI or secondary UTI with common uropathogens - YT, miniature schnauzer, bichon friese, shih tzu, springer spaniel, pomeranian, miniature poodle, cocker spaniel - hypercalcaemia predisposes this

Answer 29

- moderately radioopaque - classic jackstone appearance - acidic to neutral urine pH - no crystalluria - no UTI or secondary UTI with common uropathogens - GSD, OESH, labrador retriever - males >> females

Urolithiasis in small animals Flashcards

(55 cards)