The ROCKet science of canine urolithiasis
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Saunders
1999
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| Schriftenreihe: | [The veterinary clinics of North America / Small animal practice]
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Datensatz im Suchindex
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| adam_text | CANINE UROLITHIASIS
CONTENTS
Preface xvii
Carl A. Osborne, Jody P. Lulich, and Joseph W. Bartges
Medical Dissolution and Prevention of Canine Uroliths:
Seven Steps From Science to Service 1
Carl A. Osborne, Mark L. Morris, Jr.,
and Robert C. Wheeler
For millennia, removal of uroliths has been the province of the
surgeon. However, a paradigm shift in management of canine
uroliths occurred beginning in 1973. Translating the science asso¬
ciated with medical dissolution of canine uroliths into a form that
would serve companion animals involved the interdependent
knowledge, skills, and desire of many individuals. By practicing
the principles of being proactive, defining clear objectives, agree¬
ing how to accomplish these objectives, and empathetically lis¬
tening to each others ideas and concerns, the surgical removal of
uroliths will one day become a subject of historic interest.
Analysis of 77,000 Canine Uroliths: Perspectives From
the Minnesota Urolith Center 17
Carl A. Osborne, Jody P. Lulich, David J. Polzin,
Sherry L. Sanderson, Lori A. Koehler, Lisa K. Ulrich,
Kathleen A. Bird, Laura L. Swanson, Laura A. Pederson,
and Sara Z. Sudo
Of the hundreds of minerals that are found in the earth, most
canine uroliths are comprised of only six types: (1) magnesium
ammonium phosphate, (2) calcium oxalate, (3) calcium phos¬
phates, (4) ammonium urate and other salts or uric acid, (5)
VETERINARY CLINICS OF NORTH AMERICA:
SMALL ANIMAL PRACTICE
VOLUME 29 • NUMBER 1 • JANUARY 1999 ix
cystine, or (6) silica. Each type has characteristics that allow its
identification. During the past two decades, the prevalence of
calcium oxalate canine uroliths has dramatically increased, while
struvite has decreased. The most effective treatment and preven¬
tion protocols are based on knowledge of the primary mineral
type comprising the urolith.
Risk and Protective Factors for Urolithiasis: What Do
They Mean? 39
Carl A. Osborne and Jody P. Lulich
The occurrence of urolithiasis in companion animals is associated
with several risk and protective factors. Case control studies are
commonly designed to study the relationship between naturally
occurring urolithiasis and risk factors. However, case control
studies are subject to limitations, biases, and confounding vari¬
ables; they do not prove cause and effect relationships. Likewise,
just because two events occur in consecutive order does not prove
a cause and effect relationship.
Methods for Evaluating Treatment of Uroliths 45
Joseph W. Bartges, Carl A. Osborne, Jody P. Lulich,
Claudia Kirk, Timothy A. Allen, and Charles Brown
Formation of uroliths is not a disease but rather a complication
of several disorders. Some disorders can be identified and cor¬
rected (e.g., infection induced struvite urolith formation), and
some can be identified but not corrected (e.g., hyperuricosuria
occurring in Dalmatians that form ammonium urate uroliths),
although for others, the underlying etiopathogenesis is not
known (e.g., calcium oxalate urolith formation in Miniature
Schnauzers). A common denominator of these disorders is that
from time to time, they can create oversaturation of urine with
one or more crystal precursors, resulting in formation of crystals.
To develop rational and effective approaches to treatment, abnor¬
malities that promote urolith formation must be identified with
the goal of eliminating or modifying them. It is therefore im¬
portant to understand several basic concepts associated with uro¬
lithiasis.
Imaging Canine Urocystoliths: Detection and Prediction
of Mineral Content 59
Daniel A. Feeney, Ralph C. Weichselbaum, Carl R. Jessen,
and Carl A. Osborne
The role of survey radiography, contrast radiography, and ultra
sonography in the assessment of urocystolithiasis has been pri
X CONTENTS
marily one of detection. Information about the radiographic char¬
acteristics of uroliths (size, shape, radiopacity, surface characteris¬
tics, number detected) for characterization and diagnosis of uro
cystolithiasis is emerging; however, there are no studies on the
accuracy or sensitivity of these techniques. In this article, the
intent is to update knowledge about available imaging techniques
used in the detection and characterization of urocystoliths based
on recent studies designed to evaluate their accuracy in prediction
of different urocystoliths mineral content.
Medical Dissolution and Prevention of Canine Struvite
Urolithiasis: Twenty Years of Experience 73
Carl A. Osborne, Jody P. Lulich, David J. Polzin,
Timothy A. Allen, John M. Kruger, Joseph W. Bartges,
Lori A. Koehler, Lisa K. Ulrich, Kathleen A. Bird,
and Laura L. Swanson
Two types of canine struvite uroliths have been recognized: infec¬
tion induced struvite is the most common type; sterile struvite
is uncommonly recognized. Infection induced struvite is most
commonly associated with urease producing staphylocoecal UTI.
For dogs that qualify, medical dissolution is an effective method
of treatment. Medical dissolution protocols encompass: (1) eradi¬
cation or control of UTI; (2) use of calculolytic diets; and (3)
administration of urease inhibitors to patients with persistent UTI
caused by urease producing microbes.
Epidemiology of Canine Calcium Oxalate Uroliths:
Identifying Risk Factors 113
Jody P. Lulich, Carl A. Osborne, Rosama Thumchai,
Chalermpol Lekcharoensuk, Lisa K. Ulrich,
Lori A. Koehler, Kathleen A. Bird, Laura L. Swanson,
and Yasushi Nakagawa
Calcium oxalate uroliths are most commonly encountered in
Miniature Schnauzcrs, Lhaso Apsos, Yorkshire Terriers, Bichons
Frises, Shih Tzus, and Miniature Poodles. They are more common
in males than females, and more common in older than young
dogs. Dogs that form abnormal nephrocalcin are also predisposed
to calcium oxalate uroliths. Dietary risk factors for calcium oxalate
uroliths include excessive calcium supplementation or excessive
calcium restriction, excessive oxalic acid, high protein, high so¬
dium, restricted phosphorus, restricted potassium, and restricted
moisture (dry formulations). Dogs with hyperadrenocorticism or
hypercalcemia are predisposed to calcium oxalate urolith forma¬
tion.
CONTENTS xi
Canine Calcium Oxalate Urolithiasis: Case Based
Applications of Therapeutic Principles 123
Jody P. Lulich, Carl A. Osborne,
Chalermpol Lekcharoensuk, Timothy A. Allen,
and Yasushi Nakagawa
This case study illustrates the diagnosis and management of
calcium oxalate urolithiasis in Bichon Frise, a breed at increased
risk for this type of stone. If the Bichon Prise had persistent
hypercalcemia, serum concentrations of ionized calcium, parathy¬
roid hormone, and vitamin D would be evaluated to identify
an underlying cause. Because his urine was alkaline, additional
potassium citrate was not provided. Likewise, as a fortified diet
was fed to him, vitamin B6 therapy was not considered. This case
study illustrates the benefits of radiographic evaluation immedi¬
ately following surgery and during follow up examinations. If we
had postponed radiographs until the patient developed clinical
signs, additional surgical procedures may have been required.
Canine Calcium Phosphate Uroliths: Etiopathogenesis,
Diagnosis, and Management 141
John M. Kruger, Carl A. Osborne,
and Jody P. Lulich
Uroliths composed predominantly of calcium phosphates have
been infrequently identified in dogs. Factors incriminated in the
etiopathogenesis of calcium phosphate urolithiasis include an al¬
kaline urine pH, hypercalciuria, decreased urine concentrations
of crystallization inhibitors, and increased urine concentrations
of crystallization promoters. Disorders associated with calcium
phosphate urolith formation in dogs include primary hyperpara
thyroidism, hyperadrenocorticism, and idiopathic hypercalciuria.
Medical therapy of patients with recurring calcium phosphate
uroliths should be directed at removing or minimizing factors
contributing to urine supersaturation with calcium phosphate.
Canine Urate Urolithiasis: Etiopathogenesis, Diagnosis,
and Management 161
Joseph W. Bartges, Carl A. Osborne, Jody P. Lulich,
John M. Kruger, Sherry L. Sanderson, Lori A. Koehler,
and Lisa K. Ulrich
Etiopathologic factors predisposing to urate lithogenesis in Dal¬
matian and non Dalmatian dogs represent diverse pathologic
and/or physiologic processes involving purine nucleotide and
ammonia synthesis, biodegradation, and excretion. Predisposing
factors for urate urolith formation include hyperuricemia, hyper
ammonemia, hyperuricosuria, hyperammonuria, aciduria, and
Xii CONTENTS
genetic predisposition. Medical therapy of dogs forming urate
uroliths should be directed at modifying these predisposing fac¬
tors through dietary modification, administration of allopurinol,
and/or surgical correction of portovascular anomalies if present.
The precise mechanisms resulting in urate urolith formation in
dogs have not been determined.
Canine Cystine Urolithiasis: Cause, Detection,
Treatment, and Prevention 193
Carl A. Osborne, Sherry L. Sanderson, Jody P. Lulich,
Joseph W. Bartges, Lisa K. Ulrich, Lori A. Koehler,
Kathleen A. Bird, and Laura L. Swanson
Cystine uroliths are a sequela to cystinuria, an inherited renal
tubular defect in reabsorption of cystine and some other ammo
acids. At the Minnesota Urolith Center, 67 breeds of dogs were
identified, including English Bulldogs, Dachshunds, Mastiffs, and
Newfoundlands. In some dogs, the severity of cystinuria may
decline with advancing age. Current recommendations for disso¬
lution of cystine uroliths include various combinations of diet
modification, diuresis, administration of 2 MPG, and alkaliniza
tion of urine.
Canine Silica Urolithiasis: Risk Factors, Detection,
Treatment, and Prevention 213
Carl A. Osborne, Frederic Jacob, Jody P. Lulich,
Matthew J. Hansen, Chalermpol Lekcharoensul,
Lisa K. Ulrich, Lori A. Koehler, Kathleen A. Bird, and
Laura L. Swanson
Uroliths containing 70% or greater silica comprise approximately
1% of the canine uroliths submitted to the Minnesota Urolith
Center. Male dogs are far more commonly affected than females.
In our series, 84 different breeds were affected. Currently avail¬
able data suggest dietary factors play a role in their formation.
Diagnosis is facilitated by the characteristic jackstone configura¬
tion of silica uroliths, but must be confirmed by quantitative
analysis. Voiding urohydropropulsion or surgery are currently
the most practical methods of removal of silica uroliths.
Canine and Feline Nephrolithiasis: Epidemiology,
Detection, and Management 231
Sheri J. Ross, Carl A. Osborne, Jody P. Lulich,
David J. Polzin, Lisa K. Ulrich, Lori A. Koehler,
Kathleen A. Bird, and Laura L. Swanson
Calcium oxalate (39%) and struvite (33%) were the predominant
mineral types in canine nephroliths submitted to the Minnesota
CONTENTS Xiii
Urolith Center. Urate salts (12%) and calcium phosphate (2%)
occurred less frequently. Provided they are not causing obstruc¬
tion, struvite nephroliths may be dissolved with medical proto¬
cols. Although there are no dissolution protocols for nephroliths
containing calcium, risk benefit ratios should be considered be¬
fore proceeding with surgery.
Drug Induced Urolithiasis 251
Carl A. Osborne, Jody P. Lulich, Joseph W. Bartges,
Lisa K. Ulrich, Lori A. Koehler, Kathleen A. Bird,
Laura L. Swanson, Glenn W. Austin, Edwin L. Prien, Jr.,
and Kirk U. Steinam
Diagnostic and therapeutic drugs may enhance urolithiasis in one
or a combination of ways, including: (1) alteration of urine pH in
such fashion as to create an environment that increases the solu¬
bility of some lithogenic substances, (2) alteration of glomerular
filtration rate, tubular reabsorption, and tubular secretion of
drugs of endogenous substances so as to enhance promoters or
impair inhibitors of urolithiasis, and (3) precipitation (e.g., drugs
or their metabolites) to form a portion or all of a urolith.
Canine Retrograde Urohydropropulsion: Lessons From
25 Years of Experience 267
Carl A. Osborne, Jody P. Lulich, and David J. Polzin
Uroliths are commonly voided into the urethra where they often
lodge adjacent to the os penis in male dogs. Urethral patency can,
with few exceptions, be restored by flushing uroliths back into
the bladder lumen by retrograde urohydropropulsion. To be con¬
sistently successful, one must be familiar with the concepts of the
procedure and each step of the technique.
Voiding Urohydropropulsion: Lessons From 5 Years of
Experience 283
Jody P. Lulich, Carl A. Osborne, Sherry L. Sanderson,
Lisa K. Ulrich, Lori A. Koehler, Kathleen A. Bird,
and Laura L. Swanson
Voiding urohydropropulsion is a nonsurgical method of removing
uroliths from the urinary bladder. Any urocystolith of sufficient
size to pass through the distended urethral lumen can be safely
and effectively removed by this technique. Compared to cysto
tomy, voiding urohydropropulsion offers several advantages: uro¬
lith removal can be performed in minutes, anesthetic period is
shorter, postprocedural dysuria and hematuria are less severe,
and it provides greater success for complete removal of small
urocystoliths. This technique is not suitable for removal of large
xiv CONTENTS
urocystoliths or uroliths that become lodged in the urethral lu¬
men.
Electrohydraulic and Extracorporeal Shock Wave
Lithotripsy 293
Larry G. Adams and David F. Senior
The literal meaning of lithotripsy is the act of breaking stones.
There are two forms of lithotripsy available for use in veterinary
medicine: electrohydraulic shock wave lithotripsy (EHL) and ex¬
tracorporeal shock wave lithotripsy (ESWL). With EHL, a shock
wave is generated immediately adjacent to a urolith within the
urinary bladder. In dogs, nephroliths or ureteroliths can be suc¬
cessfully treated with ESWL. With ESWL, the shock waves are
generated outside the body and directed toward the urolith.
Index 303
Subscription Information Inside back cover
CONTENTS XV
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| spelling | The ROCKet science of canine urolithiasis Carl A. Osborne ..., guest ed. Philadelphia [u.a.] Saunders 1999 XVIII, 306 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier [The veterinary clinics of North America / Small animal practice] 29,1 Urolithiasis cabt Dog Diseases cabt Dogs Dogs Diseases Urinary Calculi veterinary Urinary organs Calculi Veterinary urology Harnsteinkrankheit (DE-588)4072330-6 gnd rswk-swf Hund (DE-588)4026181-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Hund (DE-588)4026181-5 s Harnsteinkrankheit (DE-588)4072330-6 s DE-604 Osborne, Carl A. Sonstige oth Small animal practice] [<<The>> veterinary clinics of North America 29,1 (DE-604)BV000001819 29,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008434803&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The ROCKet science of canine urolithiasis Urolithiasis cabt Dog Diseases cabt Dogs Dogs Diseases Urinary Calculi veterinary Urinary organs Calculi Veterinary urology Harnsteinkrankheit (DE-588)4072330-6 gnd Hund (DE-588)4026181-5 gnd |
| subject_GND | (DE-588)4072330-6 (DE-588)4026181-5 (DE-588)4143413-4 |
| title | The ROCKet science of canine urolithiasis |
| title_auth | The ROCKet science of canine urolithiasis |
| title_exact_search | The ROCKet science of canine urolithiasis |
| title_full | The ROCKet science of canine urolithiasis Carl A. Osborne ..., guest ed. |
| title_fullStr | The ROCKet science of canine urolithiasis Carl A. Osborne ..., guest ed. |
| title_full_unstemmed | The ROCKet science of canine urolithiasis Carl A. Osborne ..., guest ed. |
| title_short | The ROCKet science of canine urolithiasis |
| title_sort | the rocket science of canine urolithiasis |
| topic | Urolithiasis cabt Dog Diseases cabt Dogs Dogs Diseases Urinary Calculi veterinary Urinary organs Calculi Veterinary urology Harnsteinkrankheit (DE-588)4072330-6 gnd Hund (DE-588)4026181-5 gnd |
| topic_facet | Urolithiasis Dog Diseases Dogs Dogs Diseases Urinary Calculi veterinary Urinary organs Calculi Veterinary urology Harnsteinkrankheit Hund Aufsatzsammlung |
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