Veterinary Medicine - October 2008 - (Page 552) Urolithiasis PEER-REVIEWED TABLE 2 Quick Reference Guide for Uroliths in Dogs and Cats Composition Struvite (magnesium ammonium phosphate hexahydrate) Crystal or Urolith Characteristics • Crystal—angular, prismlike • Urolith—often spherical or pyramidal; white, cream, or light brown; radiopaque Predisposing Factors • Bacterial urinary tract infection is most common in dogs. • Sterile form is most common in cats and may be caused by alkaline urine and low urine volume or increased magnesium in diet. • Hypercalcemia • Hypercalciuria • Increased oxalates in diet • Acidic urine Treatment* • Infectious: Resolve bacterial infection; medical dissolution with an antibiotic and a calculolytic diet or a maintenance diet and d,l-methionine if needed (see text) • Sterile: Medical dissolution with a calculolytic diet • Removal** or lithotripsy • Removal** or lithotripsy • Leaving the urolith and monitoring clinical signs Calcium oxalate (100% monohydrate) • Crystal—dumbbell- or picket-fence-shaped (monohydrate) or Maltese cross (dihydrate) • Urolith—smooth or jagged (rose rock); radiopaque (80% dihydrate) Urate (purine) • Crystal—slender and hexagonal (uric acid) or large and irregular (ammonium urate) • Urolith—small; smooth; round; light-yellow, lightbrown, or light-green; radiolucent • Crystal—resembles uric acid crystal or is amorphous • Urolith—a few millimeters in size with a smooth surface and yellow, tan, or light-brown; radiolucent • Metabolism in Dalmatians and English bulldogs • Liver disease, especially portosystemic shunt • Diet high in purines • Idiopathic, especially in cats • Suspected familial or congenital defect in xanthine oxidase activity in cats • Probable inborn error of purine metabolism in Cavalier King Charles spaniels and dachshunds • Allopurinol administration • Removal** or lithotripsy • Medical dissolution in dogs: Feed a diet formulated for managing urate stones and allopurinol. • Medical dissolution in cats: Feed a diet formulated for managing kidney disease. Removal** or lithotripsy Xanthine (purine) *Treatment and prevention plans for all uroliths should include increasing the patient’s water intake. **Removal refers to surgical removal or voiding urohydropropulsion. 552 October 2008 VETERINARY MEDICINE
Table of Contents Feed for the Digital Edition of Veterinary Medicine - October 2008 Veterinary Medicine - October 2008 Contents Leading Off Clinical Exposures Idea Exchange Stalking Stones Vaginitis in Dogs CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller Veterinary Medicine - October 2008 Veterinary Medicine - October 2008 - Veterinary Medicine - October 2008 (Page Cover1) Veterinary Medicine - October 2008 - Veterinary Medicine - October 2008 (Page Cover2) Veterinary Medicine - October 2008 - Veterinary Medicine - October 2008 (Page 527) Veterinary Medicine - October 2008 - Veterinary Medicine - October 2008 (Page 528) Veterinary Medicine - October 2008 - Contents (Page 529) Veterinary Medicine - October 2008 - Contents (Page 530) Veterinary Medicine - October 2008 - Contents (Page 531) Veterinary Medicine - October 2008 - Contents (Page 532) Veterinary Medicine - October 2008 - Contents (Page 533) Veterinary Medicine - October 2008 - Leading Off (Page 534) Veterinary Medicine - October 2008 - Leading Off (Page 535) Veterinary Medicine - October 2008 - Leading Off (Page 536) Veterinary Medicine - October 2008 - Leading Off (Page 537) Veterinary Medicine - October 2008 - Clinical Exposures (Page 538) Veterinary Medicine - October 2008 - Clinical Exposures (Page 539) Veterinary Medicine - October 2008 - Idea Exchange (Page 540) Veterinary Medicine - October 2008 - Idea Exchange (Page 541) Veterinary Medicine - October 2008 - Stalking Stones (Page 542) Veterinary Medicine - October 2008 - Stalking Stones (Page 543) Veterinary Medicine - October 2008 - Stalking Stones (Page 544) Veterinary Medicine - October 2008 - Stalking Stones (Page 545) Veterinary Medicine - October 2008 - Stalking Stones (Page 546) Veterinary Medicine - October 2008 - Stalking Stones (Page 547) Veterinary Medicine - October 2008 - Stalking Stones (Page 548) Veterinary Medicine - October 2008 - Stalking Stones (Page 549) Veterinary Medicine - October 2008 - Stalking Stones (Page 550) Veterinary Medicine - October 2008 - Stalking Stones (Page 551) Veterinary Medicine - October 2008 - Stalking Stones (Page 552) Veterinary Medicine - October 2008 - Stalking Stones (Page 553) Veterinary Medicine - October 2008 - Stalking Stones (Page 554) Veterinary Medicine - October 2008 - Stalking Stones (Page 555) Veterinary Medicine - October 2008 - Stalking Stones (Page 556) Veterinary Medicine - October 2008 - Stalking Stones (Page 557) Veterinary Medicine - October 2008 - Stalking Stones (Page 558) Veterinary Medicine - October 2008 - Stalking Stones (Page 559) Veterinary Medicine - October 2008 - Stalking Stones (Page 560) Veterinary Medicine - October 2008 - Stalking Stones (Page 561) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 562) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 563) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 564) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 565) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 566) Veterinary Medicine - October 2008 - Vaginitis in Dogs (Page 567) Veterinary Medicine - October 2008 - Advertiser Index (Page 568) Veterinary Medicine - October 2008 - Marketplace/Classifieds (Page 569) Veterinary Medicine - October 2008 - Marketplace/Classifieds (Page 570) Veterinary Medicine - October 2008 - Marketplace/Classifieds (Page 571) Veterinary Medicine - October 2008 - Marketplace/Classifieds (Page 572) Veterinary Medicine - October 2008 - Marketplace/Classifieds (Page 573) Veterinary Medicine - October 2008 - Mind Over Miller (Page 574) Veterinary Medicine - October 2008 - Mind Over Miller (Page Cover3) Veterinary Medicine - October 2008 - Mind Over Miller (Page Cover4) Veterinary Medicine - October 2008 - Mind Over Miller (Page P1) Veterinary Medicine - October 2008 - Mind Over Miller (Page P2) Veterinary Medicine - October 2008 - Mind Over Miller (Page P3) Veterinary Medicine - October 2008 - Mind Over Miller (Page P4) Veterinary Medicine - October 2008 - Mind Over Miller (Page P5) Veterinary Medicine - October 2008 - Mind Over Miller (Page P6) Veterinary Medicine - October 2008 - Mind Over Miller (Page P7) Veterinary Medicine - October 2008 - Mind Over Miller (Page P8) Veterinary Medicine - October 2008 - Mind Over Miller (Page P9) Veterinary Medicine - October 2008 - Mind Over Miller (Page P10) Veterinary Medicine - October 2008 - Mind Over Miller (Page P11) Veterinary Medicine - October 2008 - Mind Over Miller (Page P12) Veterinary Medicine - October 2008 - Mind Over Miller (Page P13) Veterinary Medicine - October 2008 - Mind Over Miller (Page P14) Veterinary Medicine - October 2008 - Mind Over Miller (Page P15) Veterinary Medicine - October 2008 - Mind Over Miller (Page P16)
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