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Abstract

Objective—To evaluate the effect of dietary supplementation with sodium chloride (NaCl) on urinary calcium excretion, urine calcium concentration, and urinary relative supersaturation (RSS) with calcium oxalate (CaOx).

Animals—6 adult female healthy Beagles.

Procedure—By use of a crossover study design, a canned diet designed to decrease CaOx urolith recurrence with and without supplemental NaCl (ie, 1.2% and 0.24% sodium on a dry-matter basis, respectively) was fed to dogs for 6 weeks. Every 14 days, 24- hour urine samples were collected. Concentrations of lithogenic substances and urine pH were used to calculate values of urinary RSS with CaOx.

Results—When dogs consumed a diet supplemented with NaCl, 24-hour urine volume and 24-hour urine calcium excretion increased. Dietary supplementation with NaCl was not associated with a change in urine calcium concentration. However, urine oxalate acid concentrations and values of urinary RSS with CaOx were significantly lower after feeding the NaCl-supplemented diet for 28 days.

Conclusions and Clinical Relevance—Dietary supplementation with NaCl in a urolith-prevention diet decreased the propensity for CaOx crystallization in the urine of healthy adult Beagles. However, until long-term studies evaluating the efficacy and safety of dietary supplementation with NaCl in dogs with CaOx urolithiasis are preformed, we suggest that dietary supplementation with NaCl be used cautiously. (Am J Vet Res 2005;66:319–324)

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in American Journal of Veterinary Research

Abstract

Objective—To evaluate urine concentrations of glycosaminoglycans, Tamm-Horsfall glycoprotein, and nephrocalcin in cats fed a diet formulated to prevent calcium oxalate uroliths.

Animals—10 cats with calcium oxalate urolithiasis.

Procedures—In a previous study conducted in accordance with a balanced crossover design, cats were sequentially fed 2 diets (the diet each cat was consuming prior to urolith detection and a diet formulated to prevent calcium oxalate uroliths). Each diet was fed for 8 weeks. At the end of each 8-week period, a 72-hour urine sample was collected. Concentrations of glycosaminoglycans, Tamm-Horsfall glycoprotein, and the 4 isoforms of nephrocalcin in urine samples collected during that previous study were measured in the study reported here.

Results—Diet had no effect on the quantity of Tamm-Horsfall glycoprotein and nephrocalcin in urine. However, the urine concentration of glycosaminoglycans was significantly higher during consumption of the urolith prevention diet.

Conclusions and Clinical Relevance—Feeding a urolith prevention diet increased the urine concentration of glycosaminoglycans, which are glycoprotein inhibitors of growth and aggregation of calcium oxalate crystals.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To test the hypothesis that urate uroliths are uncommonly detected in female Dalmatians, compared with males.

Design—Case-control study.

Sample Population—Medical records of dogs evaluated at veterinary teaching hospitals in North America from 1981 to 2002 and compiled by the Veterinary Medical Database, and records of dogs with uroliths submitted for quantitative analyses to the Minnesota Urolith Center from 1981 to 2002.

Procedures—Crude odds ratios (ORs) and 95% confidence intervals were calculated to assess whether sex (male vs female) was a risk factor for urate urolithiasis.

Results—In Dalmatians evaluated by veterinary teaching hospitals in North America, males were more likely (OR, 13.0) to form uroliths, compared with females. In Dalmatians that formed uroliths analyzed by the Minnesota Urolith Center, males were more likely (OR, 14.0) to form urate uroliths, compared with females. In all dogs (Dalmatian and non-Dalmatian) that formed uroliths analyzed by the Minnesota Urolith Center, males were also more likely (OR, 48.0) to form urate uroliths, compared with females.

Conclusions and Clinical Relevance—When conducting studies and formulating generalities about urate urolithiasis in Dalmatians, it is important to consider sex-related differences in urolith occurrence. Long-term dietary or drug protocols designed to minimize formation of urate uroliths in male Dalmatians may not be warranted in female Dalmatians. (J Am Vet Med Assoc 2005;227:565–569)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare efficacy, required resources, and perioperative complications between laser lithotripsy and cystotomy for urolith (ie, urocystoliths and urethroliths) removal in dogs.

Design—Retrospective case-control study.

Animals—66 dogs with urolithiasis treated by laser lithotripsy (case dogs) and 66 dogs with urolithiasis treated by cystotomy (control dogs).

Procedures—Medical records were reviewed. Complete urolith removal rate, resources (ie, duration of hospitalization, procedure time, anesthesia time, procedure cost, and anesthesia cost), and complications (ie, hypotension, hypothermia, incomplete urolith removal, and requirement of an ancillary procedure) were compared between cystotomy group dogs and lithotripsy group dogs.

Results—Duration of hospitalization was significantly shorter for lithotripsy group dogs, compared with cystotomy group dogs. Procedure time was significantly shorter for cystotomy group dogs, compared with lithotripsy group dogs. Cost of anesthesia was significantly less for cystotomy group dogs, compared with lithotripsy group dogs. No significant differences were found between cystotomy group dogs and lithotripsy group dogs with regard to urolith removal rate, procedure cost, anesthesia time, or any of the evaluated complications.

Conclusions and Clinical Relevance—Laser lithotripsy is a minimally invasive procedure that has been shown to be safe and effective in the removal of urocystoliths and urethroliths in dogs. No significant differences were found in the required resources or complications associated with laser lithotripsy, compared with cystotomy, for removal of uroliths from the lower portions of the urinary tract of dogs. Laser lithotripsy is a suitable, minimally invasive alternative to surgical removal of urethroliths and urocystoliths in dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify demographic factors associated with urate urolithiasis in cats and determine whether the rate of urolith submission to a laboratory had changed over time.

Design—Case series and case-control study.

Animals—Cases consisted of 5,072 cats with urate uroliths submitted to the Minnesota Urolith Center between January 1, 1981, and December 31, 2008. Controls consisted of 437,228 cats without urinary tract diseases identified in records of the Veterinary Medical Database during the same period.

Procedures—Information on cat breed, age, sex, reproductive status, and location of uroliths was used to identify risk factors. Changes in annual urolith submission rates were evaluated.

Results—Purebred cats had significantly higher odds of developing urate uroliths than did cats of mixed breeding (reference group). On the other hand, cats of the Abyssinian, American Shorthair, Himalayan, Manx, and Persian breeds had significantly lower odds of developing urate uroliths than did mixed breeds. Neutered cats were 12 times as likely to develop urate uroliths as were sexually intact cats. Cats in all age groups had significantly increased odds of developing urate uroliths, compared with cats < 1 year of age (reference group). Cats ≥ 4 but < 7 years of age had the highest odds of all groups and were 51 times as likely to develop urate uroliths as were cats < 1 year of age. Urolith submission rates did not change significantly with time.

Conclusions and Clinical Relevance—Findings of this study suggested that the typical cat with urate uroliths was a purebred neutered cat, 4 to 7 years old, with uroliths in the bladder or urethra. This information may be helpful in predicting mineral composition of uroliths in vivo. However, no conclusions can be made regarding cause-and-effect relationships.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether hydrochlorothiazide (HCTZ) reduces urinary calcium excretion in dogs with calcium oxalate urolithiasis.

Design—Original study.

Animals—8 dogs with calcium oxalate urolithiasis.

Procedure—4 treatment protocols were evaluated in each dog (a low calcium, low protein diet designed to prevent calcium oxalate urolith formation with and without administration of HCTZ [2 mg/kg (0.9 mg/lb) of body weight, PO, q 12 h] and a maintenance diet with higher quantities of protein and calcium with and without administration of HCTZ). At the end of each 2-week treatment period, 24-hour urine samples were collected. Blood samples were collected during the midpoint of each urine collection period. Analysis of variance was performed to evaluate the effects of HCTZ and diet on urine and serum analytes.

Results—Hydrochlorothiazide significantly decreased urine calcium and potassium concentration and excretion. Hydrochlorothiazide also significantly decreased serum potassium concentration. Compared with the maintenance diet, the urolith prevention diet significantly decreased urine calcium and oxalic acid concentration and excretion. Dogs consuming the urolith prevention diet had significantly lower serum concentrations of albumin and urea nitrogen.

Conclusions and Clinical Relevance—Administration of HCTZ decreased urine calcium excretion in dogs with a history of calcium oxalate urolith formation. The greatest reduction in urine calcium concentration and excretion was achieved when dogs received HCTZ and the urolith prevention diet. Results of this study suggest that the hypocalciuric effect of HCTZ will minimize recurrence of calcium oxalate urolith formation in dogs; however, long-term controlled clinical trials are needed to confirm the safety and effectiveness of HCTZ. (J Am Vet Med Assoc 2001;218:1583–1586)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether breed, age, sex, or reproductive status (ie, neutered versus sexually intact) was associated with the apparent increase in prevalence of calcium oxalate (CaOx) uroliths and the decrease in prevalence of magnesium ammonium phosphate (MAP) uroliths in cats over time.

Design—Case-control study.

Animals—Case cats consisted of cats with CaOx (n = 7,895) or MAP (7,334) uroliths evaluated at the Minnesota Urolith Center between 1981 and 1997. Control cats consisted of cats without urinary tract disease admitted to veterinary teaching hospitals in the United States and Canada during the same period (150,482).

Procedure—Univariate and multivariate logistic regression were performed.

Results—British Shorthair, Exotic Shorthair, Foreign Shorthair, Havana Brown, Himalayan, Persian, Ragdoll, and Scottish Fold cats had an increased risk of developing CaOx uroliths, as did male cats and neutered cats. Chartreux, domestic shorthair, Foreign Shorthair, Himalayan, Oriental Shorthair, and Ragdoll cats had an increased risk of developing MAP uroliths, as did female cats and neutered cats. Cats with CaOx uroliths were significantly older than cats with MAP uroliths.

Conclusions and Clinical Relevance—Results suggest that changes in breed, age, sex, or reproductive status did not contribute to the apparent reciprocal relationship between prevalences of CaOx and MAP uroliths in cats during a 17-year period. However, cats of particular breeds, ages, sex, and reproductive status had an increased risk of developing CaOx and MAP uroliths. (J Am Vet Med Assoc 2000;217:520–525)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether storage in neutral-buffered 10% formalin in vitro has any effect on the composition of biogenic minerals of canine and feline uroliths.

Design—Prospective in vitro study.

Sample Population—Canine and feline uroliths submitted to the Minnesota Urolith Center from 34 dogs and 27 cats.

Procedures—Submissions from each dog or cat consisted of multiple uroliths of a single mineral type. After retrieval from the urinary tract, none of the uroliths had been placed in a preservative before submission. Evaluated uroliths were exclusively composed of the following: only struvite (uroliths from 5 dogs and 5 cats), calcium oxalate (5 dogs and 5 cats), calcium phosphate apatite (5 dogs and 5 cats), cystine (5 dogs and 5 cats), ammonium urate (5 dogs and 5 cats), or silica (5 dogs). One urolith from each dog or cat was quantitatively analyzed by polarized light microscopy, infrared spectroscopy, or both. Another urolith from the same animal was immersed in 1 mL of neutral-buffered 10% formalin for 48 hours at room temperature (22.5°C). Uroliths exposed to formalin were then air-dried for 30 minutes, and the analysis was repeated.

Results—After exposure to formalin, a portion of every struvite urolith was transformed into newberyite. This was not observed with any other urolith mineral type. Quantitative mineral analysis of nonstruvite uroliths revealed no detectable change in mineral composition. However, 3 of 10 ammonium urate uroliths dissolved when placed in formalin.

Conclusions and Clinical Relevance—To avoid misdiagnosis of mineral composition, uroliths should not be immersed in formalin prior to analysis.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether nephrolithiasis was associated with an increase in mortality rate or in the rate of disease progression in cats with naturally occurring stage 2 (mild) or 3 (moderate) chronic kidney disease.

Design—Retrospective case-control study.

Animals—14 cats with stage 2 (mild) or 3 (moderate) chronic kidney disease (7 with nephroliths and 7 without).

Procedures—All cats were evaluated every 3 months for up to 24 months. Possible associations between nephrolithiasis and clinicopathologic abnormalities, incidence of uremic crises, death secondary to renal causes, and death secondary to any cause were evaluated.

Results—There were no clinically important differences in biochemical, hematologic, or urinalysis variables between cats with and without nephroliths at baseline or after 12 and 24 months of monitoring. No associations were detected between nephrolithiasis and rate of disease progression, incidence of uremic crises, or death.

Conclusions and Clinical Relevance—Results suggested that in cats with mild or moderate chronic kidney disease, nephrolithiasis was not associated with an increase in mortality rate or in the rate of disease progression. Findings support recommendations that cats with severe kidney disease and nephrolithiasis be managed without surgery.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To test the hypothesis that feline calcium oxalate uroliths are intrinsically more resistant to comminution via shock wave lithotripsy (SWL) than canine calcium oxalate uroliths through comparison of the fragility of canine and feline uroliths in a quantitative in vitro test system.

Sample Population—Calcium oxalate uroliths (previously obtained from dogs and cats) were matched by size and mineral composition to create 7 pairs of uroliths (1 canine and 1 feline urolith/pair).

Procedure—Uroliths were treated in vitro with 100 shock waves (20 kV; 1 Hz) by use of an electrohydraulic lithotripter. Urolith fragmentation was quantitatively assessed via determination of the percentage increase in projected area (calculated from the digital image area of each urolith before and after SWL).

Results—After SWL, canine uroliths (n = 7) fragmented to produce a mean ± SD increase in image area of 238 ± 104%, whereas feline uroliths (7) underwent significantly less fragmentation (mean image area increase of 78 ± 97%). The post-SWL increase in fragment image area in 4 of 7 feline uroliths was < 50%, whereas it was > 150% in 6 of 7 canine uroliths.

Conclusions and Clinical Relevance—Results indicate that feline calcium oxalate uroliths are less susceptible to fragmentation via SWL than canine calcium oxalate uroliths. In some cats, SWL may not be efficacious for fragmentation of calcium oxalate nephroliths or ureteroliths because the high numbers of shock waves required to adequately fragment the uroliths may cause renal injury. (Am J Vet Res 2005;66:1651–1654)

Full access
in American Journal of Veterinary Research