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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 confirm that the predominant mineral type in naturally occurring uroliths in ferrets is struvite; to determine whether age, breed, sex, reproductive status, geographic location, season, and anatomic location are risk factors associated with urolith formation in ferrets; to compare features of struvite uroliths in cats with those in ferrets; and to determine whether there is a logical evidence-based rationale for clinical trials of the safety and efficacy of diet-induced dissolution of struvite uroliths in ferrets.

Design—Retrospective case-control study.

Animals—408 ferrets with uroliths (272 struvite uroliths) from the Minnesota Urolith Center, and 6,528 control ferrets from the Veterinary Medical Database.

Procedures—Historical information was obtained about each ferret. The association between proposed risk factors and outcome (struvite urolith formation) was assessed.

Results—Sterile struvite was the predominant mineral in uroliths in ferrets. Neutered male ferrets had a significantly increased risk of developing sterile struvite uroliths. A significant association was also found between increasing age and the detection of struvite uroliths. Struvite uroliths in ferrets were more likely to be retrieved from the lower urinary tract than from the upper urinary tract.

Conclusions and Clinical Relevance—Knowledge of predominant mineral type in uroliths along with insight into etiologic, demographic, and environmental risk and protective factors for urolithiasis may facilitate development of surveillance strategies that result in earlier detection of uroliths in ferrets. Modification of risk factors, including dietary risk factors, may help to minimize urolith formation, dissolve existing uroliths, and minimize urolith recurrence.

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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 characterize the efficacy and safety of laser lithotripsy in the fragmentation of urocystoliths and urethroliths for removal in dogs.

Design—Prospective case series.

Animals—100 dogs with naturally occurring urocystoliths and urethroliths.

Procedures—Via cystoscopy, laser lithotripsy was performed to fragment uroliths. Basket retrieval and voiding urohydropropulsion were used to remove fragments. Postprocedural contrast cystography was performed to assess efficacy and safety. In 40 dogs, midstream urine samples were collected just prior to laser lithotripsy (day 0) and on days 1, 3, and 11 after laser lithotripsy to assess inflammation.

Results—Urolith removal was complete in 82% of dogs (52/66 with only urocystoliths, 17/17 with only urethroliths, and 13/17 with urocystoliths and urethroliths). Urolith removal was incomplete in 18 dogs; of these dogs, 9, 6, and 3 had urolith fragments ≥ 3 mm, 1 to < 3 mm, and < 1 mm in diameter, respectively. Sex (female) was the most significant predictor for success. Median procedure time was 72 minutes. Two dogs developed urinary tract obstruction following laser lithotripsy. Hematuria was detected in 53% of dogs on day 0 and in 84%, 13%, and 3% of dogs on days 1, 3, and 11, respectively. Leukocyturia was detected in 13% of dogs on day 0 and in 47%, 0%, and 3% of dogs on days 1, 3, and 11, respectively.

Conclusions and Clinical Relevance—Results suggested that use of laser lithotripsy was a safe and effective alternative to surgical removal of urocystoliths and urethroliths in dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the prevalence of cystine uroliths in domestic ferrets with urolithiasis and determine whether age, breed, sex, reproductive status, anatomic location, and season are risk factors associated with cystine urolith formation.

Design—Retrospective cross-sectional case-control study.

Sample—Records of 435 ferrets (Mustela putorius furo) with uroliths submitted for analyses between 1992 and 2009, of which 70 were cystine uroliths.

Procedures—Specific descriptive information was obtained about each ferret to determine whether specific risk factors were associated with the development of cystine uroliths.

Results—Cystine uroliths comprised 70 of the 435 (16%) uroliths. Cystine uroliths were more common in male (n = 54) than in female (16) ferrets. All cystine uroliths were retrieved from the lower portion of the urinary tract (bladder and urethra [n = 67]) or were voided (3); none of the uroliths were retrieved from the upper portion of the urinary tract (kidney and ureters).

Conclusions and Clinical Relevance—Awareness of the prevalence of cystine uroliths along with knowledge of etiologic, demographic, and environmental risk and protective factors for urolithiasis may facilitate development of surveillance strategies that result in earlier detection of cystinuria. Genetic factors associated with this disease have not yet been reported in ferrets, but a familial pattern of inheritance determined to be a major underlying factor in cystine urolithiasis in dogs and humans suggests that this may be a factor in ferrets and that the parent stock of ferrets in the present study may have been inbred.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine effects of storage temperature and time on pH and specific gravity of and number and size of crystals in urine samples from dogs and cats.

Design—Randomized complete block design.

Animals—31 dogs and 8 cats.

Procedure—Aliquots of each urine sample were analyzed within 60 minutes of collection or after storage at room or refrigeration temperatures (20 vs 6°C [68 vs 43°F]) for 6 or 24 hours.

Results—Crystals formed in samples from 11 of 39 (28%) animals. Calcium oxalate (CaOx) crystals formed in vitro in samples from 1 cat and 8 dogs. Magnesium ammonium phosphate (MAP) crystals formed in vitro in samples from 2 dogs. Compared with aliquots stored at room temperature, refrigeration increased the number and size of crystals that formed in vitro; however, the increase in number and size of MAP crystals in stored urine samples was not significant. Increased storage time and decreased storage temperature were associated with a significant increase in number of CaOx crystals formed. Greater numbers of crystals formed in urine aliquots stored for 24 hours than in aliquots stored for 6 hours. Storage time and temperature did not have a significant effect on pH or specific gravity.

Conclusions and Clinical Relevance—Urine samples should be analyzed within 60 minutes of collection to minimize temperature- and time-dependent effects on in vitro crystal formation. Presence of crystals observed in stored samples should be validated by reevaluation of fresh urine. (J Am Vet Med Assoc 2003;222:176–179)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine frequency of and interval until recurrence after initial ammonium urate, calcium oxalate, and struvite uroliths in cats and whether breed, age, or sex was associated with increased risk for urolith recurrence.

Design—Case-control study.

Animals—4,435 cats with recurrent uroliths.

Procedures—To identify recurrence of uroliths in cats for which uroliths were submitted for analysis at the Minnesota Urolith Center in 1998, the facility's database was searched for urolith resubmissions from the same cats between 1998 and 2003. Risk factors and differences in mean interval until recurrence were assessed.

Results—Of 221 cats with ammonium urate uroliths in 1998, 29 (13.1%) had a first and 9 (4.1%) had a second recurrence. Mean interval until recurrence was 22 and 43 months for the first and second recurrence, respectively. Of 2,393 cats with calcium oxalate uroliths in 1998, 169 (7.1%) had a first, 15 (0.6%) had a second, and 2 (0.1%) had a third recurrence. Mean interval until recurrence was 25, 38, and 48 months for the first, second, and third recurrence, respectively. Of 1,821 cats with struvite uroliths in 1998, 49 (2.7%) had a first and 3 (0.2%) had a second recurrence. Mean interval until recurrence was 29 months for first and 40 months for second recurrences.

Conclusions and Clinical Relevance—These results provided insights into the frequency of urolith recurrence in cats. Because some uroliths associated with recurrent episodes probably were not submitted to our facility, our data likely represented an underestimation of the actual recurrence rate.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare the efficacy and safety of using 2 commercially available, low-magnesium, urine-acidifying dry foods to dissolve sterile struvite uroliths in cats.

Design—Prospective, multicenter, randomized clinical trial

Sample—37 cats with presumed struvite uroliths.

Procedures—Cats were randomly assigned to be fed 1 of 2 low-magnesium, urine-acidifying dry foods (food A or B). For each cat, physical examination, urinalysis, and abdominal radiography were performed weekly to assess treatment response.

Results—32 cats had complete urolith dissolution. Mean ± SD times for a 50% reduction in urolith size (0.69 ± 0.1 weeks) and complete urolith dissolution (13.0 ± 2.6 days) were significantly shorter for cats fed food A, compared with those (1.75 ± 0.27 weeks and 27.0 ± 2.6 days, respectively) for cats fed food B. At study termination, mean ± SD urine pH (6.083 ± 0.105) for cats fed food A was lower than that (6.431 ± 0.109) for cats fed food B. In 5 cats, uroliths did not dissolve and were subsequently determined to be composed of 100% ammonium urate (n = 4) or 100% calcium oxalate (1). Adverse events associated with diet were not observed in any of the cats.

Conclusions and Clinical Relevance—Results indicated that dietary dissolution is safe and effective for eradication of sterile struvite uroliths in cats. Cats fed food A had faster urolith dissolution than did cats fed food B. Lack of a reduction in urolith size at 2 weeks after diet initiation was indicative of misdiagnosis or noncompliance.

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in Journal of the American Veterinary Medical Association