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History

An 8-month-old spayed female Wheaten Terrier was evaluated because of a mass protruding from the urogenital tract. The owners associated the mass with the dog's reluctance to maintain a sitting posture. Three months prior to evaluation, the dog was neutered. At that time, the reproductive tract appeared abnormal and was submitted for histologic evaluation. Results indicated that the uterus was normal; however, the gonads were identified as testes. The testes were devoid of germ cells; ovarian structures were absent. On the basis of those findings, the dog was considered as a male pseudohermaphrodite.

On physical examination, a fleshy protuberance

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine hospital proportional morbidity rates (HPMR) for urethral obstructions, urethral plugs or urethroliths, and urethrostomies in cats in veterinary teaching hospitals (VTH) in Canada and the United States between 1980 and 1999.

Design—Epidemiologic study.

Animals—305,672 cats evaluated at VTH.

Procedures—Yearly HPMR were determined for cats with urethral obstructions, urethral plugs or urethroliths, or urethrostomies from data compiled by the Purdue Veterinary Medical Database. The test for a linear trend in proportions was used.

Results—Urethral obstructions were reported in 4,683 cats. Yearly HPMR for urethral obstructions declined from 19 cases/1,000 feline evaluations in 1980 to 7 cases/1,000 feline evaluations in 1999. Urethral plugs or urethroliths affected 1,460 cats. Yearly HPMR for urethral plugs or urethroliths decreased from 10 cases/1,000 feline evaluations in 1980 to 2 cases/1,000 feline evaluations in 1999. A total of 2,359 urethrostomies were performed. Yearly HPMR for urethrostomies decreased from 13 cases/1,000 feline evaluations in 1980 to 4 cases/1,000 feline evaluations in 1999.

Conclusions and Clinical Relevance—Frequency of feline urethrostomies performed at VTH in Canada and the United States declined during the past 20 years and paralleled a similar decline in frequency of urethral obstructions and urethral plugs or urethroliths. These trends coincide with widespread use of diets to minimize struvite crystalluria in cats, which is important because struvite has consistently been the predominant mineral in feline urethral plugs during this period. (J Am Vet Med Assoc 2002;221:502–505)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine proportional morbidity rates (PMR) and risk factors for lower urinary tract diseases (LUTD) in cats.

Design—Case-control study.

Sample Population—Records of 22,908 cats with LUTD and 263,168 cats without LUTD.

Procedure—Data were retrieved from the Purdue Veterinary Medical Data Base. Descriptive statistics and univariate logistic regression analyses were performed to assess whether breed, age, sex, and neutering status were associated with different causes of LUTD.

Results—Mean PMR for LUTD irrespective of cause was 8/100 cats (range, 2 to 13/100 cats). Increased risk for urocystolithiasis (Russian Blue, Himalayan, and Persian cats), bacterial urinary tract infections (UTI; Abyssinian cats), congenital urinary tract defects (Manx and Persian cats), and urinary incontinence (Manx cats) was detected. Cats between 2 and < 7 years of age had increased risk for urethral plugs, neurogenic disorders, congenital defects, and iatrogenic injuries. Cats between 4 and < 10 years of age had increased risk for urocystolithiasis, urethral obstructions, and idiopathic LUTD. Cats ≥ 10 years of age had increased risk for UTI and neoplasia. Castrated males had increased risk for each cause of LUTD except UTI and incontinence. Spayed females had increased risk for urocystolithiasis, UTI, and neoplasia. Sexually intact females had decreased risk for each cause of LUTD except neurogenic disorders and iatrogenic injuries.

Conclusion and Clinical Relevance—Specific breed, age, sex, and neutering status may be associated with specific types of feline LUTD. Knowledge of patient risk factors for LUTD may facilitate development of surveillance strategies that enhance earlier detection. (J Am Vet Med Assoc 2001;218:1429–1435)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the reproducibility and accuracy of 4 portable pH meters, a reagent strip, and pH paper for measuring urine pH in dogs.

Design—Prospective masked randomized study.

Sample Population—201 free-catch urine samples from 114 hospitalized dogs.

Procedures—Urine samples were divided into 2-mL aliquots. Measurements of urine pH were obtained by use of a laboratory benchtop pH meter, 4 portable pH meters, a urine reagent strip, and pH paper. The pH of each aliquot was measured within 4 hours of collection by an evaluator unaware of the aliquot's origin.To assess reproducibility, the coefficient of variation for each pH measurement device was calculated. To determine which device was most accurate, the degree of agreement among the different devices was assessed in comparison with the benchtop pH meter, which was considered the reference method.

Results—3 of the 4 portable pH meters had nearly perfect agreement with the reference method. The reagent strip and pH paper had moderate to poor agreement with the reference method.

Conclusions and Clinical Relevance—Urine pH measurements should be made by use of a portable or benchtop pH meter when accurate measurements are crucial for diagnosis or treatment. Reagent strips and pH papers are useful in obtaining pH approximations but are not recommended when accurate measurements of urine pH are required.

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in Journal of the American Veterinary Medical Association

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.

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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 body condition score (BCS) and urinalysis variables between dogs with and without calcium oxalate (CaOx) uroliths.

DESIGN Case-control study.

ANIMALS 46 Miniature Schnauzers, 16 Bichons Frises, and 6 Shih Tzus.

PROCEDURES Medical records were reviewed for Miniature Schnauzers, Bichons Frises, and Shih Tzus that were examined between January 2001 and November 2014 for another urolithiasis study or for a urolith removal procedure. Dogs with CaOx uroliths were classified as cases. Dogs without a history of urinary tract disease and with no evidence of radiopaque uroliths on abdominal radiographs were classified as controls. Each case was matched with 1 control on the basis of age (± 2 years), sex, and breed. Body condition score and urinalysis results were compared between cases and controls, and the relationship between BCS and urine pH was analyzed.

RESULTS Median BCS was significantly greater for cases than controls, although the proportion of overweight dogs did not differ significantly between the 2 groups. Urine pH was negatively associated with age, but was not associated with BCS or the presence of CaOx uroliths. Cases infrequently had acidic urine or CaOx crystalluria but frequently had hematuria and proteinuria.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs with CaOx uroliths had a greater median BCS than control dogs, but the clinical importance of that finding was unclear. Acidic urine and CaOx crystalluria were uncommon and not adequate predictors of CaOx urolith status. Hematuria and proteinuria were commonly observed in dogs with CaOx urolithiasis, but they are not pathognomonic for that condition.

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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