Jody P. Lulich

Epidemiology of Canine Calcium Oxalate Uroliths: Identifying Risk Factors

Calcium oxalate uroliths are most commonly encountered in Miniature Schnauzers, 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 sodium, restricted phosphorus, restricted potassium, and restricted moisture (dry formulations). Dogs with hyperadrenocorticism or hypercalcemia are predisposed to calcium oxalate urolith formation.

Medical Management of Feline Urethral Obstruction

A step-by-step priority of procedures is recommended when attempting to restore urethral patency in an obstructed male cat. In order of priority they are: (1) massage of the distal urethra, (2) attempts to induce voiding by gentle palpation of the urinary bladder, (3) cystocentesis, (4) retrograde urethral flushing, (5) combinations of 1 through 4, (6) diagnostic radiology to determine if the cause of urethral obstruction is intraluminal, mural or extramural, and if absolutely necessary, (7) surgical procedures.

Prednisolone Therapy of Idiopathic Feline Lower Urinary Tract Disease: A Double-Blind Clinical Study

A double-blind clinical study was performed to evaluate prednisolone as treatment for idiopathic feline lower urinary tract disease. No differences in response were observed in prednisolone- and placebo-treated cats.

Diagnosis, medical treatment, and prognosis of feline urolithiasis.

Radiographic or ultrasonographic evaluation of the urinary tract is required to consistently detect feline uroliths. Evaluation of clinical, laboratory, and radiographic findings facilitate guesstimation of the mineral composition of uroliths. Therapy should not be initiated before appropriate samples have been collected for diagnosis. The objectives of medical management of uroliths are to arrest further growth and to promote urolith dissolution by correcting or controlling underlying abnormalities. For therapy to be effective, it must induce undersaturation of urine with calculogenic crystalloids by (1) increasing the solubility of crystalloids in urine, (2) increasing the volume of urine in which crystalloids are dissolved or suspended, and (3) reducing the quantity of calculogenic crystalloids in urine.

Management of Nonobstructive Idiopathic Feline Lower Urinary Tract Disease

Consistently effective treatment and prevention of nonobstructive idiopathic lower urinary tract disease (LUTD) in male and female cats remains an enigma. Because clinical signs associated with this form are frequently self-limiting, considerable debate exists about the efficacy of various symptomatic therapies advocated for management of idiopathic feline LUTD. Any form of therapy might appear to be beneficial, as long as it was not harmful. The self-limiting nature of some forms of idiopathic feline LUTD underscores the need for controlled prospective double-blind clinical studies to prove the value of various forms of therapy.

Canine Calcium Phosphate Uroliths: Etiopathogenesis, Diagnosis, and Management

Uroliths composed predominantly of calcium phosphates have been infrequently identified in dogs. Factors incriminated in the etiopathogenesis of calcium phosphate urolithiasis include an alkaline 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 hyperparathyroidism, 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.

Treatment of Feline Lower Urinary Tract Disease by Debriding The Bladder Mucosa: First Do No Harm

Based on current knowledge and understanding about the cases and biologic behavior of feline lower urinary tract diseases, debridement of the bladder mucosa is likely to increase rather than decrease the morbidity associated with these diseases. It is not recommended.