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26 Jun 2019 at 01:35
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Bibliography on: Urolithiasis


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Some mineral solutes precipitate to form crystals in urine; these crystals may aggregate and grow to macroscopic size, at which time they are known as uroliths (calculi or stones). Mechanisms involved in stone formation are incompletely understood in dogs and cats. Regardless of the underlying mechanism(s), uroliths are not produced unless sufficiently high urine concentrations of urolith-forming constituents exist and transit time of crystals within the urinary tract is prolonged. Clinical signs associated with urolithiasis are seldom caused by microscopic crystals. However, formation of macroscopic uroliths in the lower urinary tract that interfere with the flow of urine and/or irritate the mucosal surface often results in dysuria, hematuria, and stranguria. Urethral obstruction is common in male dogs and cats. It may occur suddenly or may develop throughout days or weeks. Initially, the animal may frequently attempt to urinate and produce only a fine stream, a few drops, or nothing. Animals may also exhibit extreme pain manifested by crying out when attempting to urinate. Complete obstruction causes uremia within 36–48 hr, which leads to depression, anorexia, vomiting, diarrhea, dehydration, coma, and death within ~72 hr.

NOTE: Urethral obstruction is an emergency condition, and treatment should begin immediately.

Created with PubMed® Query: (canine OR feline) and (urolithiasis) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

RevDate: 2019-06-18
CmpDate: 2019-06-18

Swieton N (2018)

Urinary calculi in a shih tzu dog with hyperadrenocorticism.

The Canadian veterinary journal = La revue veterinaire canadienne, 59(8):905-907.

An 11-year-old spayed female shih tzu dog was presented with pollakiuria, stranguria, and hematuria. Radiographs revealed a large number of radiodense urinary calculi within the bladder. Physical examination, complete blood cell count, biochemistry and ACTH stimulation test suggested possible hyperadrenocorticism. A cystotomy was performed and the patient was treated for hyperadrenocorticism.

RevDate: 2019-05-10
CmpDate: 2019-05-10

Groth EM, Lulich JP, Chew DJ, et al (2019)

Vitamin D metabolism in dogs with and without hypercalciuric calcium oxalate urolithiasis.

Journal of veterinary internal medicine, 33(2):758-763.

BACKGROUND: There are abnormalities in vitamin D metabolism in people with calcium nephrolithiasis, but limited data are available on vitamin D status in dogs with calcium oxalate (CaOx) urolithiasis.

OBJECTIVE: To compare serum concentrations of vitamin D metabolites in dogs with and without hypercalciuric CaOx urolithiasis.

ANIMALS: Thirty-eight dogs with (n = 19) and without (n = 19) a history of CaOx urolithiasis and hypercalciuria.

METHODS: Retrospective cross-sectional study. Serum 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2 D], and 24,25-dihydroxyvitamin D [24,25(OH)2 D] were measured. The ratios of 25(OH)D/24,25(OH)2 D and 1,25(OH)2 D/25(OH)D were compared between cases and controls.

RESULTS: There were no significant differences between cases and controls when comparing 25(OH)D, 24,25(OH)2 D, 1,25(OH)2 D, or 1,25(OH)2 D/25(OH)D. Cases had higher 25(OH)D/24,25(OH)2 D (median = 1.40, range = 0.98-1.58) compared to controls (median = 1.16, range = 0.92-2.75; P = .01). There was overlap in the ranges for 25(OH)D/24,25(OH)2 D between cases and controls, but 6 cases (32%) had ratios above the control dog range. There was a moderate positive correlation between the ratio of 25(OH)D/24,25(OH)2 D and urinary calcium-to-creatinine ratios (r = 0.40, 95% confidence interval = 0.10-0.64; P = .01).

These data suggest that decreased conversion of 25(OH)D to 24,25(OH)2 D occurs in a subset of dogs with CaOx urolithiasis. Abnormalities in vitamin D metabolism might contribute to stone risk in dogs.

RevDate: 2019-03-20
CmpDate: 2019-02-20

Milligan M, AC Berent (2019)

Medical and Interventional Management of Upper Urinary Tract Uroliths.

The Veterinary clinics of North America. Small animal practice, 49(2):157-174.

Nephroliths are often clinically silent. When non-obstructive and of an amenable stone type, dissolution should be attempted. When problematic, nephrolithotomy can be considered. Depending on stone type, size, and species, extracorporeal shockwave lithotripsy or endoscopic nephrolithotomy are preferred techniques. Obstructive ureterolithiasis should be addressed immediately to preserve kidney function. Because of decreased morbidity and mortality and versatility for all causes, interventional techniques for kidney decompression are preferred by the authors. Proper training and expertise in these interventional techniques should be acquired before performing them on clinical patients for the best possible outcomes.

RevDate: 2019-05-10
CmpDate: 2019-05-10

Labadie JD, Magzamen S, Morley PS, et al (2019)

Associations of environment, health history, T-zone lymphoma, and T-zone-like cells of undetermined significance: A case-control study of aged Golden Retrievers.

Journal of veterinary internal medicine, 33(2):764-775.

BACKGROUND: T-zone lymphoma (TZL), an indolent disease in older dogs, comprises approximately 12% of lymphomas in dogs. TZL cells exhibit an activated phenotype, indicating the disease may be antigen-driven. Prior research found that asymptomatic aged Golden Retrievers (GLDRs) commonly have populations of T-zone-like cells (phenotypically identical to TZL) of undetermined significance (TZUS).

OBJECTIVE: To evaluate associations of inflammatory conditions, TZL and TZUS, using a case-control study of GLDRs.

ANIMALS: TZL cases (n = 140), flow cytometrically diagnosed, were identified through Colorado State University's Clinical Immunology Laboratory. Non-TZL dogs, recruited through either a database of owners interested in research participation or the submitting clinics of TZL cases, were subsequently flow cytometrically classified as TZUS (n = 221) or control (n = 147).

METHODS: Health history, signalment, environmental, and lifestyle factors were obtained from owner-completed questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using multivariable logistic regression, obtaining separate estimates for TZL and TZUS (versus controls).

RESULTS: Hypothyroidism (OR, 0.3; 95% CI, 0.1-0.7), omega-3 supplementation (OR, 0.3; 95% CI, 0.1-0.6), and mange (OR, 5.5; 95% CI, 1.4-21.1) were significantly associated with TZL. Gastrointestinal disease (OR, 2.4; 95% CI, 0.98-5.8) had nonsignificantly increased TZL odds. Two shared associations for TZL and TZUS were identified: bladder infection or calculi (TZL OR, 3.5; 95% CI, 0.96-12.7; TZUS OR, 5.1; 95% CI, 1.9-13.7) and eye disease (TZL OR, 2.3; 95% CI, 0.97-5.2; TZUS OR, 1.9; 95% CI, 0.99-3.8).

These findings may elucidate pathways involved in TZUS risk and progression from TZUS to TZL. Further investigation into the protective association of omega-3 supplements is warranted.

RevDate: 2019-05-10
CmpDate: 2019-05-10

Luskin AC, Lulich JP, Gresch SC, et al (2019)

Bone resorption in dogs with calcium oxalate urolithiasis and idiopathic hypercalciuria.

Research in veterinary science, 123:129-134.

People with calcium oxalate (CaOx) urolithiasis and idiopathic hypercalciuria (IH) often have evidence of increased bone resorption, but bone turnover has not previously been investigated in dogs with these conditions. The aim of this study was to determine whether a marker of bone resorption, β-crosslaps, differs between dogs with CaOx urolithiasis and IH compared to controls. This retrospective, cross-sectional study used a canine specific ELISA to measure β-crosslaps concentrations in stored frozen serum samples from 20 dogs with CaOx urolithiasis and IH and 20 breed-, sex-, and age-matched stone-free controls (18 Miniature Schnauzers, 14 Bichons Frise, and 8 Shih Tzus). Dogs with CaOx urolithiasis and IH had lower β-crosslaps concentrations relative to controls (P = .0043), and β-crosslaps had a moderate negative correlation with urinary calcium-to-creatinine ratios (r = -0.44, P = .0044). Miniature Schnauzers had lower β-crosslaps concentrations than the other two breeds (P = .0035). The ELISA had acceptable intra-assay precision, but concentrations decreased when samples were repeatedly assayed over time. Assay recovery rates were also below acceptance criteria. In conclusion, Miniature Schnauzers, Bichons Frise, and Shih Tzus with CaOx urolithiasis and IH have evidence of decreased bone resorption compared to stone-free controls. This suggests that other causes of IH, such as intestinal hyperabsorption of calcium, underlie risk for CaOx urolithiasis in these breeds. Results should be confirmed in larger populations and with other β-crosslaps assays and additional biomarkers of bone turnover. The stability of canine serum β-crosslaps after freeze-thaw cycles and storage at various temperatures requires investigation.

RevDate: 2019-03-20
CmpDate: 2019-02-20

Queau Y (2019)

Nutritional Management of Urolithiasis.

The Veterinary clinics of North America. Small animal practice, 49(2):175-186.

Dietary management of urolithiasis in dogs and cats is designed to dissolve calculi when possible and/or reduce the risk of recurrence. The diet must reduce urine relative supersaturation for the particular salt in order to prevent crystallization. To decrease urinary concentrations of crystal precursors, increasing water intake is essential regardless of the stone type. Altering the amounts of dietary precursors of the stone and controlling urine pH is mostly effective for struvite, urate, xanthine, and cystine, but still subject to controversy for calcium oxalate. The investigation of underlying metabolic disorders and close monitoring of animals at risk is recommended.

RevDate: 2019-06-10

Hesse A, Frick M, Orzekowsky H, et al (2018)

Canine calcium oxalate urolithiasis: Frequency of Whewellite and Weddellite stones from 1979 to 2015.

The Canadian veterinary journal = La revue veterinaire canadienne, 59(12):1305-1310.

This study reports on a retrospective evaluation of epidemiological data from calcium oxalate stones in dogs differentiated into calcium oxalate monohydrate (Whewellite, Wh) and calcium oxalate dihydrate (Weddellite, Wd). Of the 22 456 uroliths submitted from 1979 to 2015, 6690 (29.8%) were composed of > 70% calcium oxalate. During the observation period, the proportion of calcium oxalate stones rose from 4% (1979) to 46% (2015). Of all the calcium oxalate stones, 31.0% were Wh and 49.4% Wd, while 19.6% were a mixture of Wh and Wd. The dogs with Wh stones were significantly older than the dogs with Wd stones. Several breeds have increased odds ratios (OR) for either Wh (5 highest OR: Norwich terrier, keeshond, Norfolk terrier, fox terrier, sheltie) or Wd (Pomeranian, borzoi, Japanese spitz, Finnish lapphund, bichon frise). Analytical differentiation of the calcium oxalate stones into Wh and Wd is important for understanding the cause and possible treatment and prevention of the uroliths.

RevDate: 2019-06-03
CmpDate: 2019-06-03

Berent AC, Weisse CW, Bagley DH, et al (2018)

Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009-2015).

Journal of the American Veterinary Medical Association, 253(10):1309-1327.

OBJECTIVE To determine outcomes of subcutaneous ureteral bypass (SUB) device placement for treatment of benign ureteral obstruction in cats. DESIGN Retrospective case series. ANIMALS 134 cats with SUB devices placed in 174 obstructed ureters during 144 hospitalizations. PROCEDURES Medical records of cats that underwent SUB device placement for treatment of benign ureteral obstruction between 2009 and 2015 were reviewed. The SUB device was placed by use of fluoroscopic and surgical methods. Signalment, history, diagnostic imaging results, postprocedural results, duration of hospitalization, complications, and short- and long-term outcomes were recorded. RESULTS Ureteral obstructions were caused by ureterolithiasis (114/174 [65.5%]), stricture (28/174 [16.1%]), both ureterolithiasis and stricture (29/174 [16.7%]), or pyonephrosis (1/174 [0.6%]); in 2 (1.1%) cats, the cause was not recorded. Fifty-two of the 134 (39%) cats had bilateral ureteral obstruction. At admission, 127 (95%) cats were azotemic. Median serum creatinine concentrations at admission and 3 months after SUB device placement were 6.6 and 2.6 mg/dL, respectively. Median renal pelvis diameters before and after the procedure were 9.2 and 1.5 mm, respectively. Postsurgical complications included device occlusion with blood clots (14/172 [8.1%]), device leakage (6/172 [3.5%]), and kinking of the device tubing (8/174 [4.6%]). Cats survived to hospital discharge after 135 of the 144 (94%) hospital admissions. The most common long-term complication was catheter mineralization (40/165 [24.2%]), which was documented a median of 463 days after device placement. A high postoperative serum ionized calcium concentration was significantly associated with SUB device occlusion. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that SUB device placement may be a viable option for treatment of cats with benign ureteral obstruction.

RevDate: 2019-04-24
CmpDate: 2019-04-24

Cohen SM (2018)

Crystalluria and Chronic Kidney Disease.

Toxicologic pathology, 46(8):949-955.

Crystalluria can involve the kidney and lower urinary tract, can produce acute and chronic effects, and occurs in all mammalian species. Most commonly urinary crystals contain calcium. Numerous other endogenous and exogenous substances can produce crystalluria. Crystals are identified in kidneys of many species, up to 100% in certain rat strains. More severe renal disease (acute tubular necrosis and chronic renal disease) can be secondary to crystal accumulation, such as observed with melamine-cyanuric acid in cats and dogs. Aggregation of crystals leads to calculi that act as urothelial abrasives with consequent regenerative proliferation. Accumulation in the kidney pelvis or bladder can lead to partial or complete obstruction and hydronephrosis. Long-term presence of urinary tract calculi in rodents leads to increased risk of urothelial tumors, but not in humans. Crystals in the lower urinary tract can act as irritants in rodents, but not in humans. It is critical that specific procedures are followed to optimize the presence of crystals in urine for diagnosis, including not fasting the animals. Numerous factors have been identified which can enhance or inhibit crystal formation. Extrapolation from animals for the threshold toxicity of crystals/calculi is appropriate but is not relevant for cancer risk assessment.

RevDate: 2018-11-14

Reines BP, RA Wagner (2018)

Resurrecting FUS: Adrenal Androgens as an Ultimate Cause of Hematuria, Periuria, Pollakuria, Stranguria, Urolithiasis and Obstruction in Neutered Cats.

Frontiers in veterinary science, 5:207.

Although many authors have doubted that "feline urological syndrome" (FUS) describes a real pathogenetic entity, because it subsumes such a large variety of signs, Sumner's recent finding that urethral obstruction occurs most frequently in springtime adds to a large body of evidence that lower urinary tract problems occur most commonly in late winter and spring. This suggests that FUS may be a unitary disorder, with a hormonal basis, driven by increasing day length. We argue that rising adrenal androgens (AA) in neutered cats induce stress, and other more concrete manifestations of FUS through androgen-driven mechanisms.

RevDate: 2019-01-14
CmpDate: 2019-01-14

Nesser VE, Reetz JA, Clarke DL, et al (2018)

Radiographic distribution of ureteral stones in 78 cats.

Veterinary surgery : VS, 47(7):895-901.

OBJECTIVE: To document the distribution of ureteral stones in cats.

STUDY DESIGN: Retrospective case series.

ANIMALS: Seventy-eight cats.

METHODS: Abdominal radiographs with ureteral stones were reviewed. The location of stones was categorized as proximal ureter (PU), midureter (MU), or ureterovesicular junction (UVJ). The number, size, and location of stones were recorded by using the kidneys and vertebral bodies as landmarks. Stone location in cats with 1 versus multiple stones was assessed. Descriptive statistics were used to describe the incidence of ureteral stone location.

RESULTS: Among cats with a single stone (44%, 34/78), 44% (15/34) had a stone in the PU, 41% (14/34) had a stone in the MU, and 15% (5/34) had a stone at the UVJ. When multiple stones were present, 61% (27/44) of cats had at least 1 stone located in the PU, 70% (31/44) had at least 1 stone located in the MU, and 34% (15/44) had at least 1 stone located at the UVJ. The L4 vertebral body most commonly marked stone location in cats with 1 stone and the most distal stone in cats with multiple stones. Stones located at the UVJ site were more common in male (37%) than in female (12%) cats (P = 0.004). Larger stone size was associated with a more proximal location (P = 0.04).

CONCLUSION: Ureteral stones were more commonly located in the PU and the MU than in the UVJ. UVJ stones were more common in male than in female cats, and larger stones had a more proximal location.

CLINICAL SIGNIFICANCE: This study enhances our understanding of feline ureteral stone location and identifies a correlation between stone location and stone size.

RevDate: 2018-10-01
CmpDate: 2018-10-01

Cléroux A (2018)

Minimally Invasive Management of Uroliths in Cats and Dogs.

The Veterinary clinics of North America. Small animal practice, 48(5):875-889.

Urolithiasis commonly affects cats and dogs. The American College of Veterinary Internal Medicine established guidelines for the treatment of uroliths that reflect modern techniques prioritizing minimally invasive procedures with an emphasis on prevention strategies to limit morbidity and mortality. Extracorporeal shockwave lithotripsy and endoscopic nephrolithotomy constitute some of the minimally invasive treatment modalities available for upper urinary tract uroliths. Cystoscopic-guided basket retrieval, cystoscopic-guided laser lithotripsy, and percutaneous cystolithotomy are minimally invasive options for the management of lower urinary tract uroliths. Following stone removal, prevention strategies are essential to help reduce morbidity and mortality associated with stone recurrence.

RevDate: 2019-02-26

Nikousefat Z, Hashemnia M, Javdani M, et al (2018)

Obstructive bacterial cystitis following cystotomy in a Persian cat.

Veterinary research forum : an international quarterly journal, 9(2):199-203.

Feline lower urinary tract diseases are known to be life threatening conditions in cats, especially when they occur as obstructive diseases in males. Early diagnosis and treatment is necessary, otherwise it may lead to death. A 3-year-old male Persian cat was referred to the clinic with a history of anuria, lethargy, loss of appetite and exploratory cystotomy 6 months ago due to urethral obstruction following urolithiasis. Urinary bladder was enlarged and painful on palpation and urine accumulation was observed in ultrasonography. Biochemical and hematological analyses revealed hypocalcemia, hyperphosphatemia and hyperkalemia and increase in blood urea nitrogen, creatinine, white blood cell (WBC), red blood cell (RBC) and hematocrit. Urine analysis showed a turbid appearance, protein 1+, blood 3+, pH reduction, increased WBCs and RBCs and presence of bacteria, calcium oxalate crystals and epithelial cells. Urine culture reveled Staphylococcus saprophyticus. Postoperatively, microscopic examinations of the urinary bladder biopsy showed pathological lesions of bacterial cystitis. Based on these findings, bacterial cystitis and urethral obstruction due to post-operative urinary tract infections were diagnosed. For treatment, electrolyte imbalances were corrected firstly, cystotomy was performed and a catheter was conducted into the urethra; then, urethra was flushed and obstruction was resolved. Ampicillin was effective in reducing the bacterial count in urine. Despite the fact that cystotomy is a common procedure in veterinary medicine, clinicians should be aware of its complications such as post-operative urinary tract infections.

RevDate: 2018-11-14

Kim HT, Loftus JP, Gagné JW, et al (2018)

Evaluation of selected ultra-trace minerals in commercially available dry dog foods.

Veterinary medicine (Auckland, N.Z.), 9:43-51.

Purpose: To evaluate the concentrations of chromium, nickel, molybdenum, silica, and aluminum in several commercially available dry dog foods and compare these with current World Health Organization's (WHO) mean human daily dietary intake. Conversion of dietary intake per megacalorie (Mcal) for both dog foods and human average intake was performed based on the National Research Council recommendation of a 2,900 kcal diet for comparative purposes to average intake and potential toxic exposure.

Materials and methods: Forty-nine over-the-counter dry foods formulated for maintenance of healthy dogs yet listed as all life stage foods were analyzed. Concentrations of the ultra-trace minerals were measured via inductively coupled plasma atomic emission and represented per Mcal for comparative purposes as it relates to common intake in dogs in comparison with humans.

Results: Chromium, molybdenum, and aluminum concentrations in all of the dog foods were at levels that would be considered above average human daily consumption on a caloric basis. Nickel and silica calculated intakes per Mcal were comparable with human intake patterns, while both trace minerals displayed outliers exceeding at least twofold of the upper range of human daily intake.

Conclusion: Overall, ultra-trace minerals found in dog foods were above the expected average daily intake for humans on a caloric basis. There was no evidence of potential chronic toxic exposure based on presumptive intake extrapolated from WHO published toxic intake concentrations for humans or domestic animals. The large range of silica intake from various foods (2.96-83.67 mg/1,000 kcal) may have health implications in dogs prone to silica urolithiasis. Further studies investigating the bioavailability of these ultra-trace minerals and establishing dietary ultra-trace mineral allowance would be ideal; however, based on these findings, consumption of these ultra-trace minerals in over-the-counter dry dog foods appears safe.

RevDate: 2019-01-14

Brooks ED, Landau DJ, Everitt JI, et al (2018)

Long-term complications of glycogen storage disease type Ia in the canine model treated with gene replacement therapy.

Journal of inherited metabolic disease, 41(6):965-976.

BACKGROUND: Glycogen storage disease type Ia (GSD Ia) in dogs closely resembles human GSD Ia. Untreated patients with GSD Ia develop complications associated with glucose-6-phosphatase (G6Pase) deficiency. Survival of human patients on intensive nutritional management has improved; however, long-term complications persist including renal failure, nephrolithiasis, hepatocellular adenomas (HCA), and a high risk for hepatocellular carcinoma (HCC). Affected dogs fail to thrive with dietary therapy alone. Treatment with gene replacement therapy using adeno-associated viral vectors (AAV) expressing G6Pase has greatly prolonged life and prevented hypoglycemia in affected dogs. However, long-term complications have not been described to date.

METHODS: Five GSD Ia-affected dogs treated with AAV-G6Pase were evaluated. Dogs were euthanized due to reaching humane endpoints related to liver and/or kidney involvement, at 4 to 8 years of life. Necropsies were performed and tissues were analyzed.

RESULTS: Four dogs had liver tumors consistent with HCA and HCC. Three dogs developed renal failure, but all dogs exhibited progressive kidney disease histologically. Urolithiasis was detected in two dogs; uroliths were composed of calcium oxalate and calcium phosphate. One affected and one carrier dog had polycystic ovarian disease. Bone mineral density was not significantly affected.

CONCLUSIONS: Here, we show that the canine GSD Ia model demonstrates similar long-term complications as GSD Ia patients in spite of gene replacement therapy. Further development of gene therapy is needed to develop a more effective treatment to prevent long-term complications of GSD Ia.

RevDate: 2019-04-09

Hoffman JM, Lourenço BN, Promislow DEL, et al (2018)

Canine hyperadrenocorticism associations with signalment, selected comorbidities and mortality within North American veterinary teaching hospitals.

The Journal of small animal practice, 59(11):681-690.

OBJECTIVE: To describe a large population of dogs with a diagnosis of hyperadrenocorticism at the time of death in North American veterinary teaching hospitals, and to identify comorbid conditions associated with hyperadrenocorticism.

MATERIALS AND METHODS: Retrospective cohort study of 1519 dogs with hyperadrenocorticism from a population of 70,574 dogs reported to the Veterinary Medical Database. Signalment, presence or absence of hyperadrenocorticism, aetiology of hyperadrenocorticism (if described), frequency of select comorbidities and causes of death were evaluated in dogs with and without hyperadrenocorticism.

RESULTS: Hyperadrenocorticism was more frequent in females. Neutering was associated with a minor, but significant, increase in the odds of hyperadrenocorticism. Hyperadrenocorticism was the presumed cause of death of 393 (25∙9%) of affected dogs. When aetiology was specified (527 dogs, corresponding to 34∙7% of the cases), pituitary-dependent hyperadrenocorticism [387 (73∙4%) out of 527 dogs] was more common than functional adrenocortical tumour [136 (25∙8%) out of 527 dogs). Hyperadrenocorticism was over-represented in certain expected (miniature poodle, dachshund) and unexpected (Irish setter, bassett hound) breeds compared with the population at large. Of the select comorbidities investigated, dogs with hyperadrenocorticism were at increased risk for concurrent diabetes mellitus, urinary tract infection, urolithiasis, hypertension, gall bladder mucocoele and thromboembolic disease compared with dogs without hyperadrenocorticism.

CLINICAL SIGNIFICANCE: Hyperadrenocorticism is significantly associated with certain comorbid conditions but is not a major cause of mortality in affected dogs. Documented patterns now provide targets for prospective clinical research.

RevDate: 2019-05-24

Lund HS, AV Eggertsdóttir (2019)

Recurrent episodes of feline lower urinary tract disease with different causes: possible clinical implications.

Journal of feline medicine and surgery, 21(6):590-594.

CASE SERIES SUMMARY: While descriptions of cats with recurrent episodes of feline idiopathic cystitis (FIC) exist, little is published on cats with recurrent episodes of feline lower urinary tract disease (FLUTD) where the cat is diagnosed with different causes of FLUTD at separate episodes. In the present paper, six cats, originally part of larger studies of FLUTD among Norwegian cats, are described. In the project period (2003-2009), these cats had several episodes of FLUTD. At each episode, the cats had a complete physical examination, abdominal imaging, blood work, urinalysis and urine culture performed. Two of the cats initially presented with urolithiasis and subsequently with episodes of non-obstructed FIC. Four of the cats presented with non-obstructed FIC at one or more episodes, but were later diagnosed with urolithiasis or bacterial cystitis without prior catheterisation or other known predisposing factors.

Cats with recurrent episodes of FLUTD may present with different causes at different times. The need to thoroughly work-up cats with recurrent episodes of FLUTD at each presentation is emphasised. FIC may be considered as a predisposing factor in cats developing urolithiasis or bacterial cystitis; alternatively, interrelated FLUTD disease mechanisms exists. Thus, applying multimodal environmental enrichment and modification (MEMO) to cats with signs of FLUTD independent of diagnosis should be considered.

RevDate: 2018-07-04

Clarke DL (2018)

Feline ureteral obstructions Part 2: surgical management.

The Journal of small animal practice, 59(7):385-397.

Feline obstructive ureteral disease will likely remain a common and frustrating cause of critical illness in cats for the foreseeable future. Since many cats are uraemic and cardiovascularly unstable secondary to obstructive nephropathy, prompt recognition using clinical intuition, blood work and diagnostic imaging is essential to make a timely diagnosis and decision about timing for intervention, if indicated. Multiple surgical and interventional procedures exist for the management of feline ureteral obstructions but there is no ideal technique and all currently available procedures carry risk of infection, re-obstruction, urine leakage and the need for additional procedures in the future. Therefore, until clear, evidence-based guideline exist, the decision about which ureteral procedure to perform in cats should be guided by nature of the obstruction, location, concurrent urolithiasis, infection and surgeon preference. In all likelihood, ureteral surgery, stents and ureteral bypass devices will continue to remain viable options and the decision about which procedure to use will be made on a case-by-case basis.

RevDate: 2019-03-13
CmpDate: 2019-03-13

Mariano AD, Penninck DG, Sutherland-Smith J, et al (2018)

Ultrasonographic evaluation of the canine urinary bladder following cystotomy for treatment of urolithiasis.

Journal of the American Veterinary Medical Association, 252(9):1090-1096.

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis. DESIGN Prospective, longitudinal study. ANIMALS 18 client-owned dogs. PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening. RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery). CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

RevDate: 2018-12-26
CmpDate: 2018-12-26

Walker MA (2018)

Struvite urolithiasis with eosinophilic polypoid cystitis in a shih tzu dog.

The Canadian veterinary journal = La revue veterinaire canadienne, 59(2):181-183.

A 7-year-old female spayed shih tzu dog was presented with hematuria of 4 weeks' duration. Radiographs revealed 1 cystic calculus. A polypoid mass was found incidentally during cystotomy and was removed by partial cystectomy. Histopathology revealed eosinophilic polypoid cystitis and urolith analysis reported struvite. A urinary tract infection was treated.

RevDate: 2018-11-13
CmpDate: 2018-03-22

Gomes VDR, Ariza PC, Borges NC, et al (2018)

Risk factors associated with feline urolithiasis.

Veterinary research communications, 42(1):87-94.

Urinary tract diseases are among the main reasons for consultation in veterinary clinics and hospitals. It affects animals of any age, breed and gender. Among the diseases that affect this system, urolithiasis is the second largest cause of clinical signs compatible with feline urinary tract disease. The term urolithiasis refers to the presence of uroliths in any region of the urinary tract, but it is more commonly seen in the bladder and urethra. Uroliths are classified based on the type of mineral present in their composition, therefore, quantitative and qualitative analyzes are important for a better therapeutic approach. The animals may suffer from the disease and be asymptomatic, or show nonspecific clinical signs, making the diagnosis difficult. The disease should not be seen as a single problem, but as a consequence of various disorders. As dietary, metabolic, genetic and infectious causes, as well as factors that potentiate the chance of development of uroliths such as breed, age, sex, age range, obesity, sedentary lifestyle, geographic region and climate. Thus, the knowledge of the factors that influence the formation of uroliths, as well as the understanding of the pathophysiology, are key elements for better alternatives of therapy and prevention. The recognition of these factors helps to identify susceptible populations, minimizing exposure and increasing the protection factors, which facilitates the diagnosis and treatment of patients with urolithiasis. The objective of this paper is to present the main risk factors involved in the formation of urinary lithiasis in felines.

RevDate: 2019-05-13

Cannizzo SA, Stinner M, S Kennedy-Stoskopf (2017)


Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians, 48(4):1102-1107.

Cystinuria is a condition caused by defects in amino acid transport within the kidneys and small intestines. It has been reported in humans, dogs, domestic cats, ferrets, nondomestic canids, and nondomestic felids, including servals (Leptailurus serval). Genetic mutations have been identified in dogs, humans, and domestic cats. Cystinuria usually follows an autosomal recessive inheritance, although it can be autosomal dominant and sex linked. The primary objective of this study was to screen urine samples dried on filter paper from captive servals in the United States for cystinuria by using the cyanide-nitroprusside screening test. A second objective was to determine whether cystinuria is inheritable in servals. Servals were initially recruited for the study by survey. Owners and institutions interested in participating were sent a second survey and filter paper for collecting urine samples. Samples were collected from 25 servals. One additional serval with confirmed cystine urolithiasis was added for a total sample size of 26 servals. Twenty-seven percent (7/26) were positive, 54% (14/26) were weakly positive, and 19% (5/26) were negative. Sex, reproductive status, and urine collection method had no significant association with test results. This condition is likely underreported in servals and should be ruled out in any serval with nonspecific signs of illness; neurologic signs such as lethargy, ataxia, or seizures; ptyalism; or signs of lower urinary tract disease such as dysuria, hematuria, stranguria, pollakiuria, or urethral obstructions.

RevDate: 2018-11-26

Daniels M, Bartges JW, Raditic DM, et al (2018)

Evaluation of three herbal compounds used for the management of lower urinary tract disease in healthy cats: a pilot study.

Journal of feline medicine and surgery, 20(12):1094-1099.

OBJECTIVES: Lower urinary tract disease (LUTD) occurs commonly in cats, and idiopathic cystitis (FIC) and urolithiasis account for >80% of cases in cats <10 years of age. Although several strategies have been recommended, a common recommendation is to induce dilute urine resulting in more frequent urination and to dilute calculogenic constituents. In addition to conventional therapy using modified diets, traditional Chinese and Western herbs have been recommended, although only one - choreito - has published data available. We evaluated three commonly used herbal treatments recommended for use in cats with LUTD: San Ren Tang, Wei Ling Tang and Alisma. We hypothesized that these three Chinese herbal preparations would induce increased urine volume, decreased urine saturation for calcium oxalate and struvite, and differences in mineral and electrolyte excretions in healthy cats.

METHODS: Six healthy spayed female adult cats were evaluated in a placebo-controlled, randomized, crossover design study. Cats were randomized to one of four treatments, including placebo, San Ren Tang, Wei Ling Tang or Alisma. Treatment was for 2 weeks each with a 1 week washout period between treatments. At the end of each treatment period, a 24 h urine sample was collected using modified litter boxes.

RESULTS: Body weights were not different between treatments. No differences were found in 24 h urinary analyte excretions, urine volume, urine pH or urinary saturation for calcium oxalate or struvite between treatments.

CONCLUSIONS AND RELEVANCE: The results of this study do not support the hypothesis; however, evaluation of longer-term and different dosage studies in cats with LUTD is warranted.

RevDate: 2018-05-25
CmpDate: 2018-05-25

Vila A, Movilla R, Castro J, et al (2018)

Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction.

Australian veterinary journal, 96(1-2):33-38.

CASE REPORT: The present case series describes the clinical course and outcome of three cats diagnosed with pseudomembranous cystitis. This is an uncommon presentation of lower urinary tract obstruction but can be easily be identified by ultrasonography, revealing severe bladder wall thickening and thin hyperechoic luminal strips. The condition can be secondary to severe bacterial urinary tract infection. All cats were successfully treated with medical management only, mainly based on antimicrobials and individualised supportive therapy.

CONCLUSION: Further evaluation of this condition is necessary in order to determine potential underlying aetiologies, pathophysiological mechanisms and the most appropriate standardised treatment.

RevDate: 2018-11-13
CmpDate: 2018-10-30

Vinaiphat A, V Thongboonkerd (2018)

Characterizations of PMCA2-interacting complex and its role as a calcium oxalate crystal-binding protein.

Cellular and molecular life sciences : CMLS, 75(8):1461-1482.

Three isoforms of plasma membrane Ca2+-ATPase (PMCA) are expressed in the kidney. While PMCA1 and PMCA4 play major role in regulating Ca2+ reabsorption, the role for PMCA2 remains vaguely defined. To define PMCA2 function, PMCA2-interacting complex was characterized by immunoprecipitation followed by nanoLC-ESI-Qq-TripleTOF MS/MS (IP-MS). After subtracting non-specific binders using isotype-controlled IP-MS, 474 proteins were identified as PMCA2-interacting partners. Among these, eight were known and 20 were potential PMCA2-interacting partners based on bioinformatic prediction, whereas other 446 were novel and had not been previously reported/predicted. Quantitative immuno-co-localization assay confirmed the association of PMCA2 with these partners. Gene ontology analysis revealed binding activity as the major molecular function of PMCA2-interacting complex. Functional validation using calcium oxalate monohydrate (COM) crystal-protein binding, crystal-cell adhesion, and crystal internalization assays together with neutralization by anti-PMCA2 antibody compared to isotype-controlled IgG and blank control, revealed a novel role of PMCA2 as a COM crystal-binding protein that was crucial for crystal retention and uptake. In summary, a large number of novel PMCA2-interacting proteins have been defined and a novel function of PMCA2 as a COM crystal-binding protein sheds light onto its involvement, at least in part, in kidney stone pathogenesis.

RevDate: 2018-11-13
CmpDate: 2017-11-20

Hall JA, Brockman JA, Davidson SJ, et al (2017)

Increased dietary long-chain polyunsaturated fatty acids alter serum fatty acid concentrations and lower risk of urine stone formation in cats.

PloS one, 12(10):e0187133.

The lifespan of cats with non-obstructive kidney stones is shortened compared with healthy cats indicating a need to reduce stone formation and minimize chronic kidney disease. The purpose of this study was to investigate the effects of increasing dietary polyunsaturated fatty acids (PUFA) on urine characteristics. Domestic-short-hair cats (n = 12; mean age 5.6 years) were randomized into two groups and fed one of two dry-cat foods in a cross-over study design. For one week before study initiation, all cats consumed control food that contained 0.07% arachidonic acid (AA), but no eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA). Group 1 continued eating control food for 56 days. Group 2 was fed test food for 56 days, which was control food plus fish oil and high-AA oil. Test food contained 0.17% AA, 0.09% EPA and 0.18% DHA. After 56 days, cats were fed the opposite food for another 56 days. At baseline and after each feeding period, serum was analyzed for fatty acid concentrations, and urine for specific gravity, calcium concentration, relative-super-saturation for struvite crystals, and a calcium-oxalate-titrimetric test was performed. After consuming test food, cats had increased (all P<0.001) serum concentrations of EPA (173%), DHA (61%), and AA (35%); decreased urine specific gravity (P = 0.02); decreased urine calcium concentration (P = 0.06); decreased relative-super-saturation for struvite crystals (P = 0.03); and increased resistance to oxalate crystal formation (P = 0.06) compared with cats consuming control food. Oxalate crystal formation was correlated with serum calcium concentration (r = 0.41; P<0.01). These data show benefits for reducing urine stone formation in cats by increasing dietary PUFA.

RevDate: 2018-11-13
CmpDate: 2018-09-17

Lulich JP, Prasad HS, Manno M, et al (2017)

Ectopic Bone as a Nidus for Calcium Oxalate Urocystolithiasis in a Cat.

Journal of veterinary internal medicine, 31(6):1866-1870.

A 7-year-old female spayed domestic shorthair cat was referred to the urology service for nonsurgical urocystolith removal. A urolith was attached to the urothelium by ectopic bone. Interventional removal without surgery was successful. Follow-up evaluation 3 years after urolith removal revealed recurrent uroliths, bladder wall mineralization, and marked renal mineralization. This case illustrates the metaplastic potential of the urothelium and that ectopic bone should be included among the pathological factors that promote lithogenesis.

RevDate: 2018-06-07
CmpDate: 2018-06-07

Vedrine B (2017)

Perioperative Occlusion of a Subcutaneous Ureteral Bypass Secondary to a Severe Pyonephrosis in a Birman Cat.

Topics in companion animal medicine, 32(2):58-60.

A subcutaneous ureteral bypass (SUB) was placed in a 10-year-old Birman cat for management of unilateral ureterolithiasis. Perioperative occlusion of the nephrostomy tube of the SUB device happened secondary to a severe pyonephrosis. Flushing of the system throught the subcutaneous shunting port was made with saline solution after clamping the urinary bladder catheter. Repetitive flushing of the device was performed daily for 3 days to be sure of the remanent patency of the catheter. Repetitive flushing of the SUB device is a successful renal-sparing treatment for pyonephrosis in a cat and may be considered as an effective treatment option for this condition.

RevDate: 2018-06-07
CmpDate: 2018-06-07

Torres-Henderson C, Bunkers J, Contreras ET, et al (2017)

Use of Purina Pro Plan Veterinary Diet UR Urinary St/Ox to Dissolve Struvite Cystoliths.

Topics in companion animal medicine, 32(2):49-54.

The objective of this study was to determine the efficacy of feeding the commercially available diet, Purina Pro Plan Veterinary Diets UR Urinary St/Ox, for the dissolution of struvite cystoliths in cats with naturally occurring disease. Twelve cats with clinical signs of lower urinary tract disease and cystoliths confirmed via radiographs were enrolled. The cats were fed the study diet ad libitum and assessed by abdominal radiographs weekly. Cats with cystoliths that resolved based on radiographs and confirmatory ultrasound examination were considered diet successes. Cats with no change in cystolith size after 2-6 weeks underwent cystotomy for stone removal, aerobic culture and antimicrobial susceptibility testing, and analysis. All cats accepted the study diet, and weight loss was not noted over the course of the study. Total cystolith dissolution was achieved by week 2 for 5 cats, which were presumed to have struvite cystoliths. All other cats underwent cystotomy for stone removal after radiographic evidence of cystoliths were still present at 2 weeks (1 cat with severe signs), 4 weeks (5 cats), or 6 weeks (1 cat). The cystoliths that were surgically removed were calcium oxalate (5 cats) and mixed (2 cats) and would not be expected to dissolve with this diet. Follow-up radiographs from 6 cats fed the diet long term (3 presumed struvite and 3 with other cystoliths removed surgically) were collected from 1 to 6 months after beginning the study and showed no evidence of cystolith recurrence. While larger case numbers are needed, these results suggest that feeding Purina Pro Plan Veterinary Diets UR Urinary St/Ox can successfully dissolve cystoliths that are likely struvite and may lessen the risk of recurrence of struvite and calcium oxalate cystoliths.

RevDate: 2018-12-02
CmpDate: 2018-02-13

Nykamp SG (2017)

Dual-energy computed tomography of canine uroliths.

American journal of veterinary research, 78(10):1150-1155.

OBJECTIVE To determine whether dual-energy CT (DECT) could accurately differentiate the composition of common canine uroliths in a phantom model. SAMPLE 30 canine uroliths with pure compositions. PROCEDURES Each urolith was composed of ≥ 70% struvite (n = 10), urate (8), cystine (5), calcium oxalate (4), or brushite (3) as determined by standard laboratory methods performed at the Canadian Veterinary Urolith Centre. Uroliths were suspended in an agar phantom, and DECT was performed at low (80 kV) and high (140 kV) energies. The ability of low- and high-energy CT numbers, DECT number, and DECT ratio to distinguish uroliths on the basis of composition was assessed with multivariate ANOVA. RESULTS No single DECT measure differentiated all urolith types. The DECT ratio differentiated urate uroliths from all other types of uroliths. The DECT and low-energy CT numbers were able to differentiate between 8 and 7 pairs of urolith types, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that DECT was unable to differentiate common types of canine uroliths in an in vitro model; therefore, it is unlikely to be clinically useful for determining urolith composition in vivo. Given that the primary reasons for determining urolith composition in vivo are to predict response to shock wave lithotripsy and develop a treatment plan, future research should focus on the correlation between DECT measurements and urolith fragility rather than urolith composition.

RevDate: 2018-10-15
CmpDate: 2018-10-15

Mack JK, E Kienzle (2017)

[Unusual case of struvite urolithiasis in a dog. A case report].

Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere, 45(5):344-351.

A dog was referred for nutrition consultation after surgical removal of struvite uroliths from the bladder. Inspection of the dog's current ration revealed a pronounced vitamin-A deficiency together with a marked deficiency of protein, phosphorus and magnesium. Therefore, a supersaturation of the urine with ammonium, magnesium and phosphate, the three constituents of struvite, as a cause of struvite calculi formation appears rather unlikely. Vitamin-A deficiency can promote urinary infections and consequently struvite stone formation because of the lack of the protective effect of vitamin A on the epithelia of the urinary tract. Not only common causes for struvite urolith formation, including urinary supersaturation with stone-forming constituents and urinary tract infection, but also less common causes, including vitamin-A deficiency, which was the presumed trigger in the present case study, have to be taken into consideration. Dietetic measures appear to be a useful tool in such cases to prevent uroliths from reoccurring.

RevDate: 2017-12-28
CmpDate: 2017-12-28

Deroy C, Rossetti D, Ragetly G, et al (2017)

Comparison between double-pigtail ureteral stents and ureteral bypass devices for treatment of ureterolithiasis in cats.

Journal of the American Veterinary Medical Association, 251(4):429-437.

OBJECTIVE To compare the complication rates and outcomes in cats with ureteral obstruction treated by placement of double-pigtail ureteral stents or ureteral bypass (UB) devices. DESIGN Retrospective cohort study. ANIMALS Cats with unilateral or bilateral ureterolithiasis that received double-pigtail ureteral stents (30 stents in 27 cats; stent group) or UB devices (30 devices in 23 cats; UB group). PROCEDURES Medical records were reviewed to collect data on signalment, clinical signs, serum biochemical data, surgical procedure, duration of hospitalization, complications, and follow-up (≥ 6 months after placement) information. Outcomes were compared between device types. RESULTS Median durations of surgery and hospitalization were significantly longer in the stent versus UB group. Perioperative mortality rate was 18% (5/27) in the stent group and 13% (3/23) in the UB group. Median survival time was shorter in the stent versus UB group. Stent placement was associated with a greater risk of lower urinary tract-related signs, such as hematuria (52% [14/27]) and pollakiuria or stranguria (48% [13/27]). The risk of device occlusion was also greater in the stent (26% [7/27]) versus UB (4% [1/23]) group. The percentage of cats requiring additional procedures to treat complications was greater in the stent (44%; complications included uroabdomen, stent occlusion, and refractory cystitis) versus UB (9%; complications included UB occlusion and urethral obstruction) group. CONCLUSIONS AND CLINICAL RELEVANCE Although the benefits of stent placement in the treatment of ureteral obstruction in cats have been established, results suggested that cats treated with UB devices had a lower risk of complications and a longer survival time than those treated with double-pigtail ureteral stents.

RevDate: 2018-12-02
CmpDate: 2018-05-11

Hunprasit V, Osborne CA, Schreiner PJ, et al (2017)

Epidemiologic evaluation of canine urolithiasis in Thailand from 2009 to 2015.

Research in veterinary science, 115:366-370.

The cross-sectional study described the epidemiology of 8560 canine urolith submissions from Thailand to the Minnesota Urolith Center between January 2009 and December 2015. The frequency of urolith types, the relationships between urolith type and breed, sex, and neutered status, and change of annual submission proportion over the study period were analyzed. Struvite was the most common canine urolith (44%), and was commonly found in intact females with a mean age of 6.3±3.1years. Calcium oxalate was the second most common (27%), more frequently found in intact males with a mean age of 8.8±3.3years. Compound, purine, cystine, calcium phosphate, and silica urolith were less common. During the study period, the proportion of struvite urolith significantly decreased from 48% in 2009 to 39% in 2015 (p<0.001). The proportion of CaOx increased from 21% in 2009 to 32% in 2015 (p<0.001). The results of this study can help veterinarians predict urolith composition to select diagnostic tests and to initiate therapy prior to urolith removal.

RevDate: 2018-12-02
CmpDate: 2017-11-28

Florey J, Ewen V, H Syme (2017)

Association between cystine urolithiasis and neuter status of dogs within the UK.

The Journal of small animal practice, 58(9):531-535.

OBJECTIVES: The objectives of the study were to examine the association between diagnosis of cystine urolithiasis and entire versus neutered status in male dogs and whether the strength of association varies among breeds.

MATERIALS AND METHODS: A previously reported canine urolithiasis database was used, documenting all urolith submissions to Hill's Pet Nutrition UK over a 10-year period. Uroliths were classified as cystine or non-cystine, and only male dogs with known neuter status were included in the analysis. Breeds of dog (and an additional crossbreed group), for which there was a minimum of 10 cystine urolith submissions, were analysed individually, with all other breeds combined together to form a reference group. Results were analysed using chi-squared and Fisher's exact tests. Logistic regression was used to assess associations between breed and neuter status and formation of cystine calculi.

RESULTS: In multiple breeds, dogs with cystine uroliths were significantly more likely to be entire than dogs forming other types of urolith. Being an entire male, regardless of breed, was associated with an increased risk of cystine urolithiasis (odds ratio=4·5; 95% confidence interval: 3·22 to 6·37; P<0·001).

CLINICAL SIGNIFICANCE: Increased odds of cystine formation in entire dogs supports further investigation of castration as a method to prevent cystine urolithiasis.

RevDate: 2018-12-02
CmpDate: 2017-12-01

Hilton S, Mizukami K, U Giger (2017)

[Cystinuria caused by a SLC7A9 missense mutation in Siamese-crossbred littermates in Germany].

Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere, 45(4):265-272.

Cystinuria is caused by defective proximal renal tubular reabsorption of the amino acids cystine, ornithine, lysine, and arginine (COLA). The low solubility of cystine in mildly acidic urine may lead to the formation of urinary cystine crystals and uroliths. Much progress has been made recently in the diagnosis and understanding of cystinuria in companion animals. In cats, cystinuria affects equally both genders independent of neutering status and, despite being rare, already more cystinuria-causing mutations have been detected in cats compared to dogs. In this study a litter of Siamese-crossbred cats in Germany was assessed clinically for cystinuria and screened for mutations known to cause cystinuria in cats. An adult male castrated cat was presented with cystine crystalluria and calculi-related urinary obstruction and treated with perineal urethrostomy, cystotomy, and medical management. This cat and a neutered male littermate without evidence of urinary tract disease were found to be positive for cystine by urinary nitroprusside test, to have increased urinary COLA values and to be homozygous for the p.Val294Glu mutation in the SLC7A9 gene coding for b0,+AT subunit of the b0,+ renal COLA transporter. Another littermate was non-cystinuric and did not carry this mutation. The same SLC7A9 mutation was previously found in a Maine coon, a Sphinx and a medium-haired cat in North America suggesting a common ancestor and likely first widespread SLC7A9 mutation causing cystinuria in cats. Genetic screening for this mutation may offer a simple and precise mean to diagnose other cats for cystinuria and offer specific management.

RevDate: 2018-12-11
CmpDate: 2018-12-11

Manissorn J, Fong-Ngern K, Peerapen P, et al (2017)

Systematic evaluation for effects of urine pH on calcium oxalate crystallization, crystal-cell adhesion and internalization into renal tubular cells.

Scientific reports, 7(1):1798.

Urine pH has been thought to be an important factor that can modulate kidney stone formation. Nevertheless, there was no systematic evaluation of such pH effect. Our present study thus addressed effects of differential urine pH (4.0-8.0) on calcium oxalate (CaOx) crystallization, crystal-cell adhesion, crystal internalization into renal tubular cells, and binding of apical membrane proteins to the crystals. Microscopic examination revealed that CaOx monohydrate (COM), the pathogenic form, was crystallized with greatest size, number and total mass at pH 4.0 and least crystallized at pH 8.0, whereas COD was crystallized with the vice versa order. Fourier-transform infrared (FT-IR) spectroscopy confirmed such morphological study. Crystal-cell adhesion assay showed the greatest degree of crystal-cell adhesion at the most acidic pH and least at the most basic pH. Crystal internalization assay using fluorescein isothiocyanate (FITC)-labelled crystals and flow cytometry demonstrated that crystal internalization into renal tubular cells was maximal at the neutral pH (7.0). Finally, there were no significant differences in binding capacity of the crystals to apical membrane proteins at different pH. We concluded that the acidic urine pH may promote CaOx kidney stone formation, whereas the basic urine pH (i.e. by alkalinization) may help to prevent CaOx kidney stone disease.

RevDate: 2017-11-16
CmpDate: 2017-10-31

Segarra S, Miró G, Montoya A, et al (2017)

Randomized, allopurinol-controlled trial of the effects of dietary nucleotides and active hexose correlated compound in the treatment of canine leishmaniosis.

Veterinary parasitology, 239:50-56.

First-line treatment for canine leishmaniosis (CanL) is N-methylglucamine antimoniate (MGA) combined with allopurinol. However, in some dogs allopurinol may induce hyperxanthinuria leading to urolithiasis. Moreover, allopurinol resistance has recently been described in Leishmania infantum isolates from treated dogs with a relapse of the disease. Alternative treatments are thus needed. Since the type of host immune response strongly influences CanL progression and prognosis, dogs could benefit from treatments targeted at modulating such response, such as nucleotides and active hexose correlated compound (AHCC). The aim of this study was to evaluate the effects of an oral combination of nucleotides and AHCC in dogs with clinical leishmaniosis. Sixty-nine dogs with naturally-occurring clinical leishmaniosis were included in this multicenter, open-label, positively-controlled clinical trial and randomized to receive 10mg/kg allopurinol PO BID (allopurinol group) or 17mg/kg AHCC plus 32mg/kg nucleotides PO SID (supplement group) for 180 days. All dogs were also given 50mg/kg MGA SC BID during the first 28 days. At the time points 0, 30, and 180 days of the trial, dogs underwent a clinical examination, and blood, urine, and bone marrow samples were submitted for analytical tests. Final data analyses (allopurinol group: n=29; supplement group: n=24) revealed a significant improvement in both groups in clinical scores and ELISA-determined antibody titers after treatment. However, the supplement group showed a significantly lower clinical score (P=0.005) and significantly higher antibody titers (P=0.032) after 180 days, compared to the allopurinol group. RT-PCR parasite loads were reduced in groups (mean±SD supplement: 0.38±0.56 vs 5.23±18.9; allopurinol: 0.45±1.47 vs 3.09±8.36 parasites/ng of DNA), but there were no significant differences over time or between groups. During the study, 12 dogs in the allopurinol group developed xanthinuria (41%) compared to no dogs (0%) in the supplement group (P=0.000). Both treatments led to significantly increased CD4+/CD8+ ratio, and improvements in protein electrophoretic pattern and acute phase response. In conclusion, 6-month oral treatment with nucleotides and AHCC in addition to MGA showed similar efficacy to the current first-line treatment for CanL, without producing xanthinuria. This combination could be a good alternative to MGA-allopurinol combination treatment for CanL, especially for dogs suffering allopurinol-related adverse events.

RevDate: 2019-02-08
CmpDate: 2017-09-18

Furrow E, McCue ME, JP Lulich (2017)

Urinary metals in a spontaneous canine model of calcium oxalate urolithiasis.

PloS one, 12(5):e0176595.

Calcium oxalate urolithiasis is a common and painful condition in people. The pathogenesis of this disease is complex and poorly understood. Laboratory animal and in vitro studies have demonstrated an effect of multiple trace metals in the crystallization process, and studies in humans have reported relationships between urinary metal concentrations and stone risk. Dogs are a spontaneous model of calcium oxalate urolithiasis, and the metal content of canine calcium oxalate stones mirrors that of human stones. The aim of this study was to test for a relationship between urinary metals and calcium oxalate urolithiasis in dogs. We hypothesized that urinary metals would differ between dogs with and without calcium oxalate urolithiasis. Urine from 122 dogs (71 cases and 51 stone-free controls) was analyzed for calcium and 12 other metals. The cases had higher urinary calcium, copper, iron, and vanadium and lower urinary cobalt. Higher urinary vanadium in the cases was associated with being fed a therapeutic stone-prevention diet. Urinary calcium had a strong positive correlation with strontium and moderate positive correlations with chromium, nickel, and zinc. The results of this study complement the findings of similar human studies and suggest a potential role of trace metals in calcium oxalate urolithiasis. Further investigation into how trace metals may affect stone formation is warranted.

RevDate: 2017-09-06
CmpDate: 2017-09-06

Adamama-Moraitou KK, Pardali D, Prassinos NN, et al (2017)

Evaluation of dogs with macroscopic haematuria: a retrospective study of 162 cases (2003-2010).

New Zealand veterinary journal, 65(4):204-208.

AIMS: To retrospectively describe clinical features of dogs that were presented to a small animal clinic between 2003-10 with macroscopic haematuria, and investigate whether signalment of the dog and severity and duration of the haematuria at admission were associated with specific aetiologies.

METHODS: Medical records were evaluated of 162 dogs with macroscopic haematuria admitted to a University-based small animal clinic in Thessaloniki, Greece, from January 2003 to December 2010. The inclusion criteria were discolouration of the urine sediment combined with abnormal numbers of erythrocytes, when examined microscopically. Data collected from the medical records included signalment, severity, frequency and duration of haematuria, and diagnosis.

RESULTS: Between January 2007 and December 2010, 8,893 dogs were admitted to the clinic; of these 99 (1.1%) were admitted with haematuria. Of the 162 dogs with records of haematuria, 80 (49.4%) were aged between 5.1-10 years, presented with acute (96/162; 59.3%), constant (99/162; 61.1%) and mild/moderate (150/162; 92.6%) haematuria. Of 147 dogs with a recorded diagnosis, the commonest diagnoses were urinary tract infection (UTI, 42/147; 28.6%), urolithiasis (38/147; 25.9%), prostatic disease (25/147; 17.0%) and urinary tumours (13/147; 8.8%). The prevalence of UTI was higher in female (22/56; 39%) than male (20/91; 22%) dogs, and in medium sized (22/52; 42%) than small (6/40; 15%) dogs. Urolithiasis was most prevalent in small (21/40; 52.5%) dogs, and all dogs with urolithiasis presented with mild/moderate haematuria. The prevalence of prostatic disease was highest in large (11/46; 24%) and giant (3/9; 33%) sized dogs and in dogs aged >10 years (8/30; 27%).

In this retrospective study from one small animal clinic, UTI, urolithiasis, prostatic disease and urinary tumours predominated among the causes of canine haematuria. The consideration of sex, age, and size of the dog and characteristics of haematuria were found to be useful parameters when forming the list of differential diagnoses.

RevDate: 2018-11-13
CmpDate: 2017-09-08

Hall JA, Yerramilli M, Obare E, et al (2017)

Serum concentrations of symmetric dimethylarginine and creatinine in cats with kidney stones.

PloS one, 12(4):e0174854.

Serum concentrations of symmetric dimethylarginine (SDMA) correlate with renal function in cats and SDMA has been shown to be a more reliable and earlier marker for chronic kidney disease (CKD) compared with serum creatinine (Cr). Calcium oxalate uroliths tend to develop in mid-to-older aged cats and kidney stones may cause a reduction in renal function with increased SDMA, but normal serum Cr. The purpose of this retrospective study was to determine if cats with kidney stones had increased serum SDMA concentrations, and whether SDMA increased earlier than serum creatinine concentrations. Cats in the colony with kidney stones diagnosed between August 2010 and December 2015 (n = 43) were compared with healthy geriatric cats (n = 21) without kidney stones. Serum SDMA concentrations were determined by liquid chromatography-mass spectrometry and serum Cr concentrations were determined by enzymatic colorimetry. Cats with kidney stones were diagnosed antemortem by radiographic imaging (n = 12) or by postmortem necropsy (n = 31). Retrospectively, serum SDMA was found to be increased above the upper reference limit in 39 of 43 cats with kidney stones. Serum Cr was increased above the upper reference limit in 18 of 43 cats; 6 of these 18 cats had terminal azotemia only. The mean time that serum SDMA was increased before serum Cr was increased was 26.9 months (range 0 to 60 months). Kidney stones were composed of calcium oxalate in 30 of 34 cats. The lifespan for cats with kidney stones (mean, 12.5 years; range, 6.1 to 18.1 years) was shorter (P < 0.001) than for control cats (mean, 15.2 years; range, 13.0 to 17.2 years), suggesting that non-obstructive kidney stones have an effect on mortality rate or rate of CKD progression. In conclusion, if SDMA concentrations are elevated in mid-to-older aged cats, further imaging studies are warranted to check for the presence of kidney stones.

RevDate: 2018-11-13
CmpDate: 2018-04-19

O'Kell AL, Grant DC, SR Khan (2017)

Pathogenesis of calcium oxalate urinary stone disease: species comparison of humans, dogs, and cats.

Urolithiasis, 45(4):329-336.

Idiopathic calcium oxalate nephrolithiasis is a highly recurrent disease that is increasing in prevalence. Decades of research have not identified effective methods to consistently prevent the formation of nephroliths or induce medical dissolution. Idiopathic calcium oxalate nephroliths form in association with renal papillary subepithelial calcium phosphate deposits called Randall's plaques (RPs). Rodent models are commonly used to experimentally induce calcium oxalate crystal and stone formation, but a rodent model that conclusively forms RPs has not been identified. Both dogs and cats form calcium oxalate uroliths that can be recurrent, but the etiopathologic mechanisms of stone formation, especially renal pathologic findings, are a relatively unexploited area of study. A large animal model that shares a similar environment to humans, along with a shorter lifespan and thus shorter time to recurrence, might provide an excellent means to study preventative and therapeutic measures, along with enhancing the concepts of the one health initiative. This review article summarizes and compares important known features of idiopathic calcium oxalate stone disease in humans, dogs, and cats, and emphasizes important knowledge gaps and areas for future study in the quest to discover a naturally occurring animal model of idiopathic calcium oxalate stone disease.

RevDate: 2018-11-13
CmpDate: 2017-09-14

Yu L, Gan X, Liu X, et al (2017)

Calcium oxalate crystals induces tight junction disruption in distal renal tubular epithelial cells by activating ROS/Akt/p38 MAPK signaling pathway.

Renal failure, 39(1):440-451.

Tight junction plays important roles in regulating paracellular transports and maintaining cell polarity. Calcium oxalate monohydrate (COM) crystals, the major crystalline composition of kidney stones, have been demonstrated to be able to cause tight junction disruption to accelerate renal cell injury. However, the cellular signaling involved in COM crystal-induced tight junction disruption remains largely to be investigated. In the present study, we proved that COM crystals induced tight junction disruption by activating ROS/Akt/p38 MAPK pathway. Treating Madin-Darby canine kidney (MDCK) cells with COM crystals induced a substantial increasing of ROS generation and activation of Akt that triggered subsequential activation of ASK1 and p38 mitogen-activated protein kinase (MAPK). Western blot revealed a significantly decreased expression of ZO-1 and occludin, two important structural proteins of tight junction. Besides, redistribution and dissociation of ZO-1 were observed by COM crystals treatment. Inhibition of ROS by N-acetyl-l-cysteine (NAC) attenuated the activation of Akt, ASK1, p38 MAPK, and down-regulation of ZO-1 and occludin. The redistribution and dissociation of ZO-1 were also alleviated by NAC treatment. These results indicated that ROS were involved in the regulation of tight junction disruption induced by COM crystals. In addition, the down-regulation of ZO-1 and occludin, the phosphorylation of ASK1 and p38 MAPK were also attenuated by MK-2206, an inhibitor of Akt kinase, implying Akt was involved in the disruption of tight junction upstream of p38 MAPK. Thus, these results suggested that ROS-Akt-p38 MAPK signaling pathway was activated in COM crystal-induced disruption of tight junction in MDCK cells.

RevDate: 2017-08-08
CmpDate: 2017-08-08

Cléroux A, Alexander K, Beauchamp G, et al (2017)

Evaluation for association between urolithiasis and chronic kidney disease in cats.

Journal of the American Veterinary Medical Association, 250(7):770-774.

OBJECTIVE To determine whether urolithiasis is associated with chronic kidney disease (CKD) in cats. DESIGN Retrospective case-control study. ANIMALS 126 cats (59 and 67 with and without urolithiasis, respectively). PROCEDURES Medical records from June 2006 to July 2013 were searched to identify cats that underwent abdominal or focal urinary tract ultrasonography and for which serum creatinine concentration and urine specific gravity data were obtained ≤ 14 days before or after the examination. In cats with (urolithiasis group) and without (control group) urolithiasis, the presence of CKD was determined according to International Renal Interest Society guidelines. Information recorded included signalment, body weight, serum creatinine concentration, and urine specific gravity; when present, the location and number of uroliths were noted. Differences between groups and associations between group and categorical variables were analyzed statistically. RESULTS Age, weight, sex, and breed did not differ between groups. The prevalence of CKD was significantly higher in cats with urolithiasis than in the control group. Among cats with urolithiasis, there was a negative association between CKD and presence of cystoliths. There was no association between urolithiasis and the stage of CKD or between presence of CKD and location of nephroliths in the kidney. CONCLUSIONS AND CLINICAL RELEVANCE Results confirmed a positive association between urolithiasis and CKD in the feline population studied and suggested that cats with urolithiasis should be evaluated for CKD. Further research is warranted to assess the nature of the relationship between CKD and urolithiasis in cats.

RevDate: 2017-06-27
CmpDate: 2017-06-27

Sumner JP, M Rishniw (2017)

Urethral obstruction in male cats in some Northern United States shows regional seasonality.

Veterinary journal (London, England : 1997), 220:72-74.

Feline lower urinary tract disease (FLUTD) is a term encompassing several different conditions affecting the feline lower urinary tract. Certain FLUTD aetiologies, such as idiopathic cystitis, urethral plugs or urolithiasis, commonly produce urethral obstruction (UO) in male cats. It is widely accepted that environmental, behavioural and dietary factors can play a role in the aetiopathogenesis of these conditions. We investigated the seasonal prevalence of UO by analysing admission dates of 2443 male cats with UO from eight practices in the Northern USA over a 4-year period. A significantly greater number of cats presented for UO in April and May (P < 0.025). When stratified by geographic location, a spring peak was found in cats from the North-Eastern United States, but no peak was demonstrable in cats from the North-West coast. This suggests that UO might depend, at least in part, on geographical climatic variations.

RevDate: 2018-11-13

Mittal A, Tandon S, Singla SK, et al (2017)

Cytoprotective and anti-apoptotic role of Terminalia arjuna on oxalate injured renal epithelial cells.

Cytotechnology, 69(2):349-358.

Urolithiasis is one of the painful multifactorial disorders caused by metabolic abnormalities influencing the composition of body fluids and urine. The bark of Terminalia arjuna (T. arjuna), very well known in Ayurveda for the treatment of cardiovascular diseases, possesses antioxidant and diuretic activity. The present study was undertaken to investigate the antiurolithiatic efficacy of aqueous extract of bark of T. arjuna on oxalate-induced injury to renal tubular epithelial cells. Madin-Darby canine kidney (MDCK) cells were exposed to 2 mM oxalate for 48 h to evaluate the protective effect of T. arjuna aqueous extract on cell viability, CaOx crystal adherence and apoptotic changes caused by oxalate. The results confirmed that oxalate injured MDCK cells were protected by T. arjuna extract. On treatment with a range concentrations, the cell viability increased in a concentration dependent manner. Moreover, the extract prevented the interaction of the calcium oxalate (CaOx) crystals with the cell surface and reduced the number of apoptotic cells. The current data suggests that T. arjuna bark confers a cytoprotective role and based on our results it could be a potential candidate from natural plant sources against urolithiasis.

RevDate: 2018-11-13
CmpDate: 2017-03-27

Westropp JL, Larsen JA, Johnson EG, et al (2017)

Evaluation of dogs with genetic hyperuricosuria and urate urolithiasis consuming a purine restricted diet: a pilot study.

BMC veterinary research, 13(1):45.

BACKGROUND: Urate urolithiasis is a common problem in breed homozygous for the mutation that results in hyperuricosuria. Low purine diets have been recommended to reduce purine intake in these dogs.

METHODS: A higher protein, purine restricted diet with water added was evaluated in dogs with genetic hyperuricosuria and a history of clinical urate urolithiasis over a one year time period. Dogs were evaluated at baseline and 2, 6, and 12 months after initiating the test diet. Bloodwork, urinalysis, abdominal ultrasound, body composition, and 24-h urinary purine metabolite analyses were performed.

RESULTS: Transient, mild, self-limited lower urinary tract signs were noted in only one dog on a single day, despite variable but usually mild and occasionally moderate amounts of echogenic bladder stones (<2-3 mm in size) in almost every dog at each visit. No significant differences were noted in urine specific gravity, urine pH, lean body condition score or body composition. Urinary uric acid concentration was lower on the test diet (p = 0.008), but 24-h uric acid excretions were similar (p = 0.220) compared to baseline. Significant differences between least squares mean plasma amino acid concentrations measured at the 0 and 12-month visits were found only for valine (p = 0.0119) and leucine (p = 0.0017).

CONCLUSION: This study suggests the use of a low purine, higher protein diet with added water may be beneficial as part of the management of dogs with genetic hyperuricosuria and history of clinical urate urolithiasis.

RevDate: 2018-12-02
CmpDate: 2017-06-13

Kizivat T, Smolić M, Marić I, et al (2017)

Antioxidant Pre-Treatment Reduces the Toxic Effects of Oxalate on Renal Epithelial Cells in a Cell Culture Model of Urolithiasis.

International journal of environmental research and public health, 14(1):.

Urolithiasis is characterized by the formation and retention of solid crystals within the urinary tract. Kidney stones are mostly composed of calcium oxalate, which predominantly generates free radicals that are toxic to renal tubular cells. The aim of the study is to explore possible effects of antioxidant pre-treatment on inhibition of oxidative stress. Three cell lines were used as in vitro model of urolithiasis: MDCK I, MDCK II and LLC-PK1. Oxidative stress was induced by exposure of cells to sodium oxalate in concentration of 8 mM. In order to prevent oxidative stress, cells were pre-treated with three different concentrations of l-arginine and vitamin E. Oxidative stress was evaluated by determining the expression of superoxide dismutase (SOD), osteopontin (OPN), and by the concentration of glutathione (GSH). In all three cell lines, pre-treatment of antioxidants increased cell survival. Positive correlation of SOD and OPN expression as well as GSH concentration was observed in all groups of cells. Our results indicate that an antioxidant pre-treatment with l-arginine and vitamin E is able to hamper oxalate-induced oxidative stress in kidney epithelial cells and as such could play a role in prevention of urolithiasis.

RevDate: 2018-11-13
CmpDate: 2017-03-24

Houston DM, Weese HE, Vanstone NP, et al (2017)

Analysis of canine urolith submissions to the Canadian Veterinary Urolith Centre, 1998-2014.

The Canadian veterinary journal = La revue veterinaire canadienne, 58(1):45-50.

Understanding urolith trends and risk factors is important for understanding urolithiasis, which is a common problem in dogs. This study evaluated 75 674 canine cystolith submissions to the Canadian Veterinary Urolith Centre between 1998 and 2014. Struvite and calcium oxalate uroliths comprised 80.8% of all uroliths, with calcium oxalate outnumbering struvite. There were significant increases in the proportions of calcium oxalate, mixed and cystine uroliths, and significant decreases in struvite, urate, silica, and calcium phosphate carbonate over the study period. Breeds associated with increased risk of calcium oxalate urolithiasis tended to be small breeds, while those that were at increased risk of struvite urolith formation were larger breeds. Dalmatians were at increased risk of forming both urate and xanthine uroliths while Scottish deerhounds had a remarkably high association with cystine urolithiasis. Males were more likely to form calcium oxalate and metabolic uroliths and females were more likely to develop struvite and mixed uroliths.

RevDate: 2018-11-13
CmpDate: 2017-07-03

Mellema M, Stoller M, Queau Y, et al (2016)

Nanoparticle Tracking Analysis for the Enumeration and Characterization of Mineralo-Organic Nanoparticles in Feline Urine.

PloS one, 11(12):e0166045.

Urinary stone disease, particularly calcium oxalate, is common in both humans and cats. Calcifying nanoparticles (CNP) are spherical nanocrystallite material, and are composed of proteins (fetuin, albumin) and inorganic minerals. CNP are suggested to play a role in a wide array of pathologic mineralization syndromes including urolithiasis. We documented the development of a clinically relevant protocol to assess urinary CNP in 9 healthy cats consuming the same diet in a controlled environment using Nanoparticle Tracking Analysis (NTA®). NTA® is a novel method that allows for characterization of the CNP in an efficient, accurate method that can differentiate these particles from other urinary submicron particulates. The predominant nanoscale particles in feline urine are characteristic of CNP in terms of their size, their ability to spontaneously form under suitable conditions, and the presence of an outer layer that is rich in calcium and capable of binding to hydroxyapatite binders such as alendronate and osteopontin. The expansion of this particle population can be suppressed by the addition of citrate to urine samples. Further, compounds targeting exosomal surfaces do not label these particulates. As CNP have been associated with a number of significant urologic maladies, the method described herein may prove to be a useful adjunct in evaluating lithogenesis risk in mammals.

RevDate: 2018-11-13
CmpDate: 2018-06-04

Peerapen P, V Thongboonkerd (2016)

Caffeine prevents kidney stone formation by translocation of apical surface annexin A1 crystal-binding protein into cytoplasm: In vitro evidence.

Scientific reports, 6:38536.

Recent large 3 cohorts have shown that caffeinated beverage consumption was associated with lower risk of kidney stone disease. However, its protective mechanisms remained unknown and had not been previously investigated. We thus evaluated protective effects of caffeine (1 μM-10 mM) on calcium oxalate monohydrate (COM) kidney stone formation, using crystallization, crystal growth, cell-crystal adhesion, Western blotting, and immunofluorescence assays. The results showed that caffeine reduced crystal number but, on the other hand, increased crystal size, resulting in unchanged crystal mass, consistent with crystal growth that was not affected by caffeine. However, caffeine significantly decreased crystal-binding capacity of MDCK renal tubular cells in a dose-dependent manner. Western blotting and immunofluorescence study of COM crystal-binding proteins revealed significantly decreased level of annexin A1 on apical surface and its translocation into cytoplasm of the caffeine-treated cells, but no significant changes in other COM crystal-binding proteins (annexin A2, α-enolase, HSP70, and HSP90) were observed. Moreover, caffeine decreased intracellular [Ca2+] but increased [Ca2+] secretory index. Taken together, our findings showed an in vitro evidence of the protective mechanism of caffeine against kidney stone formation via translocation of annexin A1 from apical surface into cytoplasm to reduce the crystal-binding capacity of renal tubular epithelial cells.

RevDate: 2017-08-17
CmpDate: 2017-07-05

Singh A, Hoddinott K, Morrison S, et al (2016)

Perioperative characteristics of dogs undergoing open versus laparoscopic-assisted cystotomy for treatment of cystic calculi: 89 cases (2011-2015).

Journal of the American Veterinary Medical Association, 249(12):1401-1407.

OBJECTIVE To compare perioperative characteristics of dogs with cystic calculi treated via open versus laparoscopic-assisted cystotomy (LAC). DESIGN Retrospective case series. ANIMALS 89 client-owned dogs that underwent open cystotomy (n = 39) or LAC (50). PROCEDURES Medical records of dogs that underwent cystotomy between 2011 and 2015 were reviewed. History, signalment, surgery date, results of physical examination, results of preoperative diagnostic testing, details of surgical treatment, duration of surgery, perioperative complications, treatment costs, and duration of hospitalization were recorded. RESULTS 5 of 50 (10%) dogs required conversion from LAC to open cystotomy (OC). There was no significant difference between the LAC (1/50) and OC (2/39) groups with regard to percentage of patients with incomplete removal of calculi. Duration of surgery was not significantly different between the LAC (median, 80 min; range, 35 to 145 min) and OC (median, 70 min; range, 45 to 120 min) groups. Postoperative duration of hospitalization was significantly shorter for dogs that underwent LAC (median, 24 hours; range, 12 to 48 hours) versus OC (median, 26 hours; range, 12 to 63 hours). Surgical and total procedural costs were significantly higher for patients undergoing LAC. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that LAC may be an acceptable minimally invasive technique for treatment of cystic calculi in dogs. Surgery times were similar to those for dogs undergoing OC; however, surgical and total procedural costs were higher. Further investigation is suggested to determine which patients may benefit from LAC versus traditional OC.

RevDate: 2017-05-25
CmpDate: 2017-05-25

Thierry F, Drew S, Del-Pozo J, et al (2017)

Incomplete Urethral Duplication Associated with a Dermoid Cyst in a Dog with Urinary Obstruction.

Journal of comparative pathology, 156(1):29-32.

A 20-month-old male miniature dachshund was evaluated for a 10-week history of intermittent stranguria, pollakiuria, haematuria and obstructive urolithiasis. Retrograde urethrocystography revealed a subcutaneous saccular structure in the perineal area connected to the intrapelvic urethra associated with urolithiasis. After excision of the perineal saccular structure, microscopical examination confirmed the presence of transitional epithelium lining the diverticulum, with isolated submucosal smooth muscle bundles. This structure was attached to another saccular structure lined by stratified squamous keratinizing epithelium with hair follicles, sebaceous glands and apocrine glands. An incomplete urethral duplication with dermoid cyst was diagnosed. The dog recovered uneventfully from surgery and was still urinary continent and free from clinical signs 5 months after surgery. To the authors' knowledge this is the first report of an incomplete urethral duplication with a dermoid cyst and concurrent obstructive urolithiasis in a dog.

RevDate: 2018-11-13
CmpDate: 2017-07-05

Kennedy SM, Lulich JP, Ritt MG, et al (2016)

Comparison of body condition score and urinalysis variables between dogs with and without calcium oxalate uroliths.

Journal of the American Veterinary Medical Association, 249(11):1274-1280.

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.

RevDate: 2018-11-13
CmpDate: 2017-03-13

Yang X, Ding H, Qin Z, et al (2016)

Metformin Prevents Renal Stone Formation through an Antioxidant Mechanism In Vitro and In Vivo.

Oxidative medicine and cellular longevity, 2016:4156075.

Oxidative stress is a causal factor and key promoter of urolithiasis associated with renal tubular epithelium cell injury. The present study was designed to investigate the preventive effects of metformin on renal tubular cell injury induced by oxalate and stone formation in a hyperoxaluric rat model. MTT assays were carried out to determine the protection of metformin from oxalate-induced cytotoxicity. The intracellular superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels were measured in vitro. Male Sprague-Dawley rats were divided into control group, ethylene glycol (EG) treated group, and EG + metformin treated group. Oxidative stress and crystal formations were evaluated in renal tissues after 8-week treatment. Metformin significantly inhibited the decrease of the viability in MDCK cells and HK-2 cells induced by oxalate. Besides, metformin markedly prevented the increased concentration of MDA and the decreased tendency of SOD in oxalate-induced MDCK cells and HK-2 cells. In vivo, the increased MDA levels and the reduction of SOD activity were detected in the EG treated group compared with controls, while these parameters reversed in the EG + metformin treated group. Kidney crystal formation in the EG + metformin treated group was decreased significantly compared with the EG treated group. Metformin suppressed urinary crystal deposit formation through renal tubular cell protection and antioxidative effects.

RevDate: 2017-04-07
CmpDate: 2017-04-07

Li S, Wu W, Wu W, et al (2016)

L-Carnitine Protects Renal Tubular Cells Against Calcium Oxalate Monohydrate Crystals Adhesion Through Preventing Cells From Dedifferentiation.

Kidney & blood pressure research, 41(5):582-592.

BACKGROUND/AIMS: The interactions between calcium oxalate monohydrate (COM) crystals and renal tubular epithelial cells are important for renal stone formation but still unclear. This study aimed to investigate changes of epithelial cell phenotype after COM attachment and whether L-carnitine could protect cells against subsequent COM crystals adhesion.

METHODS: Cultured MDCK cells were employed and E-cadherin and Vimentin were used as markers to estimate the differentiate state. AlexaFluor-488-tagged COM crystals were used in crystals adhesion experiment to distinguish from the previous COM attachment, and adhesive crystals were counted under fluorescence microscope, which were also dissolved and the calcium concentration was assessed by flame atomic absorption spectrophotometry.

RESULTS: Dedifferentiated MDCK cells induced by transforming growth factor β1 (TGF-β1) shown higher affinity to COM crystals. After exposure to COM for 48 hours, cell dedifferentiation were observed and more subsequent COM crystals could bind onto, mediated by Akt/GSK-3β/Snail signaling. L-carnitine attenuated this signaling, resulted in inhibition of cell dedifferentiation and reduction of subsequent COM crystals adhesion.

CONCLUSIONS: COM attachment promotes subsequent COM crystals adhesion, by inducing cell dedifferentiation via Akt/GSK-3β/Snail signaling. L-carnitine partially abolishes cell dedifferentiation and resists COM crystals adhesion. L-carnitine, may be used as a potential therapeutic strategy against recurrence of urolithiasis.

RevDate: 2017-01-19
CmpDate: 2016-12-16

Gerber B, Brandenberger-Schenk F, Rothenanger E, et al (2016)

[Uroliths of cats in Switzerland from 2002 to 2009].

Schweizer Archiv fur Tierheilkunde, 158(10):711-716.

INTRODUCTION: In this study data on composition of uroliths collected from cats and epidemiologic data of affected cats in Switzerland from 2002 to 2009 are summarised. Of 884 stones analysed 50% (n=441) were composed of calcium oxalate, 45% (n=398) of struvite, 3% (n=18) of ammonium urate, 1% (n=12) were mixed stones, 1% (n=9) were composed of silica, 3 stones were solidified blood, 2 consisted of cystine and 1of xanthine. 40% of the ureteral stones were composed of struvite. Domestic cats had significantly less calcium oxalate stones compared to British Shorthair or Persian cats. Cats with calcium oxalate stones were older and cats with struvite stones were younger than other affected cats. Female and male cats were equally affected with stones. Compared to studies from other countries, in Switzerland silica stones occurred more often and ureteral stones were more often composed of Struvite. The present study shows that occurrence and prevalence of urinary calculi of cats from Switzerland exhibited only slight differences to studies from other countries.

RevDate: 2017-08-17
CmpDate: 2017-07-14

Tong K, Weisse C, AC Berent (2016)

Rigid urethrocystoscopy via a percutaneous fluoroscopic-assisted perineal approach in male dogs: 19 cases (2005-2014).

Journal of the American Veterinary Medical Association, 249(8):918-925.

OBJECTIVE To describe the technique and outcome for male dogs undergoing rigid urethrocystoscopy via a novel percutaneous, fluoroscopic-assisted perineal approach. DESIGN Retrospective case series. ANIMALS 19 client-owned male dogs. PROCEDURES Medical records of male dogs that underwent urethrocystoscopy via a percutaneous perineal approach for treatment of a variety of conditions from 2005 through 2014 were reviewed. Signalment, history, pertinent diagnostic imaging results, endourologic and postprocedure details, duration of hospitalization, complications, and outcome (short-term, < 1 month; long-term, ≥ 1 month) were recorded. After flexible urethrocystoscopy, direct percutaneous perineal needle puncture and guidewire placement by means of fluoroscopic guidance (with or without ultrasonography) allowed access to the urethral lumen. The perineal tract was subsequently serially dilated to accommodate a peel-away sheath and rigid endoscope. Rigid urethrocystoscopy was performed, and on completion of endourologic procedures, the access site was left to heal by second intention. RESULTS 19 male dogs successfully underwent 20 procedures. No intraoperative complications were reported. Short-term outcome was good (ie, mild perineal urine leakage) for 3 dogs and excellent (ie, no abnormalities with urination) for 16. Long-term outcome was excellent for the 17 dogs for which follow-up information was available. CONCLUSIONS AND CLINICAL RELEVANCE A percutaneous fluoroscopic-assisted perineal approach (with or without ultrasonography) allowed access to the pelvic urethra with no major complications in the present series of patients. This minimally invasive approach may be a valuable tool for endourologic procedures in male dogs.

RevDate: 2018-11-13
CmpDate: 2017-08-16

Mittal A, Tandon S, Singla SK, et al (2016)

Mechanistic Insights into the Antilithiatic Proteins from Terminalia arjuna: A Proteomic Approach in Urolithiasis.

PloS one, 11(9):e0162600.

Kidney stone formation during hyperoxaluric condition is inherently dependent on the interaction between renal epithelial cells and calcium oxalate (CaOx) crystals. Although modern medicine has progressed in terms of removal of these stones, recurrence and persistent side effects restricts their use. Strategies involving plant based agents which could be used as adjunct therapy is an area which needs to be explored. Plant proteins having antilithiatic activity is a hitherto unexplored area and therefore, we conducted a detailed identification and characterization of antilithiatic proteins from Terminalia arjuna (T. arjuna). Proteins were isolated from the dried bark of T. arjuna and those having molecular weights > 3 kDa were subjected to anion exchange chromatography followed by gel filtration chromatography. Four proteins were identified exhibiting inhibitory activity against CaOx crystallization and crystal growth kinetics The cytoprotective and anti-apoptotic efficacy of these purified proteins was further investigated on oxalate injured renal epithelial cells (MDCK and NRK-52E) wherein, injury due to oxalate was significantly attenuated and led to a dose dependent increase in viability of these cells. These proteins also prevented the interaction of the CaOx crystals to the cell surface and reduced the number of apoptotic cells. Identification of these 4 anionic proteins from the bark of T. arjuna was carried out by Matrix-assisted laser desorption/ionization-time of flight Mass spectrometry (MALDI-TOF MS). This was followed by database search with the MASCOT server and sequence similarity was found with Nuclear pore anchor, DEAD Box ATP-dependent RNA helicase 45, Lon protease homolog 1 and Heat shock protein 90-3. These novel proteins isolated from T. arjuna have the potential to inhibit CaOx crystallization and promote cell survival and therefore, offer novel avenues which need to be explored further for the medical management of urolithiasis.

RevDate: 2018-11-13
CmpDate: 2018-02-05

Lulich JP, Berent AC, Adams LG, et al (2016)

ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats.

Journal of veterinary internal medicine, 30(5):1564-1574.

In an age of advancing endoscopic and lithotripsy technologies, the management of urolithiasis poses a unique opportunity to advance compassionate veterinary care, not only for patients with urolithiasis but for those with other urinary diseases as well. The following are consensus-derived, research and experience-supported, patient-centered recommendations for the treatment and prevention of uroliths in dogs and cats utilizing contemporary strategies. Ultimately, we hope that these recommendations will serve as a foundation for ongoing and future clinical research and inspiration for innovative problem solving.

RevDate: 2018-12-02
CmpDate: 2017-08-18

Bartges JW (2016)

Feline Calcium Oxalate Urolithiasis: Risk factors and rational treatment approaches.

Journal of feline medicine and surgery, 18(9):712-722.

PRACTICAL RELEVANCE: Uroliths occur commonly in the bladder and/or urethra of cats and can be lifethreatening if urethral obstruction occurs. Calcium oxalate accounts for 40-50% of urocystoliths and these stones are not amenable to medical dissolution; therefore, removal by surgery or minimally invasive techniques is required if uroliths must be treated. Medical protocols for prevention involve decreasing urine saturation for minerals that form uroliths.

ETIOPATHOGENESIS: Formation of uroliths is not a disease, but rather a complication of several disorders. Some disorders can be identified and corrected (such as infection-induced struvite urolith formation); others can be identified but not corrected (such as idiopathic hypercalcemia). In most cats with calcium oxalate urolith formation the underlying etiopathogenesis is not known. A common denominator of all these disorders is that they can from time to time create oversaturation of urine with one or more crystal precursors, resulting in formation of crystals.

BASIC CONCEPTS: In order to develop rational and effective approaches to treatment, abnormalities that promote urolith formation must be identified, with the goal of eliminating or modifying them. It is important, therefore, to understand several basic concepts associated with urolithiasis and the factors that promote urolith formation that may be modified with medical treatment; for example, the state of urinary saturation, modifiers of crystal formation, potential for multiple crystal types, and presence of bacterial infection or urinary obstruction.

RevDate: 2018-02-26
CmpDate: 2018-02-26

Nguyen P, Reynolds B, Zentek J, et al (2017)

Sodium in feline nutrition.

Journal of animal physiology and animal nutrition, 101(3):403-420.

High sodium levels in cat food have been controversial for a long time. Nonetheless, high sodium levels are used to enhance water intake and urine volume, with the main objective of reducing the risk of urolithiasis. This article is a review of current evidence of the putative risks and benefits of high dietary sodium levels. Its secondary aim is to report a possible safe upper limit (SUL) for sodium intake. The first part of the manuscript is dedicated to sodium physiology, with a focus on the mechanisms of sodium homeostasis. In this respect, there is only few information regarding possible interactions with other minerals. Next, the authors address how sodium intake affects sodium balance; knowledge of these effects is critical to establish recommendations for sodium feed content. The authors then review the consequences of changes in sodium intake on feline health, including urolithiasis, blood pressure changes, cardiovascular alterations and kidney disease. According to recent, long-term studies, there is no evidence of any deleterious effect of dietary sodium levels as high as 740 mg/MJ metabolizable energy, which can therefore be considered the SUL based on current knowledge.

RevDate: 2018-11-13
CmpDate: 2017-07-31

Donner J, Kaukonen M, Anderson H, et al (2016)

Genetic Panel Screening of Nearly 100 Mutations Reveals New Insights into the Breed Distribution of Risk Variants for Canine Hereditary Disorders.

PloS one, 11(8):e0161005.

BACKGROUND: The growing number of identified genetic disease risk variants across dog breeds challenges the current state-of-the-art of population screening, veterinary molecular diagnostics, and genetic counseling. Multiplex screening of such variants is now technologically feasible, but its practical potential as a supportive tool for canine breeding, disease diagnostics, pet care, and genetics research is still unexplored.

RESULTS: To demonstrate the utility of comprehensive genetic panel screening, we tested nearly 7000 dogs representing around 230 breeds for 93 disease-associated variants using a custom-designed genotyping microarray (the MyDogDNA® panel test). In addition to known breed disease-associated mutations, we discovered 15 risk variants in a total of 34 breeds in which their presence was previously undocumented. We followed up on seven of these genetic findings to demonstrate their clinical relevance. We report additional breeds harboring variants causing factor VII deficiency, hyperuricosuria, lens luxation, von Willebrand's disease, multifocal retinopathy, multidrug resistance, and rod-cone dysplasia. Moreover, we provide plausible molecular explanations for chondrodysplasia in the Chinook, cerebellar ataxia in the Norrbottenspitz, and familiar nephropathy in the Welsh Springer Spaniel.

CONCLUSIONS: These practical examples illustrate how genetic panel screening represents a comprehensive, efficient and powerful diagnostic and research discovery tool with a range of applications in veterinary care, disease research, and breeding. We conclude that several known disease alleles are more widespread across different breeds than previously recognized. However, careful follow up studies of any unexpected discoveries are essential to establish genotype-phenotype correlations, as is readiness to provide genetic counseling on their implications for the dog and its breed.

RevDate: 2017-04-07
CmpDate: 2017-04-07

Palm CA, WT Culp (2016)

Nephroureteral Obstructions: The Use of Stents and Ureteral Bypass Systems for Renal Decompression.

The Veterinary clinics of North America. Small animal practice, 46(6):1183-1192.

Canine and feline nephroureteral obstruction is a complex disease process that can be challenging to treat. Although the availability of various imaging modalities allows for a straightforward diagnosis to be made in most cases, the decision-making process for when a case should be taken to surgery and the optimal treatment modality that should be used for renal decompression remains controversial. In the following discussion, an overview of the perioperative management of cases with nephroureterolithiasis and nephroureteral obstruction is reviewed, with particular focus on the use of renal decompressive procedures, such as ureteral stenting and subcutaneous ureteral bypass system placement.

RevDate: 2017-08-17
CmpDate: 2017-04-10

Ruggerone B, Marelli SP, Scarpa P, et al (2016)

Genetic evaluation of English bulldogs with cystine uroliths.

The Veterinary record, 179(7):174.

RevDate: 2018-11-13

Wightman PF, Hill KE, Cohen EB, et al (2016)

An imaging investigation of in situ uroliths in hospitalized cats in New Zealand and in the United States.

Veterinary medicine and science, 2(4):255-265.

The submission rates of feline uroliths to laboratories and the composition of uroliths have been reported in studies. The prevalence of uroliths reported on imaging findings has not been published. The objective of this retrospective study was to use imaging data to investigate the anatomical location and the prevalence of macroscopic in situ uroliths in cats. Radiographs, sonograms and imaging reports from two cohorts of cats (from New Zealand (n = 497) and the United States (n = 693)) from 2004-2013 were reviewed for the presence of in situ uroliths. Uroliths were categorized by their location in the lower or upper urinary tract. Radiographic studies were performed on 43% (212/497) of the cats from New Zealand and 50% (349/693) of the cats from the USA. Sonographic studies were performed on 57% (285/497) of the cats from New Zealand and 50% (344/693) of the cats from the USA. The total prevalence of uroliths was 3% in the New Zealand cohort and 13% in the USA cohort. Lower tract urolith prevalence in the New Zealand cohort was 2.4% (5/212) in cats ≤ 6y and 1.1% (3/285) in cats >6y. Upper tract urolith prevalence in the New Zealand cohort was 0.5% (1/212) in cats ≤ 6y and 1.8% (5/285) in cats >6y. Lower tract urolith prevalence in the United States cohort was 6.0% (11/183) in cats ≤ 6y and 2.9% (15/510) in cats >6y. Upper tract urolith prevalence in the United States cohort was 2.7% (5/183) in cats ≤ 6y and 10.2% (52/510) in cats >6y. The prevalence of uroliths in the upper tract or lower tract was low in the New Zealand cohort compared to that of cats in the USA cohort, irrespective of age category. Geographical location may be important when evaluating risk factors for feline urolithiasis.

RevDate: 2018-01-17
CmpDate: 2017-11-20

Changtong C, Peerapen P, Khamchun S, et al (2016)

In vitro evidence of the promoting effect of testosterone in kidney stone disease: A proteomics approach and functional validation.

Journal of proteomics, 144:11-22.

UNLABELLED: Incidence of kidney stone disease in males is 2- to 4-fold greater than in females. This study aimed to determine effects of testosterone on kidney stone disease using a proteomics approach. MDCK renal tubular cells were treated with or without 20nM testosterone for 7days. Cellular proteins were extracted, resolved by 2-DE, and stained with Deep Purple fluorescence dye (n=5 gels derived from 5 independent samples/group). Spot matching, quantitative intensity analysis, and statistics revealed significant changes in levels of nine protein spots after testosterone treatment. These proteins were then identified by nanoLC-ESI-Qq-TOF MS/MS. Global protein network analysis using STRING software revealed α-enolase as the central node of protein-protein interactions. The increased level of α-enolase was then confirmed by Western blotting analysis, whereas immunofluorescence study revealed the increased α-enolase on cell surface and intracellularly. Functional analysis confirmed the potential role of the increased α-enolase in enhanced calcium oxalate monohydrate (COM) crystal-cell adhesion induced by testosterone. Finally, neutralization of surface α-enolase using anti-α-enolase antibody successfully reduced the enhanced COM crystal-cell adhesion to the basal level. Our data provided in vitro evidence of promoting effect of testosterone on kidney stone disease via enhanced COM crystal-cell adhesion by the increased surface α-enolase.

BIOLOGICAL SIGNIFICANCE: The incidence of kidney stone disease in male is 2- to 4-fold greater than in female. One of the possible factors of the male preference is the higher testosterone hormone level. However, precise molecular mechanisms that testosterone plays in kidney stone disease remained unclear. Our present study is the first exploratory investigation on such aspect using a proteomics approach. Our data also provide a novel mechanistic aspect of how testosterone can impact the risk of kidney stone formation (i.e. the discovery that testosterone increases alpha-enolase expression on the surface of renal tubular cells that is responsible, at least in part, for crystal-cell adhesion).

RevDate: 2017-08-17
CmpDate: 2017-03-22

Torres M, Pastor J, Roura X, et al (2016)

Adverse urinary effects of allopurinol in dogs with leishmaniasis.

The Journal of small animal practice, 57(6):299-304.

OBJECTIVE: The objective of this study was to describe the adverse effects of allopurinol on the urinary system during treatment of canine leishmaniasis.

METHODS: Retrospective case series of 42 dogs that developed xanthinuria while receiving allopurinol treatment for leishmaniasis.

RESULTS: Of 320 dogs diagnosed with leishmaniasis, 42 (13%) developed adverse urinary effects. Thirteen (of 42) dogs (31%) developed xanthinuria, renal mineralisation and urolithiasis; 11 (26·2%) showed xanthinuria with renal mineralisation; 9 (21·4%) had xanthinuria with urolithiasis and 9 (21·4%) developed xanthinuria alone. Urinary clinical signs developed in 19 dogs (45·2%).

CLINICAL SIGNIFICANCE: This study demonstrates that urolithiasis and renal mineralisation can occur in dogs receiving allopurinol therapy. Dogs receiving therapy should be monitored for the development of urinary adverse effects from the beginning of treatment.

RevDate: 2018-11-13
CmpDate: 2016-12-13

Hesse A, Hoffmann J, Orzekowsky H, et al (2016)

Canine cystine urolithiasis: A review of 1760 submissions over 35 years (1979-2013).

The Canadian veterinary journal = La revue veterinaire canadienne, 57(3):277-281.

This study reports a retrospective evaluation of epidemiological data from cystine stones of dogs submitted to the Urinary Stone Analysis Center Bonn, Germany, over a period of 35 years. Of the 20 316 uroliths submitted from 1979 to 2013, 1760 were cystine stones. In total, 109 breeds were affected with 16 breeds having an odds ratio > 1.0. Most of the cystine uroliths were retrieved from male dogs, with only 19 female dogs (1.1%) being affected. Percentage of submitted cystine stones amongst all stones decreased significantly over 35 years from 38.9% to 4.4%.

RevDate: 2017-06-06
CmpDate: 2017-06-06

Heilmann RM, Pashmakova M, Lamb JH, et al (2016)

[Subcutaneous ureteral bypass devices as a treatment option for bilateral ureteral obstruction in a cat with ureterolithiasis].

Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere, 44(3):180-188.

A 6-year-old female spayed Domestic Shorthair cat was presented with acute lethargy, dehydration, marked azotemia, metabolic acidosis, left-sided renomegaly, and bilateral hydronephrosis. Ureterolithiasis and ureteral obstruction were suspected based on further diagnostics including abdominal sonography. Medical treatment was not successful. Fluoroscopically guided antegrade pyelography confirmed the diagnosis of bilateral ureteral obstruction due to ureterolithiasis. Subcutaneous ureteral bypass (SUB) devices were placed bilaterally, followed by close patient monitoring. Frequent reassessment of patient parameters and blood work served to adjust the fluid needs of the patient and to ensure proper hydration, correction of azotemia at an appropriate rate, and cardiovascular stability. After significant improvement of all patient parameters within 5 days, the patient was discharged from the hospital. Treatment included a dietary change to reduce the risk of stone formation as well as a phosphorus binder. Clinical and clinicopathologic parameters were unchanged at the 1- and 4- and 7-month rechecks (consistent with IRIS CKD stage II-NP-AP0), and both SUB devices continued to provide unobstructed urine flow. Bilateral placement of subcutaneous ureteral bypass devices may be a safe and potentially effective treatment option for acute bilateral ureteral obstruction in cats with ureterolithiasis. Strict patient monitoring and patient-centered postoperative treatment decisions are crucial to successful treatment outcomes.

RevDate: 2018-11-13
CmpDate: 2016-12-13

Brooks ED, Yi H, Austin SL, et al (2016)

Natural Progression of Canine Glycogen Storage Disease Type IIIa.

Comparative medicine, 66(1):41-51.

Glycogen storage disease type IIIa (GSD IIIa) is caused by a deficiency of glycogen debranching enzyme activity. Hepatomegaly, muscle degeneration, and hypoglycemia occur in human patients at an early age. Long-term complications include liver cirrhosis, hepatic adenomas, and generalized myopathy. A naturally occurring canine model of GSD IIIa that mimics the human disease has been described, with progressive liver disease and skeletal muscle damage likely due to excess glycogen deposition. In the current study, long-term follow-up of previously described GSD IIIa dogs until 32 mo of age (n = 4) and of family-owned GSD IIIa dogs until 11 to 12 y of age (n = 2) revealed that elevated concentrations of liver and muscle enzyme (AST, ALT, ALP, and creatine phosphokinase) decreased over time, consistent with hepatic cirrhosis and muscle fibrosis. Glycogen deposition in many skeletal muscles; the tongue, diaphragm, and heart; and the phrenic and sciatic nerves occurred also. Furthermore, the urinary biomarker Glc4, which has been described in many types of GSD, was first elevated and then decreased later in life. This urinary biomarker demonstrated a similar trend as AST and ALT in GSD IIIa dogs, indicating that Glc4 might be a less invasive biomarker of hepatocellular disease. Finally, the current study further demonstrates that the canine GSD IIIa model adheres to the clinical course in human patients with this disorder and is an appropriate model for developing novel therapies.

RevDate: 2018-11-13
CmpDate: 2016-10-25

Houston DM, Vanstone NP, Moore AE, et al (2016)

Evaluation of 21 426 feline bladder urolith submissions to the Canadian Veterinary Urolith Centre (1998-2014).

The Canadian veterinary journal = La revue veterinaire canadienne, 57(2):196-201.

This study reports emerging trends in feline urolithiasis in Canada during the past 16.8 y, evaluates associations of breed and gender with urolith types, and reports on feline submissions from outside of Canada. Struvite and calcium oxalate uroliths comprised > 90% of all uroliths submitted. In cats, oxalate submissions outnumbered struvite submissions from Canada, Hong Kong, Denmark, and the United Arab Emirates, while Australian struvite submissions outnumbered calcium oxalate submissions. In Canada, the majority of urolith submissions were from domestic cats followed by Himalayan, Persian, and Siamese cats. Males were more likely to form calcium oxalate uroliths and females were more likely to develop struvite uroliths. Compared to domestic short-haired cats, Tonkinese, Burmese, Devon rex, Himalayan, Persian, and Siamese cats were significantly associated with calcium oxalate urolith submission. Egyptian mau, Birman, ocicat, and Siamese breeds were over-represented amongst urate submissions.

RevDate: 2016-11-26
CmpDate: 2016-02-16

Brandenberger-Schenk F, Rothenanger E, Reusch CE, et al (2015)

[Uroliths of dogs in Switzerland from 2003 to 2009].

Schweizer Archiv fur Tierheilkunde, 157(1):41-48.

Information on composition of uroliths collected between 2003 and 2009 from dogs in Switzerland and epidemiologic data of affected dogs are summarised in this paper. Of 490 stones analysed 44% were composed of calcium oxalate, 330% of struvite, 80% of silica, 7% of urate, 3% of cystine, 3% were mixed stones and 1% each were calcium phosphate and xanthine stones. Compared to other dogs, Norwich Terriers, Norfolk Terriers, Miniature Schnauzers, Miniature Pinscher and Yorkshire Terriers had a significantly increased risk to suffer from calcium oxalate stones, Dalmatians and Continental Bulldogs from urate stones and English Bulldogs from cystine stones. No breed had an increased risk of struvite or silica stones. Stones composed of silica were more prevalent in Switzerland compared to other countries and were more common in the eastern part than in the western part of Switzerland. This study shows that there are differences in occurrence and prevalence of uroliths between Switzerland and surveys of other countries.

RevDate: 2018-12-02
CmpDate: 2016-11-01

Li YH, Yu SL, Gan XG, et al (2016)

Externalization of phosphatidylserine via multidrug resistance 1 (MDR1)/P-glycoprotein in oxalate-treated renal epithelial cells: implications for calcium oxalate urolithiasis.

International urology and nephrology, 48(2):175-181.

OBJECTIVES: We investigated the possible involvement of multidrug resistance protein 1 P-glycoprotein (MDR1 P-gp) in the oxalate-induced redistribution of phosphatidylserine in renal epithelial cell membranes.

METHODS: Real-time PCR and western blotting were used to examine MDR1 expression in Madin-Darby canine kidney cells at the mRNA and protein levels, respectively, whereas surface-expressed phosphatidylserine was detected by the annexin V-binding assay.

RESULTS: Oxalate treatment resulted in increased synthesis of MDR1, which resulted in phosphatidylserine (PS) externalization in the renal epithelial cell membrane. Treatment with the MDR1 inhibitor PSC833 significantly attenuated phosphatidylserine externalization. Transfection of the human MDR1 gene into renal epithelial cells significantly increased PS externalization.

CONCLUSIONS: To our knowledge, this study is the first to show that oxalate increases the synthesis of MDR1 P-gp, which plays a key role in hyperoxaluria-promoted calcium oxalate urolithiasis by facilitating phosphatidylserine redistribution in renal epithelial cells.

RevDate: 2018-06-25

Bende B, Kovács KB, Solymosi N, et al (2015)

Characteristics of urolithiasis in the dog population of Hungary from 2001 to 2012.

Acta veterinaria Hungarica, 63(3):323-336.

The objective of this study was to describe the epidemiology of canine urolithiasis in Hungary in order to determine the annual incidence of urolithiasis and to identify breeds at risk for different types of urolithiasis. Data of a total of 2,543 canine uroliths analysed in the laboratory of the Budapest Urolith Centre were evaluated retrospectively from 2001 to 2012. Logistic regression was used to assess odds ratios for the proportion of each affected breed compared to those of crossbreeds. The annual incidence of urolithiasis was evaluated by the number of submissions compared to the estimated number of dogs in the population from which the samples originated. Epidemiologic data revealed a relatively high and increasing proportion of struvite urolithiasis. Statistical analysis of breed predispositions resulted in the detection of breeds not having been reported at risk (e.g. Bernese Mountain dog - struvite, Bichon Frise, Bolognese, Tibetan Terrier - purine, French Bulldog - cystine). Conflicting results were revealed for some other breeds previously described as being affected by certain types of urolithiasis (Chihuahua, Pekingese, Shih Tzu, English Cocker Spaniel). Regardless of the type of urolithiasis, its average cumulative incidence in the dog population of Hungary was found to be 1.76/10,000/year.

RevDate: 2018-11-13
CmpDate: 2016-08-22

Cosgrove L, Hammond G, G Mclauchlan (2015)

Primary portal vein hypoplasia and SLC2A9 mutation associated with urate urolithiasis in a Spanish water dog.

The Canadian veterinary journal = La revue veterinaire canadienne, 56(11):1153-1157.

This report describes a Spanish water dog with an ammonium urate urethrolith which was diagnosed with primary portal vein hypoplasia and was found to be homozygous for the mutated SLC2A9 gene. This is the first Spanish water dog described with the SLC2A9 mutation and the first case of concurrent portal vascular abnormalities and SLC2A9 mutation.

RevDate: 2018-11-13

Furman E, Hooijberg EH, Leidinger E, et al (2015)

Hereditary xanthinuria and urolithiasis in a domestic shorthair cat.

Comparative clinical pathology, 24(6):1325-1329.

A 2-year-old domestic shorthair cat was presented with a history of hematuria, stranguria and intermittent urethral obstruction. Urine sediment showed hematuria, pyuria, and yellow-brown, amorphous and spherical crystals. Upon surgical correction of the obstructed urethra by perineal urethrostomy, many dark yellow to grey, irregular, gravel-like to millet grain-sized uroliths, consisting of 100% xanthine by crystallography were found. The urinary xanthine concentration was high. The cat subsequently developed bilateral nephroliths, recurrent urinary tract infection, and chronic kidney failure. Dietary management with a low-purine diet failed in part due to poor compliance, and the cat was euthanized at 6 years of age. Xanthinuria is rare inborn error of metabolism in cats and other species but should be considered as a differential diagnosis in cases of feline urolithiasis. No associated molecular genetic defect has been elucidated, and management of these cases is difficult. In the absence of calculi for analysis, measuring urinary xanthine concentration can help in diagnosing this metabolic defect.

RevDate: 2018-12-02
CmpDate: 2016-04-05

Cho JG, Gebhart CJ, Furrow E, et al (2015)

Assessment of in vitro oxalate degradation by Lactobacillus species cultured from veterinary probiotics.

American journal of veterinary research, 76(9):801-806.

OBJECTIVE: To culture Lactobacillus spp from veterinary probiotics and measure their in vitro oxalate-degrading capacity.

SAMPLE: 2 commercial veterinary probiotics containing Lactobacillus spp.

PROCEDURES: Lactobacillus spp were cultured anaerobically on selective deMan, Rogosa, Sharpe agar medium and subcultured for speciation by 16S rDNA gene sequencing. Isolates were inoculated into broth containing sodium oxalate (5 mg/L) and incubated anaerobically for 72 hours. An oxalate-degrading isolate of Lactobacillus acidophilus (American Type Culture Collection [ATCC] 53544) was the positive control sample; sterile broth containing a known quantity of sodium oxalate was the negative control sample. Oxalate concentrations were detected with ion chromatography. Oxalate degradation was assessed with Dunnett tests to detect differences in mean oxalate concentration for each isolate, compared with results for the negative control.

RESULTS: Lactobacillus acidophilus, Lactobacillus plantarum, and Lactobacillus casei or Lactobacillus zeae (too closely related to differentiate) were isolated from probiotic 1, and L plantarum was isolated from probiotic 2. Sequencing of the 16S rDNA gene confirmed 100% homology to type species. Lactobacillus acidophilus (ATCC 53544) and L acidophilus from probiotic 1 significantly decreased oxalate concentrations by 85.3 and 161.9 mg/L, respectively. Lactobacillus plantarum from probiotics 1 and 2 significantly increased oxalate concentrations by 56.1 and 36.1 mg/L, respectively. Lactobacillus casei did not alter oxalate concentrations.

Lactobacillus acidophilus isolates significantly reduced oxalate concentrations. In vivo studies are needed to determine whether probiotics containing L acidophilus decrease urine oxalate concentrations and reduce risk of urolith recurrence in dogs with a history of calcium oxalate urolithiasis.

RevDate: 2015-10-29
CmpDate: 2016-08-23

Cinti F, Pisani G, Carusi U, et al (2015)

Urethrotomy of the glans penis in three male dogs with urolithiasis.

The Journal of small animal practice, 56(11):671-674.

Three intact male dogs with stranguria and haematuria caused by uroliths in the penile urethra underwent urethrotomy using a novel surgical approach directly over the caudal part of the os penis because conservative procedures to resolve the obstructions had failed. Haemorrhage was minimal, and the incisions healed rapidly by second intention. Complications did not occur during the 6-month follow-up period. Urethrotomy directly over the os penis is straightforward, associated with few complications and holds promise for the removal of urinary calculi in the penile urethra.

RevDate: 2018-11-13
CmpDate: 2016-04-21

Killilea DW, Westropp JL, Shiraki R, et al (2015)

Elemental Content of Calcium Oxalate Stones from a Canine Model of Urinary Stone Disease.

PloS one, 10(6):e0128374.

One of the most common types of urinary stones formed in humans and some other mammals is composed of calcium oxalate in ordered hydrated crystals. Many studies have reported a range of metals other than calcium in human stones, but few have looked at stones from animal models such as the dog. Therefore, we determined the elemental profile of canine calcium oxalate urinary stones and compared it to reported values from human stones. The content of 19 elements spanning 7-orders of magnitude was quantified in calcium oxalate stones from 53 dogs. The elemental profile of the canine stones was highly overlapping with human stones, indicating similar inorganic composition. Correlation and cluster analysis was then performed on the elemental profile from canine stones to evaluate associations between the elements and test for potential subgrouping based on elemental content. No correlations were observed with the most abundant metal calcium. However, magnesium and sulfur content correlated with the mineral hydration form, while phosphorous and zinc content correlated with the neuter status of the dog. Inter-elemental correlation analysis indicated strong associations between barium, phosphorous, and zinc content. Additionally, cluster analysis revealed subgroups within the stones that were also based primarily on barium, phosphorous, and zinc. These data support the use of the dog as a model to study the effects of trace metal homeostasis in urinary stone disease.

RevDate: 2016-12-30
CmpDate: 2016-10-12

Liu Y, Xu H, Zhong W, et al (2015)

Organic Selenium Alleviated the Formation of Ethylene Glycol-Induced Calcium Oxalate Renal Calculi by Improving Osteopontin Expression and Antioxidant Capability in Dogs.

Biological trace element research, 168(2):392-400.

Twenty one-year-old local male dogs were randomly assigned into four groups (five dogs per group). The control and the ethylene glycol (EG) groups were fed basal diets without and with EG, and the EG+sodium selenite (EG+SS) and EG+selenium yeast (EG+SY) groups were fed basal diets with EG containing SS and SY, respectively. Blood, urine, and renal samples were taken after 18 weeks of feeding. The results showed that compared with the control group, the serum calcium levels and antioxidase activities significantly decreased in the EG group. Serum creatinine, urea nitrogen, and malondialdehyde (MDA) levels and urine calcium and oxalate levels significantly increased. Calcium oxalate crystal deposition and osteopontin (OPN) messenger RNA and protein expression in the renal tissues significantly increased. These changes above in the EG group were reversed within limits by adding selenium in the diets (both EG+SS and EG+SY groups). Further, compared with the EG+SS group, the EG+SY group showed better effects in decreasing the formation of EG-induced calcium oxalate renal calculi and OPN expression and improving antioxidant capability in dogs. It indicates that organic selenium has the potential value to alleviate the formation of EG-induced calcium oxalate renal calculi.

RevDate: 2016-11-25
CmpDate: 2016-04-19

Pineda C, Aguilera-Tejero E, Raya AI, et al (2015)

Effects of two calculolytic diets on parameters of feline mineral metabolism.

The Journal of small animal practice, 56(8):499-504.

OBJECTIVES: To evaluate the influence of two feline calculolytic diets on selected parameters of mineral metabolism.

MATERIALS AND METHODS: Two dry commercial diets designed for struvite urolith dissolution were evaluated in 14 cats. The study was designed as a two-sequence, four-period crossover protocol with a baseline period, two 60-day "run-in" periods in which calculolytic diets (Diet 1 and Diet 2) were fed and one 30-day "wash-out" period. Data are expressed as median (range).

RESULTS: Feeding the calculolytic diets for two months did not alter plasma concentrations of calcium, phosphorus, magnesium and parathyroid hormone. A significant (P < 0.05 in each case) decline in calcitriol was observed after administering both diets from 236.4 (122.4-429.6) to 170.4 (108.0-394.3) pmol/L (Diet 1) and from 278.4 (153.6-492.0) to 177.1 (87.6-392.4) pmol/L (Diet 2). Cats fed Diet 1 showed a significant increase in urine calcium concentration (from 0.3 (0.2-0.5) to 0.4 (0.3-0.7) mmol/L). Magnesium concentration in urine was significantly increased with both diets, from 1.4 (0.1-1.7) to 1.5 (1.3-2.4) mmol/L (Diet 1) and from 1.1 (0.4-1.9) to 2.0 (0.1-3.1) mmol/L (Diet 2).

CLINICAL SIGNIFICANCE: Both diets resulted in an increased urinary concentration of magnesium, through different mechanisms: urine acidification (Diet 1) and increased sodium load (Diet 2).

RevDate: 2015-05-24
CmpDate: 2016-02-12

Bartges JW, AJ Callens (2015)


The Veterinary clinics of North America. Small animal practice, 45(4):747-768.

Uroliths occur commonly in the bladder and/or urethra of dogs and cats and can be life-threatening if urethral obstruction occurs. The majority of uroliths are composed of struvite or calcium oxalate; however, other minerals such as urate and cystine occur. Uroliths may be composed of more than one mineral. Some uroliths are amenable to medical dissolution (eg, struvite, urate, and cystine) while others (eg, calcium oxalate) are not. Medical management involves decreasing urine saturation for the minerals that form uroliths.

RevDate: 2018-11-13
CmpDate: 2016-06-22

Li JY, Liu J, Jiang J, et al (2015)

Calcium oxalate calculi-induced clusterin expression in kidney.

Urolithiasis, 43(5):411-418.

The aim of the study was to investigate clusterin expression in the kidney and evaluate the urine clusterin level in the kidney stone formers. (1) In vitro, we treated the Madin-Darby canine kidney (MDCK) cell line with different concentrations of calcium oxalate (CaOx), and then the clusterin protein expression in the cells was evaluated by Western blotting. (2) Kidney stone patients who received percutaneous nephrolithotomy were enrolled in our study. Urine samples were collected before surgery, the kidney punctured to obtain kidney tissue guided by ultrasound intraoperatively. Clusterin expression in the human kidney tissue was evaluated by immunochemistry. The urine clusterin level was determined by enzyme-linked immunosorbent assay. Non-kidney disease subjects were chosen as controls. In vitro, the clusterin expression was up-regulated in the MDCK cells induced by CaOx. The study included 49 patients and 41 non-kidney disease subjects. All calculi were composed of calcium oxalate monohydrate or calcium oxalate dihydrate and a few also contained protein or uric acid. Mean ± SD urine clusterin level was 17.47 ± 18.61 μg/ml in patients, and 3.31 ± 5.42 μg/ml in non-kidney disease subjects, respectively (p < 0.001). Immunohistochemistry revealed the clusterin was located in the cytoplasm of the renal distal and collecting tubular epithelial cells. Also the tissue clusterin expression increased significantly in the kidney stone formers compared to the control groups (p = 0.001). CaOx could induce clusterin expression in renal tubular cells, and increase clusterin levels in the kidney and urine from the kidney stone formers.

RevDate: 2018-11-13
CmpDate: 2016-02-05

Chi T, Kim MS, Lang S, et al (2015)

A Drosophila model identifies a critical role for zinc in mineralization for kidney stone disease.

PloS one, 10(5):e0124150.

Ectopic calcification is a driving force for a variety of diseases, including kidney stones and atherosclerosis, but initiating factors remain largely unknown. Given its importance in seemingly divergent disease processes, identifying fundamental principal actors for ectopic calcification may have broad translational significance. Here we establish a Drosophila melanogaster model for ectopic calcification by inhibiting xanthine dehydrogenase whose deficiency leads to kidney stones in humans and dogs. Micro X-ray absorption near edge spectroscopy (μXANES) synchrotron analyses revealed high enrichment of zinc in the Drosophila equivalent of kidney stones, which was also observed in human kidney stones and Randall's plaques (early calcifications seen in human kidneys thought to be the precursor for renal stones). To further test the role of zinc in driving mineralization, we inhibited zinc transporter genes in the ZnT family and observed suppression of Drosophila stone formation. Taken together, genetic, dietary, and pharmacologic interventions to lower zinc confirm a critical role for zinc in driving the process of heterogeneous nucleation that eventually leads to stone formation. Our findings open a novel perspective on the etiology of urinary stones and related diseases, which may lead to the identification of new preventive and therapeutic approaches.

RevDate: 2015-05-02
CmpDate: 2016-03-04

Allen HS, Swecker WS, Becvarova I, et al (2015)

Associations of diet and breed with recurrence of calcium oxalate cystic calculi in dogs.

Journal of the American Veterinary Medical Association, 246(10):1098-1103.

OBJECTIVE: To evaluate the long-term risk of recurrence of calcium oxalate (CaOx) cystic calculi in dogs of various breeds fed 1 of 2 therapeutic diets.

DESIGN: Retrospective cohort study. Animals-135 dogs with a history of CaOx cystic calculi.

PROCEDURES: Medical records for 4 referral hospitals were searched to identify dogs that had had CaOx cystic calculi removed. Owners were contacted and medical records evaluated to obtain information on postoperative diet, recurrence of signs of lower urinary tract disease, and recurrence of cystic calculi. Dogs were grouped on the basis of breed (high-risk breeds, low-risk breeds, and Miniature Schnauzers) and diet fed after removal of cystic calculi (diet A, diet B, and any other diet [diet C], with diets A and B being therapeutic diets formulated to prevent recurrence of CaOx calculi).

RESULTS: Breed group was a significant predictor of calculi recurrence (as determined by abdominal radiography or ultrasonography), with Miniature Schnauzers having 3 times the risk of recurrence as did dogs of other breeds. Dogs in diet group A had a lower prevalence of recurrence than did dogs in diet group C, but this difference was not significant in multivariable analysis.

Results indicated that Miniature Schnauzers had a higher risk of CaOx cystic calculi recurrence than did dogs of other breeds. In addition, findings suggested that diet may play a role in decreasing recurrence, but future prospective studies are needed to validate these observations.

RevDate: 2018-12-02
CmpDate: 2016-02-08

Nevins JR, Mai W, E Thomas (2015)


Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association, 56(4):439-447.

Urethral obstruction is a life-threatening form of feline lower urinary tract disease. Ultrasonographic risk factors for reobstruction have not been previously reported. Purposes of this retrospective cross-sectional study were to describe urinary tract ultrasound findings in cats following acute urethral obstruction and determine whether ultrasound findings were associated with reobstruction. Inclusion criteria were a physical examination and history consistent with urethral obstruction, an abdominal ultrasound including a full evaluation of the urinary system within 24 h of hospitalization, and no cystocentesis prior to ultrasound examination. Medical records for included cats were reviewed and presence of azotemia, hyperkalemia, positive urine culture, and duration of hospitalization were recorded. For medically treated cats with available outcome data, presence of reobstruction was also recorded. Ultrasound images were reviewed and urinary tract characteristics were recorded. A total of 87 cats met inclusion criteria. Common ultrasound findings for the bladder included echogenic urine sediment, bladder wall thickening, pericystic effusion, hyperechoic pericystic fat, and increased urinary echoes; and for the kidneys/ureters included pyelectasia, renomegaly, perirenal effusion, hyperechoic perirenal fat, and ureteral dilation. Six-month postdischarge outcomes were available for 61 medically treated cats and 21 of these cats had reobstruction. No findings were associated with an increased risk of reobstruction. Ultrasonographic perirenal effusion was associated with severe hyperkalemia (P = 0.009, relative risk 5.75, 95% confidence interval [1.54-21.51]). Findings supported the use of ultrasound as an adjunct for treatment planning in cats presented with urethral obstruction but not as a method for predicting risk of reobstruction.

RevDate: 2015-05-24
CmpDate: 2016-02-12

Raditic DM (2015)

Complementary and integrative therapies for lower urinary tract diseases.

The Veterinary clinics of North America. Small animal practice, 45(4):857-878.

Consumer use of integrative health care is growing, but evidence-based research on its efficacy is limited. Research of veterinary lower urinary tract diseases could be translated to human medicine because veterinary patients are valuable translational models for human urinary tract infection and urolithiasis. An overview of complementary therapies for lower urinary tract disease includes cranberry supplements, mannose, oral probiotics, acupuncture, methionine, herbs, or herbal preparations. Therapies evaluated in dogs and cats, in vitro canine cells, and other relevant species, in vivo and in vitro, are presented for their potential use as integrative therapies for veterinary patients and/or translational research.

RevDate: 2015-02-12
CmpDate: 2016-03-01

G Caporali EH, Phillips H, Underwood L, et al (2015)

Risk factors for urolithiasis in dogs with congenital extrahepatic portosystemic shunts: 95 cases (1999-2013).

Journal of the American Veterinary Medical Association, 246(5):530-536.

OBJECTIVE: To identify risk factors for urolithiasis in dogs with congenital extrahepatic portosystemic shunts (EHPSSs) and to determine whether portoazygos shunts were associated with increased risk of urolithiasis at the initial evaluation for EHPSS.

DESIGN: Retrospective case series.

ANIMALS: Dogs (n = 95) with EHPSSs confirmed via CT angiography or surgery.

PROCEDURES: Medical records from 1999 to 2013 were reviewed. Variables of interest included signalment, previous medical management, and results of urinalysis, urolith analyses, and diagnostic imaging. Univariable and multivariable logistic regression analyses for assessment of risk factors for urolithiasis at the time of initial EHPSS evaluation were performed.

RESULTS: The dogs' median age was 0.9 years (range, 0.2 to 12.6 years). Among the 95 dogs, 27 (28.4%) and 68 (71.6%) had portoazygos and portocaval shunts, respectively. Urinalysis was performed for 79 (83.2%) dogs, 29 (36.7%) of which had crystalluria (mainly ammonium urate and struvite crystals). Uroliths were present in 34 of 95 (35.8%) dogs; 16 of 17 uroliths analyzed were composed of ammonium urate. Portoazygos shunts were not associated with significantly increased odds of urolithiasis at the time of the initial evaluation for EHPSS. However, the odds of urolithiasis was significantly increased for male dogs, older dogs, and dogs that received previous medical treatment.

In dogs with EHPSS, shunt morphology was not associated with increased odds of urolithiasis at the initial evaluation. Male dogs, older dogs, and dogs having received medical management for EHPSS prior to initial evaluation should be considered at increased risk for development of urolithiasis.

RevDate: 2018-11-13
CmpDate: 2016-01-28

de Cógáin MR, Linnes MP, Lee HJ, et al (2015)

Aqueous extract of Costus arabicus inhibits calcium oxalate crystal growth and adhesion to renal epithelial cells.

Urolithiasis, 43(2):119-124.

Costus arabicus L. (C. arabicus) is a plant used in Brazilian folk medicine to treat urolithiasis; however, its mechanism of action is unclear. The interaction between calcium oxalate (CaOx) crystals and the renal epithelium is important in calculogenesis, and compounds that modulate this process represent candidate therapeutic agents for stone prevention. Therefore, we assessed the inhibitory activity of C. arabicus on CaOx crystallization and the interaction of CaOx crystals with the renal epithelium. A seeded CaOx monohydrate (COM) crystallization system was used to study the effect of C. arabicus on crystal growth. Madin Darby canine kidney (MDCK) cells were used to study [(14)C] COM crystal adhesion in the presence and absence of an aqueous extract of C. arabicus. Cytotoxicity was assessed using a tetrazolium (MTS) cell proliferation assay. Aqueous extracts of C. arabicus decreased crystal growth in a concentration-dependent fashion. Precoating crystals with C. arabicus extract prevented their adhesion to MDCK cells, while pretreating cells did not show any effect. The extract was non-cytotoxic in concentrations of at least 1 mg/ml, which is likely above concentrations achievable in the urine following oral ingestion and excretion. No inhibitory activity was found in hexane, methyl chloride, n-butanol and ethyl acetate fractions of an ethanol extract of the herb. An aqueous extract of C. arabicus may disrupt calculogenesis by interacting with CaOx crystal surfaces. Activity was present in the aqueous extract; therefore, this agent may be bioavailable when administered orally. Fractionation results suggest that the active agent might be a polar polysaccharide. Further identification and characterization along these lines may be warranted.

RevDate: 2016-10-20
CmpDate: 2016-03-07

Uchiumi Davis K, CB Grindem (2015)

What is your diagnosis? Urine crystals from a dog.

Veterinary clinical pathology, 44(2):331-332.

RevDate: 2018-11-13
CmpDate: 2015-10-19

Furrow E, Patterson EE, Armstrong PJ, et al (2015)

Fasting urinary calcium-to-creatinine and oxalate-to-creatinine ratios in dogs with calcium oxalate urolithiasis and breed-matched controls.

Journal of veterinary internal medicine, 29(1):113-119.

BACKGROUND: Hypercalciuria and hyperoxaluria are risk factors for calcium oxalate (CaOx) urolithiasis, but breed-specific reports of urinary metabolites and their relationship with stone status are lacking.

OBJECTIVE: To compare urinary metabolites (calcium and oxalate) and blood ionized calcium (iCa) concentrations between CaOx stone formers and breed-matched stone-free controls for the Miniature Schnauzer, Bichon Frise, and Shih Tzu breeds.

ANIMALS: Forty-seven Miniature Schnauzers (23 cases and 24 controls), 27 Bichons Frise (14 cases and 13 controls), and 15 Shih Tzus (7 cases and 8 controls).

METHODS: Prospective study. Fasting spot urinary calcium-to-creatinine and oxalate-to-creatinine ratios (UCa/Cr and UOx/Cr, respectively) and blood iCa concentrations were measured and compared between cases and controls within and across breeds. Regression models were used to test the effect of patient and environmental factors on these variables.

RESULTS: UCa/Cr was higher in cases than controls for each of the 3 breeds. In addition to stone status, being on a therapeutic food designed to prevent CaOx stone recurrence was associated with higher UCa/Cr. UOx/Cr did not differ between cases and controls for any of the breeds. Blood iCa was higher in cases than controls in the Miniature Schnauzer and Bichon Frise breeds and had a moderate correlation with UCa/Cr.

Hypercalciuria is associated with CaOx stone status in the Miniature Schnauzer, Bichon Frise, and Shih Tzu breeds. UOx/Cr did not correlate with stone status in these 3 breeds. These findings may influence breed-specific stone prevention recommendations.

RevDate: 2018-11-14

Loftus JP, JJ Wakshlag (2015)

Canine and feline obesity: a review of pathophysiology, epidemiology, and clinical management.

Veterinary medicine (Auckland, N.Z.), 6:49-60.

Canine and feline obesity rates have reached pandemic proportions and are similar to those in humans, with approximately 30%-40% of dogs and cats being overweight to obese. Obesity has been associated with other health problems, including osteoarthritis, renal disease, skin disease, insulin resistance, and neoplasia in dogs, while in cats obesity is associated with dermatological issues, diabetes mellitus, neoplasia, and urolithiasis. The health issues appear to be slightly different across the two species, which may be due to some inherent differences in the hormonal milieu involved in obesity that differs between the dog and the cat. In this review, we discuss the complicated nature of the pathogenesis of obesity, the hormonal stimulus for orexigenic and anorexigenic behavior, adipose tissue as an endocrine organ, and most importantly, clinical management of the number one disease in canine and feline medicine.

RevDate: 2018-11-13
CmpDate: 2015-10-19

Mizukami K, Raj K, U Giger (2015)

Feline cystinuria caused by a missense mutation in the SLC3A1 gene.

Journal of veterinary internal medicine, 29(1):120-125.

BACKGROUND: Cystinuria is an inherited metabolic disease that is relatively common in dogs, but rare in cats and is characterized by defective amino acid reabsorption, leading to cystine urolithiasis.

OBJECTIVES: The aim of this study was to report on a mutation in a cystinuric cat.

ANIMALS: A male domestic shorthair (DSH) cat with cystine calculi, 11 control cats from Wyoming, and 54 DSH and purebred control cats from elsewhere in the United States.

METHODS: Exons of the SLC3A1 gene were sequenced from genomic DNA of the cystinuric cat and a healthy cat. Genetic screening for the discovered polymorphisms was conducted on all cats.

RESULTS: A DSH cat showed stranguria beginning at 2 months of age, and cystine calculi were removed at 4 months of age. The cat was euthanized at 6 months of age because of neurological signs possibly related to arginine deficiency. Twenty-five SLC3A1 polymorphisms were observed in the sequenced cats when compared to the feline reference sequence. The cystinuric cat was homozygous for 5 exonic and 8 noncoding SLC3A1 polymorphisms, and 1 of them was a unique missense mutation (c.1342C>T). This mutation results in a deleterious amino acid substitution (p.Arg448Trp) of a highly conserved arginine residue in the rBAT protein encoded by the SLC3A1 gene. This mutation was found previously in cystinuric human patients, but was not seen in any other tested cats.

This study is the first report of an SLC3A1 mutation causing cystinuria in a cat, and could be used to characterize other cystinuric cats at the molecular level.

RevDate: 2018-12-02
CmpDate: 2015-07-08

Friedlander JI, Antonelli JA, Beardsley H, et al (2014)

A novel device to prevent stone fragment migration during percutaneous lithotripsy.

Journal of endourology, 28(12):1395-1398.

PURPOSE: We developed a novel device to capture stones in vivo in an enclosed bag (PercSac) to prevent dispersion of stone fragments during percutaneous nephrolithotomy (PCNL) or cystolitholapaxy. We report on our initial feasibility trials of the PercSac device.

MATERIALS AND METHODS: PercSac consists of a specially designed polyethylene bag that is fitted over the shaft of a rigid nephroscope. The bag is used to first entrap the target stone, then tighten around it to allow fragmentation within the bag. Matched pairs of 10 canine bladder stones (2.5 cm maximum diameter) were fragmented in a human bladder model using the CyberWand (Olympus America, Inc.), and the procedure was assessed for markers of efficiency and effectiveness.

RESULTS: Median time to entrap the stone within the PercSac was 67 seconds (range 51-185 sec). Median time for stone fragmentation was significantly shorter with the PercSac than without (182.0 sec [range 108-221] vs 296.5 sec [range 226-398], P=0.004). Overall, however, there was no significant difference in the total time to entrap and fragment the stones between the two groups. A stone-free state was not achieved for any trial without the PercSac, while 9 of 10 trials with the PercSac resulted in a stone-free state.

CONCLUSIONS: Use of the PercSac in conjunction with stone fragmentation has the potential to reduce the occurrence of residual fragments after PCNL or cystolitholapaxy. Further in vitro testing in a kidney model is planned.

RevDate: 2018-12-02
CmpDate: 2014-11-18

Proença LM, J Mayer (2014)

Prescription diets for rabbits.

The veterinary clinics of North America. Exotic animal practice, 17(3):485-502.

Dietary management can be used with drug therapy for the successful treatment of many diseases. Therapeutic nutrition is well-recognized in dogs and cats and is beginning to increase among other pet species, including rabbits. The nutritional component of some rabbit diseases (eg, urolithiasis) is not completely understood, and the clinician should evaluate the use of prescription diets based on the scientific literature and individual needs. Long-term feeding trials are needed to further evaluate the efficacy of prescription diets in rabbits. Prescription diets are available for selected diseases in rabbits, including diets for immediate-term, short-term, and long-term management.

RevDate: 2017-11-16
CmpDate: 2015-04-16

Larsen JA, Owens TJ, AJ Fascetti (2014)

Nutritional management of idiopathic epilepsy in dogs.

Journal of the American Veterinary Medical Association, 245(5):504-508.

RevDate: 2014-08-14
CmpDate: 2015-09-14

Dorsch R, Remer C, Sauter-Louis C, et al (2014)

Feline lower urinary tract disease in a German cat population. A retrospective analysis of demographic data, causes and clinical signs.

Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere, 42(4):231-239.

OBJECTIVE: To investigate epidemiologic data, clinical signs, results of urinalysis and causes of lower urinary tract disease in a German veterinary hospital population of cats and to determine if the demographic data, history, clinical signs and urinalysis results correlate with a particular etiology.

MATERIALS AND METHODS: Cats presented with signs of feline lower urinary tract disease (FLUTD) with a documented history and physical examination, a complete urinalysis (urine specific gravity, urine dipstick and sediment, urine culture) of urine obtained by cystocentesis or catheterization, and diagnostic imaging of the urinary tract were included into the study. Cats that had received a previous treatment during the same episode of FLUTD were excluded.

RESULTS: A total of 302 cats were included into the study. Cats with FLUTD presented throughout the seasons with similar frequency. The most common diagnosis was feline idiopathic cystitis (FIC) (55.0%), followed by bacterial urinary tract infection (UTI) (18.9%), urethral plug (10.3%) and urolithiasis (7.0%). Urethral obstruction was significantly more frequent in cats with FIC than in cats with UTI. Cats with FIC and urethral plugs were significantly younger and had significantly higher body weights than cats with UTI and neoplasia. FIC and urethral plugs were significantly more common causes of FLUTD in cats younger than 10 years compared to cats that were 10 years or older (65.2% versus [vs.] 35.8% and 13.3% vs. 3.0%), while the incidences of UTI and neoplasia increased with age (12.9% vs. 41.8% and 1.0% vs. 13.4%).

FIC and UTI are the most common diagnoses in cats with FLUTD, with a significant age-related difference in incidence.

RevDate: 2015-11-19
CmpDate: 2015-10-19

Paßlack N, Burmeier H, Brenten T, et al (2014)

Short term effects of increasing dietary salt concentrations on urine composition in healthy cats.

Veterinary journal (London, England : 1997), 201(3):401-405.

High dietary salt (NaCl) concentrations are assumed to be beneficial in preventing the formation of calcium oxalate (CaOx) uroliths in cats, since increased water intake and urine volume have been observed subsequent to intake. In human beings, dietary NaCl restriction is recommended for the prevention of CaOx urolith formation, since high NaCl intake is associated with increased urinary Ca excretion. The aim of the present study was to clarify the role of dietary NaCl in the formation of CaOx uroliths in cats. Eight cats received four diets that differed in Na and Cl concentrations (0.38-1.43% Na and 0.56-2.52% Cl dry matter, DM). Each feeding period consisted of a 21 day adaptation period, followed by a 7 day sampling period for urine collection. Higher dietary NaCl concentrations were associated with increased urine volume and renal Na excretion. Urinary Ca concentration was constant, but renal Ca excretion increased from 0.62 to 1.05 mg/kg bodyweight (BW)/day with higher dietary NaCl concentrations (P ≤ 0.05). Urinary oxalate (Ox), citrate, P and K concentrations decreased when NaCl intake was high (P ≤ 0.05), and urinary pH was low in all groups (6.33-6.45; P > 0.05). Relative supersaturation of CaOx in the urine was unaffected by dietary NaCl concentrations. In conclusion, the present study demonstrated several beneficial effects of high dietary NaCl intake over a relatively short time period. In particular, urinary Ca concentration remained unchanged because of increased urine volume. Decreased urinary Ox concentrations might help to prevent the formation of CaOx uroliths, but this should be verified in future studies in diseased or predisposed cats.

RevDate: 2014-06-09
CmpDate: 2015-01-28

Okafor CC, Lefebvre SL, Pearl DL, et al (2014)

Risk factors associated with calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

Preventive veterinary medicine, 115(3-4):217-228.

Calcium oxalate urolithiasis results from the formation of aggregates of calcium salts in the urinary tract. Difficulties associated with effectively treating calcium oxalate urolithiasis and the proportional increase in the prevalence of calcium oxalate uroliths relative to other urolith types over the last 2 decades has increased the concern of clinicians about this disease. To determine factors associated with the development of calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States, a retrospective case-control study was performed. A national electronic database of medical records of all dogs evaluated between October 1, 2007 and December 31, 2010 at 787 general care veterinary hospitals in the United States was reviewed. Dogs were selected as cases at the first-time diagnosis of a laboratory-confirmed urolith comprised of at least 70% calcium oxalate (n=452). Two sets of control dogs with no history of urolithiasis diagnosis were randomly selected after the medical records of all remaining dogs were reviewed: urinalysis examination was a requirement in the selection of one set (n=1808) but was not required in the other set (n=1808). Historical information extracted included urolith composition, dog's diet, age, sex, neuter status, breed size category, hospital location, date of diagnosis, and urinalysis results. Multivariable analysis showed that the odds of first-time diagnosis of calcium oxalate urolithiasis were significantly (P<0.05) greater for dogs<7 years, males (OR: 7.77, 95% CI: 4.93-12.26), neutered (OR: 2.58, 1.44-4.63), toy- vs. medium-sized breeds (OR: 3.15, 1.90-5.22), small- vs. medium-sized breeds (OR: 3.05, 1.83-5.08), large- vs. medium-sized breeds (OR: 0.05, 0.01-0.19), and those with a diagnosis of cystitis within the previous year (OR: 6.49, 4.14-10.16). Urinary factors significantly associated with first-time diagnosis of calcium oxalate urolithiasis were acidic vs. basic pH (OR: 1.94, 1.22-3.10), presence of RBCs (OR: 6.20, 3.91-9.83) or WBCs (OR: 1.62, 1.03-2.54), and protein concentration>30 mg/dL (OR: 1.55, 1.04-2.30). Patient demographics and urinalysis results are important factors that can support risk assessment and early identification of canine oxalate urolithiasis. Therefore, periodic urolith screening and monitoring of urine parameters should be encouraged for dogs at risk of developing these uroliths.

RevDate: 2014-04-28
CmpDate: 2014-12-08

Fleischhacker S, Horstmann C, Hartmann K, et al (2014)

Carbonate apatite nephrolithiasis associated with Corynebacterium urealyticum urinary tract infection in a dog.

Australian veterinary journal, 92(5):161-165.

BACKGROUND: Urinary tract infections caused by Corynebacterium urealyticum are uncommon in veterinary medicine. Encrusted cystitis, encrusted pyelitis and uroliths have been described as complications in humans, but only encrusted cystitis and cystoliths have been reported in dogs so far. Because C. urealyticum is usually resistant to all standard antibacterial drugs, antimicrobial treatment and elimination of this microorganism are challenging.

CASE REPORT: An 11-month-old female spayed mixed-breed dog was evaluated because of a C. urealyticum urinary tract infection, mineralisation within both renal pelvises and failure of antimicrobial treatment. Physical examination, haematology and biochemistry were unremarkable. Radiographic and ultrasonographic examinations confirmed bilateral nephrolithiasis. Voided uroliths were composed of 100% carbonate apatite. Urinalysis was indicative of bacterial infection. Aerobic culture of the urine and 16S rRNA sequencing identified significant growth of C. urealyticum and susceptibility testing revealed sensitivity to only vancomycin and linezolid.

CONCLUSION: Treatment with the oxazolidinone antibacterial, linezolid, in combination with a urine-acidifying diet resulted in elimination of this multiresistant microorganism and complete resolution of nephrolithiasis.


RJR Experience and Expertise


Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.


Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.


Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.


Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.


While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.


Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.


Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.


Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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Urolithioasis is a surprising common problem in make dogs and cats. An undiagnosed and untreated acute attach involving urethral blockage causes severe pain and can be lethal within dats. Complete obstruction causes uremia within 36–48 hr, which leads to depression, anorexia, vomiting, diarrhea, dehydration, coma, and death within ~72 hr. Urethral obstruction is an emergency condition, and treatment should begin immediately. Familiarity with the problem and its symptoms could save your pet's life. I know, because it saved mine: One of my long-term pets—a cat named Leonard—struggled with urolithiasis most of his life. For many years, it was possible to control the problem with dietary medications. Ultimately, however, he required surgery, which was a success and allowed his to live into a comfortable old age. R. Robbins

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Collection of publications by R J Robbins

Reprints and preprints of publications, slide presentations, instructional materials, and data compilations written or prepared by Robert Robbins. Most papers deal with computational biology, genome informatics, using information technology to support biomedical research, and related matters.

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Curriculum Vitae for R J Robbins

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Curriculum Vitae for R J Robbins

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