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[Health Class] Diagnosis and Treatment of Urinary System Stones

2021-08-27 / 690 Read

Urinary stone formation factors: the amount of salt in the urine Sufficiently high levels, sufficient time for urine in the urinary tract, suitable pH, core or parent nucleus for crystal formation, and supersaturated urine. In some cases, supersaturated urine can also develop due to decreased renal tubular reabsorption or increased urine content of metabolites from bacterial infection.

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Stone formation theory: 1. According to the precipitation-crystallization theory, supersaturated urine is the main reason for the formation of parent nucleus and the growth of stones. The higher the concentration of supersaturated urine, the higher the probability of crystal formation. 2. Mother nucleus theory, some organic matter in urine will promote the formation of early parent nucleus of calculi.

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● Magnesium ammonium phosphate stones

Magnesium ammonium phosphate stones, also known as struvite, are the most common stones in dogs. Canine urinary tract infection is an important condition for the formation of struvite, the alkalinization of urine. Most struvite stones in cats form in the absence of a urinary tract infection. The higher the degree of supersaturation in the urine, the more likely it is to occur.

● Calcium oxalate calculi

Calcium oxalate calculi include excessive calcium ion concentration in urine, excessive urinary oxalic acid, and excessive urinary uric acid.

When the pH of urine is above 6.5, the solubility of calcium oxalate will increase, and when the pH of urine is lower than 6.5, calcium oxalate will be precipitated.

● Urate stones

Most urate stones are ammonium urate. Dalmatiandogs and some Englishbullsdogs Defects in the liver's ability to transfer uric acid produce less urea resulting in increased levels of uric acid in the urine. Hence the high incidence. Urinary tract infections, especially elbow infections by urease-producing bacteria, increase ammonia levels in the urine, promoting the formation of ammonium urate stones. Acidic urine favors the formation of urate crystals, while alkaline urine favors the formation of ammonium diurate crystals.

● Silicate stones

Silicate stones are often polygonal, and polygonal stones are all silicate stones. Wheat bran and soybean hulls are high in silicates. Alkaline urine can promote the dissolution of silicate, and silicate stones can irritate the urethral mucosa and cause secondary urinary tract infection.

● Cystine stones

The main cause of cystine stones is cystinuria caused by hereditary renal tubular transport dysfunction. Cystine stones appear in acidified urine.

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A condition in which stones are present in the kidneys. Dogs have an incidence of only 5 to 10%. The incidence is lower in cats.

【Etiology】

1. During nephritis, struvite nephrolithiasis is prone to occur.

2. Dogs with defective amino acid reabsorption are susceptible to cystine-type nephrolithiasis.

3. Generally does not affect kidney function but may become a place for bacterial infection.

【Clinical symptoms】

Most of them have no clinical symptoms. hematuria. Painful urination. Abdominal pain in the kidney area. Kidney enlargement. Bun, cre level increased. Urinary tract infection, etc.

【Diagnosis】

1. Radiology or/and ultrasonography 2. Evaluation of stone structure in renal function phase.

【Treatment】

A. Nephrectomy, pyelotomy or nephrolithotomy can be performed.

B. Surgery can seriously affect the function of the operated kidney in the short term (and possibly in the long term).

C. For bilateral nephrolithiasis, it can be surgically removed at intervals of 2-4 weeks.

D. Qualitative analysis should be performed on the removal of stones.

Medication: A. Medication is the best option for dogs prone to urinary tract infections and suspected mineral kidney stones. (See below)

Calcium oxalate kidney stones cannot be dissolved by drug therapy.

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Ureteral stones form in the kidneys, enter the ureter, and stay temporarily or permanently.

【Causes】

Ureteral stones come from the kidneys.

【Clinical Symptoms】

The clinical symptoms of ureteral calculi obstruction are affected by the acute degree, completeness, duration, and unilateral or bilateral ureteral obstruction.

1. Abdominal and/or low back pain, hematuria, vomiting, restlessness, depression, abdominal wall tension, sensitive palpation, large kidney (hydronephrosis).

2. Obstruction on both sides or on one side accompanied by decreased renal function on the opposite side, accompanied by uremia.

3. If the ureteral calculi are successfully discharged to the bladder, the symptoms are transient.

4. Some ureteral stones have no symptoms.

【Diagnosis】

Radiology and ultrasonography

Descent urography. Contrast media can stay in the kidney for prolonged periods of time or accumulate at the obstruction.

【Treatment】

A. Prevent urinary tract obstruction.

B. Protect kidney function.

C. Control urinary tract infections.

D. Control clinical symptoms.

e. Renal function still exists, and ureteral calculi should be removed surgically as much as possible.

f. The renal function of one side is severely damaged and the contralateral renal function is normal, and unilateral renal ureterectomy can be performed.