Journal of veterinary internal medicine · 2024
Medical dissolution of presumptive upper urinary tract struvite uroliths in 6 dogs (2012-2018).
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Manoharan Sindumani A, Berent Allyson C, Weisse Chick W, Purdon Kira, Bagley Demetrius
Аннотация
BACKGROUND: Minimally invasive approaches are the standard for treatment of upper urinary tract uroliths in humans.
OBJECTIVE: To describe the medical dissolution of upper urinary tract uroliths in a series of dogs and report clinical outcomes.
ANIMALS: 6 female dogs (9 kidneys).
METHODS: Retrospective case series. A review of medical records in dogs that underwent medical dissolution of upper urinary tract uroliths utilizing diet, administration of antibiotics, and double-pigtail ureteral stent(s) placement, when indicated, was performed. Medical management was generally continued for 4 weeks beyond urolith dissolution. Information on biochemical, microbiological, imaging, and clinical outcomes before and after dissolution were recorded.
RESULTS: Six dogs (9 kidneys) were included with bilateral (3) or unilateral (3) nephrolithiasis, ureterolithiasis, or a combination. A ureteral stent(s) was placed endoscopically in 5/6 dogs (6/9 kidneys) for obstructive ureterolithiasis (n = 5) or a nonobstructive massive nephrolith (n = 1). All dogs had a positive urine culture of Staphylococcus pseudintermedius with a median urine pH of 7.25 (range, 6.5-8) and 4/5 had pyonephrosis. All dogs had initial evidence of urolith dissolution at a median of 1.1 months (range, 0.42-5.9), with complete dissolution of ureteroliths at a median of 3.9 months (range, 1.5-7.6), nephroliths at 5.3 months (range, 1.5-7.6), and lower urinary tract uroliths at 0.87 months (range, 0.42-5.9). Stents were removed in 3/6 once dissolution was documented. The median follow-up time was 519 days (range, 177-2492 days).
CONCLUSION AND CLINICAL IMPORTANCE: Medical dissolution and decompression of upper urinary tract struvite uroliths should be considered a minimally invasive treatment for dogs before more invasive options.
OBJECTIVE: To describe the medical dissolution of upper urinary tract uroliths in a series of dogs and report clinical outcomes.
ANIMALS: 6 female dogs (9 kidneys).
METHODS: Retrospective case series. A review of medical records in dogs that underwent medical dissolution of upper urinary tract uroliths utilizing diet, administration of antibiotics, and double-pigtail ureteral stent(s) placement, when indicated, was performed. Medical management was generally continued for 4 weeks beyond urolith dissolution. Information on biochemical, microbiological, imaging, and clinical outcomes before and after dissolution were recorded.
RESULTS: Six dogs (9 kidneys) were included with bilateral (3) or unilateral (3) nephrolithiasis, ureterolithiasis, or a combination. A ureteral stent(s) was placed endoscopically in 5/6 dogs (6/9 kidneys) for obstructive ureterolithiasis (n = 5) or a nonobstructive massive nephrolith (n = 1). All dogs had a positive urine culture of Staphylococcus pseudintermedius with a median urine pH of 7.25 (range, 6.5-8) and 4/5 had pyonephrosis. All dogs had initial evidence of urolith dissolution at a median of 1.1 months (range, 0.42-5.9), with complete dissolution of ureteroliths at a median of 3.9 months (range, 1.5-7.6), nephroliths at 5.3 months (range, 1.5-7.6), and lower urinary tract uroliths at 0.87 months (range, 0.42-5.9). Stents were removed in 3/6 once dissolution was documented. The median follow-up time was 519 days (range, 177-2492 days).
CONCLUSION AND CLINICAL IMPORTANCE: Medical dissolution and decompression of upper urinary tract struvite uroliths should be considered a minimally invasive treatment for dogs before more invasive options.