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DeBow P, Auger M, Fazio C, Cline K, Zhu X, Lulich J, de Swarte M, Lamb D, Hespel AM. The most common types of uroliths larger than 1 mm are readily visible and accurately measured in an in vitro setting mimicking the canine abdomen using digital radiography. Vet Radiol Ultrasound 2023; 64:806-812. [PMID: 37455335 DOI: 10.1111/vru.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/02/2023] [Accepted: 05/29/2023] [Indexed: 07/18/2023] Open
Abstract
Abdominal radiography is an important diagnostic to detect uroliths. Cystine and urate uroliths were historically characterized as nonmineral opaque on survey radiographs. However, recent research and clinical observations indicate that pure urate and cystine uroliths may be detected with digital radiography. The primary purpose of this prospective, in vitro, diagnostic accuracy study was to determine the sensitivity of digital radiography in detecting cystoliths of varying size and composition. Forty canine uroliths of pure composition (10 each of calcium oxalate, struvite, cystine, and urate), acquired from Minnesota Urolith Center and ranging from 1 to 10 mm, were placed in phantoms of three various sizes and radiographed. The radiographs, including three sets of each urolith separately, were evaluated by three blinded radiologists on two separate occasions. Evaluation included presence or absence of urolith, number of uroliths, and maximum diameter of the urolith(s). For all four types of uroliths and all readers, the specificity and PPV were 100% with an associated very high sensitivity (94.4%-98.9%) and NPV (94.8%-98.9%). Calcium oxalate uroliths were the most accurately measured and struvite were the least accurately measured when compared with the gross measurement. Smaller uroliths were more accurately measured than larger uroliths. Uroliths placed in smaller bladder phantoms were more accurately measured than in larger bladder phantoms. Though accurate measurement of uroliths is complicated by and dependent on numerous variables, our results reveal that urate and cystine uroliths are visualized on digital radiography making them a relevant differential diagnosis when seen clinically.
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Affiliation(s)
- Patricia DeBow
- UTCVM, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | | | - Constance Fazio
- UTCVM, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Kelsey Cline
- VCA Advanced Veterinary Care Center, Fishers, Indiana, USA
| | - Xiaojuan Zhu
- Office of Information Technology, University of Tennessee, Knoxville, Tennessee, USA
| | - Jody Lulich
- Minnesota Urolith Center, Department of Veterinary Clinical Sciences University of Minnesota, St. Paul, Minnesota, USA
| | | | - Donald Lamb
- Department of Nutritional Sciences, Auburn University, Auburn, Alabama, USA
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Konstantinidis AO, Patsikas MN, Papazoglou LG, Adamama-Moraitou KK. Congenital Portosystemic Shunts in Dogs and Cats: Classification, Pathophysiology, Clinical Presentation and Diagnosis. Vet Sci 2023; 10:vetsci10020160. [PMID: 36851464 PMCID: PMC9961057 DOI: 10.3390/vetsci10020160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Congenital portosystemic shunts (CPSS) are abnormal vascular communications between the portal and the systemic circulation, bypassing the hepatic parenchyma and resulting in liver hypoplasia and hepatic insufficiency. Such connections develop in utero and persist postnatally. CPSS are among the two most common congenital vascular anomalies of the liver in small animals, along with primary hypoplasia of the portal vein without portal hypertension (PHPV without PH). CPSS can be extrahepatic (ECPSS), most commonly diagnosed in small and toy breed dogs and cats, or intrahepatic (ICPSS), most commonly seen in large breed dogs. Single ECPSS is the most common type encountered in both dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests, such as determination of fasting plasma ammonia (FA) levels, and pre- and postprandial serum bile acids concentrations, and diagnostic imaging. The purpose of this article is to review the definition, classification, pathogenesis, clinical presentation, and diagnosis of CPSS in dogs and cats, highlighted by the authors' clinical experience.
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Affiliation(s)
- Alexandros O. Konstantinidis
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
- Correspondence:
| | - Michail N. Patsikas
- Laboratory of Diagnostic Imaging, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G. Papazoglou
- Companion Animal Clinic (Surgery and Obstetrics Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Katerina K. Adamama-Moraitou
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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Gomes V, Ariza P, Silva M, Schulz Jr. F, Oliveira H, Queiroz L, Borges N, Bragato N, Fioravanti M. Mineral composition and clinical aspects of urolithiasis in cats in Brazil. ARQ BRAS MED VET ZOO 2022. [DOI: 10.1590/1678-4162-12545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Between October 2016 and October 2017, 63 feline uroliths were analyzed at Universidade Federal de Goiás (UFG) by using both chemical analysis and energy dispersive spectroscopy (EDS). The most frequent mineral type found was struvite (53.9%), followed by urate (39.7%), calcium oxalate (30.1%) and calcium phosphate (25.3%). Calculus containing xanthine, cystine and silica were not observed. Uroliths classified as simple, comprised a total of 34/63. Amongst the 42 animals present in the study, 26 were male and 16 were female. Pure breed animals comprised 14.4% of the total, and the breeds observed within the study were the Persian, Himalayan, Siamese, and Angora. Cats between 25-72 months old were more frequently diagnosed with uroliths. The clinical signs varied between systemic and urinary signs and the most found were anorexia, vomiting, hematuria and dysuria. All patients were either spayed or neutered and 34 patients had no outdoor access. Familial information was unknown in almost 100% of the cases. The results observed in the present study serve as a basis for future comparisons related to the epidemiology of urinary lithiasis in Brazil, especially for the feline species.
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Kopecny L, Palm CA, Segev G, Larsen JA, Westropp JL. Urolithiasis in cats: Evaluation of trends in urolith composition and risk factors (2005-2018). J Vet Intern Med 2021; 35:1397-1405. [PMID: 33955071 PMCID: PMC8162610 DOI: 10.1111/jvim.16121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Urolithiasis is an important upper and lower urinary tract disease in cats that results in morbidity and mortality. OBJECTIVE To describe trends in composition of uroliths in cats and evaluate risk factors related to age, breed, sex, urolith location, and bacterial urolith cultures. SAMPLE POPULATION A total of 3940 uroliths and the cats from which they were obtained. METHODS The database of the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from cats between January 2005 and December 2018. Mineral type, age, breed, sex, and urolith location and culture results were recorded. Trends were evaluated and variables compared to evaluate risk factors. RESULTS A significant decrease in the proportion of calcium oxalate (CaOx)-containing uroliths occurred over time (P = .02), from 50.1% (204/407) of all submissions in 2005 to 37.7% (58/154) in 2018. In contrast, the proportion of struvite-containing uroliths increased significantly (P = .002), from 41.8% (170/407) in 2005 to 54.5% (84/154) in 2018. The proportion of CaOx-containing uroliths in the upper urinary tract was significantly higher compared to the proportion of other urolith types in the upper urinary tract. Urate-containing uroliths were the third most common type (361/3940, 9.2%). Overall, sex and age predispositions were similar to those reported previously. CONCLUSIONS AND CLINICAL IMPORTANCE The decrease in the proportion of CaOx-containing uroliths and increase in the proportion of struvite-containing uroliths warrants investigation. Further education regarding the efficacy of medical dissolution of struvite-containing uroliths is recommended.
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Affiliation(s)
- Lucy Kopecny
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Carrie A Palm
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Gilad Segev
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jennifer A Larsen
- Department of Molecular Biosciences, University of California Davis, Davis, California, USA
| | - Jodi L Westropp
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
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Abstract
The prevalence of urolithiasis in humans is increasing worldwide; however, non-surgical treatment and prevention options remain limited despite decades of investigation. Most existing laboratory animal models for urolithiasis rely on highly artificial methods of stone induction and, as a result, might not be fully applicable to the study of natural stone initiation and growth. Animal models that naturally and spontaneously form uroliths are an underused resource in the study of human stone disease and offer many potential opportunities for improving insight into stone pathogenesis. These models include domestic dogs and cats, as well as a variety of other captive and wild species, such as otters, dolphins and ferrets, that form calcium oxalate, struvite, uric acid, cystine and other stone types. Improved collaboration between urologists, basic scientists and veterinarians is warranted to further our understanding of how stones form and to consider possible new preventive and therapeutic treatment options.
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Lonc KM, Kaneene JB, Carneiro PAM, Kruger JM. Retrospective analysis of diagnoses and outcomes of 45 cats with micturition disorders presenting as urinary incontinence. J Vet Intern Med 2019; 34:216-226. [PMID: 31859391 PMCID: PMC6979103 DOI: 10.1111/jvim.15683] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background In contrast to dogs, the causes and outcomes of urinary incontinence (UI) in cats are largely unknown. Objectives To determine the causes, identify comorbid conditions, and assess outcomes of cats with micturition disorders presenting as UI. Animals Forty‐five cats with UI. Methods Retrospective study. Medical records of cats presented from January 2006 to December 2017 were searched using 45 keywords related to UI. History, presenting complaint, and physical examination findings were used to confirm a diagnosis. Cases were categorized based on functional and anatomic localizations. Results Forty‐five cats met inclusion criteria. Spinal cord disease was the most common cause of UI (n = 18), followed by urethral (n = 17), bladder (n = 9), and ureteral (n = 1) disorders. Proportions of voiding and storage phase disorders were similar (53% and 47%, respectively). However, voiding‐phase disorders were observed more frequently in males and younger‐aged cats (P < .03). Urinary tract infection was detected in 11 of 28 (39%) cats. Outcomes were available in 38/45 cases; 16 cats (42%) regained continence, 3 (8%) improved with treatment, and 19 (50%) remained incontinent or were euthanized. Multiple variable logistic regressions indicated that spinal cord disease was significantly more likely to be associated with poor outcomes compared to bladder or urethral disorders (P < .04). Conclusions and Clinical Importance Urinary incontinence in cats was associated with a variety of congenital and acquired disorders that affected both phases of micturition with similar frequency. Incontinent cats with spinal cord disorders were common and warrant a more guarded prognosis than do cats with bladder or urethral disorders.
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Affiliation(s)
- Kaitlin M Lonc
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - John B Kaneene
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.,Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Paulo A M Carneiro
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.,Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - John M Kruger
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
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Griffin S. Feline abdominal ultrasonography: what's normal? what's abnormal? Hepatic vascular anomalies. J Feline Med Surg 2019; 21:645-654. [PMID: 31234742 PMCID: PMC10814185 DOI: 10.1177/1098612x19856182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Although hepatic vascular anomalies are less common than disorders of the hepatic parenchyma and biliary tree, our understanding and recognition of these is gradually increasing with advancements in ultrasound technology and image quality. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, some views may be obscured by overlying structures; for example, the termination of a shunt entering the left phrenic or azygous veins is often difficut to see due to the high probability of lung passing between the shunt and the transducer as the cat breathes. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of various hepatic vascular anomalies. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Ultrasound of the liver and biliary tree were discussed in articles published in January and May 2019, respectively. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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Medical and Interventional Management of Upper Urinary Tract Uroliths. Vet Clin North Am Small Anim Pract 2019; 49:157-174. [DOI: 10.1016/j.cvsm.2018.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Reppas G, Foster SF. Practical urinalysis in the cat: 2: Urine microscopic examination 'tips and traps'. J Feline Med Surg 2016; 18:373-85. [PMID: 27143040 PMCID: PMC11132200 DOI: 10.1177/1098612x16643249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
SERIES OUTLINE This is the second article in a two-part series on urinalysis in the cat. The specific focus is urine microscopic examination. Part 1, which appeared in the March 2016 issue, discussed urine macroscopic examination. PRACTICAL RELEVANCE Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results. CLINICAL CHALLENGES For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process. AUDIENCE Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both groups can potentially benefit. EQUIPMENT Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances. EVIDENCE BASE The evidence base for feline microscopic urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.
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Affiliation(s)
- George Reppas
- Vetnostics, 60 Waterloo Road, North Ryde, NSW 2113, Australia
| | - Susan F Foster
- Vetnostics, 60 Waterloo Road, North Ryde, NSW 2113, Australia
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Keller KA, Hawkins MG, Weber EPS, Ruby AL, Guzman DSM, Westropp JL. Diagnosis and treatment of urolithiasis in client-owned chelonians: 40 cases (1987–2012). J Am Vet Med Assoc 2015; 247:650-8. [DOI: 10.2460/javma.247.6.650] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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