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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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Comparison of radiographic methods for detecting radiolucent uroliths in dogs. PLoS One 2022; 17:e0274087. [PMID: 36137162 PMCID: PMC9499233 DOI: 10.1371/journal.pone.0274087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/22/2022] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to evaluate and compare positive cystography techniques at 5%, 10%, and 20%, as well as three different double-contrast protocols for detecting radiolucent uroliths with a diameter of less than 3.0 mm in dogs. Six cadavers were used, one was selected at random to represent the negative control, and the others were submitted to urolith implantation in the bladder by urethral catheter. Three radiology professionals blindly accessed ventrodorsal and -lateral projections of each test. Contrast at 20% showed greater diagnostic sensitivity, but with greater difficulty identifying the number and size of the uroliths. Consequently, double-contrast techniques are better and should be used for diagnostic and therapeutic planning. Sensitivity and specificity tests demonstrated that positive 5% cystography and different concentrations of double contrast obtained better results in terms of sensitivity and specificity. However, due to the presence of a greater amount of artifacts in the 5% cystography, it is suggested that double contrast is used for this purpose, especially with the removal of contrast excess (protocol 2).
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Bruwier A, Godart B, Gatel L, Leperlier D, Bedu AS. Computed tomographic assessment of retrograde urohydropropulsion in male dogs and prediction of stone composition using Hounsfield unit in dogs and cats. J Vet Sci 2022; 23:e65. [PMID: 36038186 PMCID: PMC9523345 DOI: 10.4142/jvs.22109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 12/22/2022] Open
Abstract
Background Persistent uroliths after a cystotomy in dogs are a common cause of surgical failure. Objectives This study examined the following: the success rate of retrograde urohydropropulsion in male dogs using non-enhanced computed tomography (CT), whether the CT mean beam attenuation values in Hounsfield Units (mHU) measured in vivo could predict the urolithiasis composition and whether the selected reconstruction kernel may influence the measured mHU. Methods All dogs and cats that presented with lower urinary tract uroliths and had a non-enhanced CT preceding surgery were included. In male dogs, CT was performed after retrograde urohydropropulsion to detect the remaining urethral calculi. The percentage and location of persistent calculi were recorded. The images were reconstructed using three kernels, from smooth to ultrasharp, and the calculi mHU were measured. Results Sixty-five patients were included in the study. The success rate of retrograde urohydropropulsion in the 45 male dogs was 55.6% and 86.7% at the first and second attempts, respectively. The predominant components of the calculi were cystine (20), struvite (15), calcium oxalate (8), and urate (7). The convolution kernel influenced the mHU values (p < 0.05). The difference in mHU regarding the calculus composition was better assessed using the smoother kernel. A mHU greater than 1,000 HU was predictive of calcium oxalate calculi. Conclusions Non-enhanced CT is useful for controlling the success of retrograde urohydropropulsion. The mHU could allow a prediction of the calculus composition, particularly for calcium oxalate, which may help determine the therapeutic strategy.
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Affiliation(s)
- Aurélie Bruwier
- Imaging diagnostic department, Centre Hospitalier Vétérinaire (Chv) Pommery, 51100 Reims, France
| | - Benjamin Godart
- Surgery department, Centre Hospitalier Vétérinaire (Chv) Pommery, 51100 Reims, France
| | - Laure Gatel
- Imaging diagnostic department, Centre Hospitalier Vétérinaire (Chv) Pommery, 51100 Reims, France
| | - Dimitri Leperlier
- Surgery department, Centre Hospitalier Vétérinaire (Chv) Pommery, 51100 Reims, France
| | - Anne-Sophie Bedu
- Imaging diagnostic department, Centre Hospitalier Vétérinaire (Chv) Pommery, 51100 Reims, France
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Hunprasit V, Schreiner PJ, Bender JB, Lulich JP. Epidemiologic evaluation of calcium oxalate urolithiasis in dogs in the United States: 2010-2015. J Vet Intern Med 2019; 33:2090-2095. [PMID: 31471926 PMCID: PMC6766490 DOI: 10.1111/jvim.15613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/20/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Positive health implications of early recognition of calcium oxalate (CaOx) urolithiasis include increased opportunity for nonsurgical removal, early dietary modification to minimize urolith growth, early removal to avoid urinary obstruction, and early recognition of genetic and metabolic diseases before they contribute to additional morbidity. OBJECTIVES To identify high- and low-risk dog breeds for CaOx uroliths and to determine the relationship of age and sex to the development of CaOx uroliths. ANIMALS Calcium oxalate urolith submissions between 2010 and 2015. METHODS A comparative cross-sectional study was conducted to identify high- and low-risk breeds for CaOx uroliths by comparing cases to multiple comparison groups. At-risk breeds were identified if odds ratios were significant (P value <.05) across all comparison groups. RESULTS Of 258 898 urolith submissions, 124 285 were CaOx. Calcium oxalate was identified in 212 breeds. Twelve breeds were identified as high-risk breeds, and 14 breeds were identified as low-risk breeds. All high-risk breeds were small dog breeds, and all low-risk breeds were medium to large dog breeds. Overall, the mean age ± standard deviation of the first CaOx urolith was 8.4 ± 2.8 years. CONCLUSIONS AND CLINICAL IMPORTANCE To achieve the health benefits of preclinical evaluation, breeds at high risk for CaOx urolithiasis should be screened at 5 to 6 years of age, which is 2 to 3 years before likely development of clinical urolithiasis.
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Affiliation(s)
- Vachira Hunprasit
- Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Jeffrey B Bender
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Jody P Lulich
- Veterinary Clinical Sciences, College of Veterinary Medicine, Minneapolis, Minnesota
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Groth EM, Lulich JP, Chew DJ, Parker VJ, Furrow E. Vitamin D metabolism in dogs with and without hypercalciuric calcium oxalate urolithiasis. J Vet Intern Med 2019; 33:758-763. [PMID: 30851134 PMCID: PMC6430952 DOI: 10.1111/jvim.15442] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/23/2019] [Indexed: 01/28/2023] Open
Abstract
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)2D], and 24,25‐dihydroxyvitamin D [24,25(OH)2D] were measured. The ratios of 25(OH)D/24,25(OH)2D and 1,25(OH)2D/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)2D, 1,25(OH)2D, or 1,25(OH)2D/25(OH)D. Cases had higher 25(OH)D/24,25(OH)2D (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)2D 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)2D and urinary calcium‐to‐creatinine ratios (r = 0.40, 95% confidence interval = 0.10‐0.64; P = .01). Conclusions and Clinical Importance These data suggest that decreased conversion of 25(OH)D to 24,25(OH)2D occurs in a subset of dogs with CaOx urolithiasis. Abnormalities in vitamin D metabolism might contribute to stone risk in dogs.
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Affiliation(s)
- Elizabeth M Groth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Jody P Lulich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Valerie J Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Eva Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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Epidemiologic evaluation of canine urolithiasis in Thailand from 2009 to 2015. Res Vet Sci 2017; 115:366-370. [DOI: 10.1016/j.rvsc.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 06/13/2017] [Accepted: 07/08/2017] [Indexed: 11/23/2022]
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Reineke EL, Thomas EK, Syring RS, Savini J, Drobatz KJ. The effect of prazosin on outcome in feline urethral obstruction. J Vet Emerg Crit Care (San Antonio) 2017; 27:387-396. [DOI: 10.1111/vec.12611] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 06/15/2015] [Accepted: 08/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Erica L. Reineke
- Department of Clinical Studies-Philadelphia; University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
| | - Emily K. Thomas
- Department of Clinical Studies-Philadelphia; University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
| | - Rebecca S. Syring
- Department of Clinical Studies-Philadelphia; University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
| | - Jennifer Savini
- Department of Clinical Studies-Philadelphia; University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
| | - Kenneth J. Drobatz
- Department of Clinical Studies-Philadelphia; University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
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Cinti F, Pisani G, Carusi U, Buracco P. Urethrotomy of the glans penis in three male dogs with urolithiasis. J Small Anim Pract 2015. [PMID: 26200699 DOI: 10.1111/jsap.12390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- F Cinti
- Centro Veterinario Luni Mare, Ortonovo (SP), 19034, Italia
| | - G Pisani
- Centro Veterinario Luni Mare, Ortonovo (SP), 19034, Italia
| | - U Carusi
- Centro Veterinario Luni Mare, Ortonovo (SP), 19034, Italia
| | - P Buracco
- Department of Veterinary Science, University of Torino, Grugliasco, Turin, 10095, Italy
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Nevins JR, Mai W, Thomas E. ASSOCIATIONS BETWEEN ULTRASOUND AND CLINICAL FINDINGS IN 87 CATS WITH URETHRAL OBSTRUCTION. Vet Radiol Ultrasound 2015; 56:439-47. [PMID: 25850697 DOI: 10.1111/vru.12259] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 01/14/2015] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Jonathan R Nevins
- Section of Radiology, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
| | - Wilfried Mai
- Section of Radiology, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
| | - Emily Thomas
- Section of Emergency and Critical Care, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
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Lulich JP, Kruger JM, Macleay JM, Merrills JM, Paetau-Robinson I, Albasan H, Osborne CA. Efficacy of two commercially available, low-magnesium, urine-acidifying dry foods for the dissolution of struvite uroliths in cats. J Am Vet Med Assoc 2014; 243:1147-53. [PMID: 24094262 DOI: 10.2460/javma.243.8.1147] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of using 2 commercially available, low-magnesium, urine-acidifying dry foods to dissolve sterile struvite uroliths in cats. DESIGN Prospective, multicenter, randomized clinical trial . SAMPLE 37 cats with presumed struvite uroliths. PROCEDURES Cats were randomly assigned to be fed 1 of 2 low-magnesium, urine-acidifying dry foods (food A or B). For each cat, physical examination, urinalysis, and abdominal radiography were performed weekly to assess treatment response. RESULTS 32 cats had complete urolith dissolution. Mean ± SD times for a 50% reduction in urolith size (0.69 ± 0.1 weeks) and complete urolith dissolution (13.0 ± 2.6 days) were significantly shorter for cats fed food A, compared with those (1.75 ± 0.27 weeks and 27.0 ± 2.6 days, respectively) for cats fed food B. At study termination, mean ± SD urine pH (6.083 ± 0.105) for cats fed food A was lower than that (6.431 ± 0.109) for cats fed food B. In 5 cats, uroliths did not dissolve and were subsequently determined to be composed of 100% ammonium urate (n = 4) or 100% calcium oxalate (1). Adverse events associated with diet were not observed in any of the cats. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dietary dissolution is safe and effective for eradication of sterile struvite uroliths in cats. Cats fed food A had faster urolith dissolution than did cats fed food B. Lack of a reduction in urolith size at 2 weeks after diet initiation was indicative of misdiagnosis or noncompliance.
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Affiliation(s)
- Jody P Lulich
- Minnesota Urolith Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55105
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McLoughlin MA. Complications of lower urinary tract surgery in small animals. Vet Clin North Am Small Anim Pract 2011; 41:889-913, v. [PMID: 21889691 DOI: 10.1016/j.cvsm.2011.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Surgical procedures of the lower urinary tract are commonly performed in small animal practice. Cystotomy for removal of uroliths and urethrostomy diverting urine outflow due to urethral obstruction are the most commonly performed surgical procedures of the bladder and urethra respectively. Surgical procedures of the lower urinary tract are typically associated with few complications, including leakage of urine, loss of luminal diameter (stricture or stenosis), urine outflow obstruction, tissue devitalization, denervation, urinary incontinence, urinary tract infection, and death. Complications can result from inappropriate or inadequate diagnosis, localization, and surgical planning; failure to respect regional anatomy, and other causes.
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Affiliation(s)
- Mary A McLoughlin
- Department of Veterinary Clinical Sciences, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43210, USA.
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Grant DC, Harper TAM, Werre SR. Frequency of incomplete urolith removal, complications, and diagnostic imaging following cystotomy for removal of uroliths from the lower urinary tract in dogs: 128 cases (1994–2006). J Am Vet Med Assoc 2010; 236:763-6. [DOI: 10.2460/javma.236.7.763] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Byl KM, Kruger JM, Kinns J, Nelson NC, Hauptman JG, Johnson CA. In vitro comparison of plain radiography, double-contrast cystography, ultrasonography, and computed tomography for estimation of cystolith size. Am J Vet Res 2010; 71:374-80. [DOI: 10.2460/ajvr.71.3.374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bevan JM, Lulich JP, Albasan H, Osborne CA. Comparison of laser lithotripsy and cystotomy for the management of dogs with urolithiasis. J Am Vet Med Assoc 2009; 234:1286-94. [DOI: 10.2460/javma.234.10.1286] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Koehler LA, Osborne CA, Buettner MT, Lulich JP, Behnke R. Canine Uroliths: Frequently Asked Questions and Their Answers. Vet Clin North Am Small Anim Pract 2009; 39:161-81. [DOI: 10.1016/j.cvsm.2008.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weichselbaum RC, Feeney DA, Jessen CR, Osborne CA, Holte J. An integrated epidemiologic and radiographic algorithm for canine urocystolith mineral type prediction. Vet Radiol Ultrasound 2001; 42:311-9. [PMID: 11499706 DOI: 10.1111/j.1740-8261.2001.tb00946.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Research involved 2 databases. One database (occurrence frequency) comprised the age, breed, gender and urocystolith mineral type (pure chemical types only) from 2041 canine patients submitted to the Minnesota Urolith Center. The other database (imaging) comprised the maximum size, surface (rough, smooth, and smooth with blunt tips), shape (faceted, irregular, jackstone, ovoid, and round) and internal architecture (lucent center, random-nonuniform, and uniform) from 434 canine patients imaged in a urinary bladder phantom. The imaging database was a partial subset of the occurrence frequency database. Imaging techniques simulated were survey radiography and double contrast cystography. The databases were compared using multivariate analysis techniques. Equations were developed to use clinically-relevant characteristics (age, breed, gender, maximum size, surface, shape, and internal architecture) to predict urocystolith mineral types. The goal was to assess the accuracy of the various techniques in predicting the urocystolith mineral types. The combination of signalment (age, breed, gender) and simulated survey radiographic findings does not improve mineral type prediction accuracy (average across all mineral types is 69.9%) beyond that achievable with signalment alone (average across all mineral types is 69.8%). However, the combination of signalment and double contrast cystography does improve mineral type prediction accuracy (average across all mineral types is 75.3%). For comparison, mineral type prediction accuracy without signalment from survey radiographs only was 65.7% across all mineral types. The clinical utility of the algorithm is the option to distinguish urocystolith mineral types requiring surgical vs. medical treatment.
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Affiliation(s)
- R C Weichselbaum
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Veterinary Teaching Hospital, St. Paul 55108, USA
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Weichselbaum RC, Feeney DA, Jessen CR, Osborne CA, Dreytser V, Holte J. Relevance of sonographic artifacts observed during in vitro characterization of urocystolith mineral composition. Vet Radiol Ultrasound 2000; 41:438-46. [PMID: 11052368 DOI: 10.1111/j.1740-8261.2000.tb01868.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Nine pure mineral type canine uroliths (bladder or urethral origin only) were imaged ultrasonographically using 3.5 MHz, 5.0 MHz, and 7.5 MHz fixed focus, mechanical sector transducers in a urinary bladder phantom. The uroliths studied were those composed of 100% magnesium ammonium phosphate, calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate appatite, and calcium hydrogen phosphate dihydrate (brushite), ammonium acid urate, sodium acid urate, cystine, and silica. The occurrence of both reverberation/streak and acoustic shadowing artifacts were compared to urocystolith mineral type (classified by effective atomic number), urocystolith width, urocystolith height (thickness), and ultrasonographic imaging frequency. No predictable relationship was found between either of the artifacts seen beyond the urocystolith (reverberation/streak or the acoustic shadowing) and urocystolith mineral type. There was no statistical relationship between the occurrence of reverberation/streak artifact and the size (width or height) of the urocystolith or the ultrasonographic frequency. There was, however, a statistically relevant relationship between ultrasonographic imaging frequency and the occurrence of acoustic shadowing and between urocystolith height (thickness) and the occurrence of acoustic shadowing. However, regardless of ultrasound frequency, acoustic shadowing was observed less than 35% of the time in any of the urocystolith mineral types examined. Based on the imaging of the bladder phantom supporting apparatus (7.0 mm bolts covered by plastic), the accurate characterization of a curved object surface directly facing the transducer was found to be directly related to the frequency of sound used for imaging and at best predictably limited to curved vs flat. Accurate measurement of the maximum transverse dimension of an echogenic curved object or accurate characterization of the lateral borders of such an object was considered unlikely with general ultrasonographic equipment of the frequencies studied. Therefore, detailed architectural characterization of urocystoliths suitable for mineral composition prediction is considered highly unlikely with general pulse-echo ultrasonographic techniques.
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Affiliation(s)
- R C Weichselbaum
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA
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