Today's Veterinary Practice

SEP-OCT 2015

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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tvpjournal.com | September/October 2015 | TOday'S VeTerinary PracTice Feline STruViTe & calcium OxalaTe urOliThiaSiS Peer reviewed 19 Antibiotics. In addition to decreasing the concentration of crystalloids in urine, elimination of any bacterial UTI is essential in medical treatment of struvite urolithiasis. If infection is present at start of treatment, continue antibiotics throughout the course of medical dissolution because viable bacteria may be released from uroliths as they dissolve. Select antibiotics based on urine culture and sensitivity fndings. Infection-induced struvite uroliths usually dissolve in 2 to 3 months. 15 Calcium Oxalate Uroliths Medical dissolution diets for oxalate urolithiasis are not yet available. Small urocystoliths may be removed by catheter retrieval or voiding hydropropulsion in female cats; however, surgery is the usual means for removal of large calcium oxalate cystouroliths. Some calcium oxalate uroliths, especially nephroliths, may remain clinically quiescent for months to years. Cats with CKD, and with suspected calcium oxalate nephroliths, had no increased risk for kidney disease progression, uremic crises, or death compared with cats with similar stage CKD without nephroliths. 16 Manage patients with nephroliths with medical protocols designed to prevent or slow calcium oxalate urolith growth (see Prevention), and monitor location and size of the nephroliths several times a year with radiography or ultrasonography. Acute decompensation of a patient with CKD and known or suspected nephroliths should prompt swift evaluation to rule out an obstructive uropathy. FOLLOW-UP & MONITORING • Use radiography or ultrasonography to ensure complete removal of uroliths. • Monitor effects of preventive treatment on urine pH and crystalluria with frequent urinalysis (every 2–4 weeks). • In cases of new or continued hematuria, pyuria, or bacteriuria, use urine culture and sensitivity and survey abdominal radiography or ultrasonography to assess the urinary tract. PREVENTION Struvite Uroliths Measures to prevent struvite urolith recurrence include preventing and controlling UTIs in cases of infection-induced struvite uroliths, maintaining acidic urine, and decreasing dietary intake of magnesium. Numerous struvite prevention maintenance diets are available commercially (Table 3). Table 3. Examples of Feline Struvite Prevention Diets Hill's Prescription Diet c/d Multicare Feline Bladder Health (hillsvet.com) Iams Veterinary Formula Urinary-S Plus Low pH/S (iamsvetformula.com) Medi-Cal Veterinary Diets Feline Preventive Formula (Veterinary Medical Diets, Inc, Guelph, Ontario) Purina Veterinary Diets UR Urinary St/Ox Feline Formula (purinaveterinarydiets.com) Royal Canin Veterinary Diet Urinary SO (royalcanin.com) Table 4. Examples of Feline Calcium Oxalate Prevention Diets Hill's Prescription Diet c/d Multicare Feline Bladder Health (hillsvet.com) Iams Veterinary Formula Urinary O–Moderate pH/O (iamsvetformula.com) Medi-Cal Urinary SO (Veterinary Medical Diets, Inc, Guelph, Ontario) Purina Veterinary Diets UR Urinary St/Ox Feline Formula (purinaveterinarydiets.com) Royal Canin Veterinary Diet Urinary SO (royalcanin.com) tvpjournal.com | September/October 2015

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