Medical dissolution of presumptive upper urinary tract struvite uroliths in 6 dogs (2012-2018).

Autor: Manoharan SA; Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York, USA., Berent AC; Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York, USA., Weisse CW; Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York, USA., Purdon K; Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York, USA., Bagley D; Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of veterinary internal medicine [J Vet Intern Med] 2024 Nov-Dec; Vol. 38 (6), pp. 3095-3104. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1111/jvim.17204
Abstrakt: 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.
(© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)
Databáze: MEDLINE
Externí odkaz: