ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats

In an age of advancing endoscopic and lithotripsy technologies, the management of urolithiasis poses a unique opportunity to advance compassionate veterinary care, not only for patients with urolithiasis but for those with other urinary diseases as well. The following are consensus‐derived, research and experience‐supported, patient‐centered recommendations for the treatment and prevention of uroliths in dogs and cats utilizing contemporary strategies. Ultimately, we hope that these recommendations will serve as a foundation for ongoing and future clinical research and inspiration for innovative problem solving.

[1]  S. Werre,et al.  Associations of diet and breed with recurrence of calcium oxalate cystic calculi in dogs. , 2015, Journal of the American Veterinary Medical Association.

[2]  D. Bagley,et al.  Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008-2012). , 2015, Journal of the American Veterinary Medical Association.

[3]  D. Bagley,et al.  Clinical Presentation and Outcome of Cats with Circumcaval Ureters Associated with a Ureteral Obstruction , 2014, Journal of veterinary internal medicine.

[4]  J. Zentek,et al.  Relevance of dietary protein concentration and quality as risk factors for the formation of calcium oxalate stones in cats , 2014, Journal of nutritional science.

[5]  V. Viateau,et al.  Indwelling double pigtail ureteral stent combined or not with surgery for feline ureterolithiasis: complications and outcome in 15 cases , 2014, Journal of feline medicine and surgery.

[6]  D. Pearl,et al.  Risk factors associated with calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States. , 2014, Preventive veterinary medicine.

[7]  D. Bagley,et al.  Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006-2010). , 2014, Journal of the American Veterinary Medical Association.

[8]  T. Schmitt,et al.  Solubility of ammonium acid urate nephroliths from bottlenose dolphins (Tursiops truncatus). , 2013, Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians.

[9]  D. Pearl,et al.  Risk factors associated with struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States. , 2013, Journal of the American Veterinary Medical Association.

[10]  Jun Liu,et al.  SLC3A1 and SLC7A9 mutations in autosomal recessive or dominant canine cystinuria: a new classification system. , 2013, Journal of veterinary internal medicine.

[11]  J. Merrills,et al.  Efficacy of two commercially available, low-magnesium, urine-acidifying dry foods for the dissolution of struvite uroliths in cats. , 2013, Journal of the American Veterinary Medical Association.

[12]  J. Bartges,et al.  Influence of acidifying or alkalinizing diets on bone mineral density and urine relative supersaturation with calcium oxalate and struvite in healthy cats. , 2013, American journal of veterinary research.

[13]  J. B. Case,et al.  Evaluation of costs and time required for laparoscopic-assisted versus open cystotomy for urinary cystolith removal in dogs: 43 cases (2009-2012). , 2013, Journal of the American Veterinary Medical Association.

[14]  J. Asplin,et al.  The Interaction of thiol drugs and urine pH in the treatment of cystinuria. , 2013, The Journal of urology.

[15]  D. Bagley,et al.  Predictors of outcome for cats with ureteral obstructions after interventional management using ureteral stents or a subcutaneous ureteral bypass device , 2013, Journal of feline medicine and surgery.

[16]  D. Concordet,et al.  Effects of dietary salt intake on renal function: a 2-year study in healthy aged cats. , 2013, Journal of veterinary internal medicine.

[17]  Dvm PhD Dacvim Dacvn Joe Bartges,et al.  Evaluation of d,l-Methionine and Antimicrobial Agents for Medical Dissolution of Spontaneously Occurring Infection-Induced Struvite Urocystoliths in Dogs , 2013 .

[18]  P. Morley,et al.  Comparison of routine urinalysis and urine Gram stain for detection of bacteriuria in dogs. , 2013, Journal of veterinary emergency and critical care.

[19]  M. Hartl,et al.  Determination of the cause of selected canine urolith formation by advanced analytical methods. , 2012, The Journal of small animal practice.

[20]  M. Martano,et al.  Double-J ureteral stenting in nine cats with ureteral obstruction. , 2012, Veterinary journal.

[21]  V. Thongboonkerd,et al.  Citrate, not phosphate, can dissolve calcium oxalate monohydrate crystals and detach these crystals from renal tubular cells. , 2012, European journal of pharmacology.

[22]  V. Biourge,et al.  A diet with a struvite relative supersaturation less than 1 is effective in dissolving struvite stones in vivo. , 2011, The British journal of nutrition.

[23]  A. Colyer,et al.  Effect of dietary water intake on urinary output, specific gravity and relative supersaturation for calcium oxalate and struvite in the cat. , 2011, The British journal of nutrition.

[24]  M. Mcloughlin Complications of lower urinary tract surgery in small animals. , 2011, The Veterinary clinics of North America. Small animal practice.

[25]  P. Mayhew,et al.  Transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi in dogs and cats: 27 cases (2006-2008). , 2011, Journal of the American Veterinary Medical Association.

[26]  D. Goldfarb Potential pharmacologic treatments for cystinuria and for calcium stones associated with hyperuricosuria. , 2011, Clinical journal of the American Society of Nephrology : CJASN.

[27]  D. C. Brown,et al.  Postoperative mortality in cats after ureterolithotomy. , 2011, Veterinary surgery : VS.

[28]  M. d’Anjou,et al.  Clinical significance of renal pelvic dilatation on ultrasound in dogs and cats. , 2010, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[29]  P. Kass,et al.  Evaluation of trends in urolith composition and characteristics of dogs with urolithiasis: 25,499 cases (1985-2006). , 2010, Journal of the American Veterinary Medical Association.

[30]  C. Lekcharoensuk,et al.  Rate and frequency of recurrence of uroliths after an initial ammonium urate, calcium oxalate, or struvite urolith in cats. , 2009, Journal of the American Veterinary Medical Association.

[31]  D. Laflamme,et al.  Effects of dietary sodium chloride on health parameters in mature cats , 2009, Journal of feline medicine and surgery.

[32]  J. M. Bevan,et al.  Efficacy and safety of laser lithotripsy in fragmentation of urocystoliths and urethroliths for removal in dogs. , 2009, Journal of the American Veterinary Medical Association.

[33]  J. M. Bevan,et al.  Comparison of laser lithotripsy and cystotomy for the management of dogs with urolithiasis. , 2009, Journal of the American Veterinary Medical Association.

[34]  L. Adams,et al.  Changing paradigms in the treatment of uroliths by lithotripsy. , 2009, The Veterinary clinics of North America. Small animal practice.

[35]  J. Weese,et al.  Evaluation of risk factors associated with suture-nidus cystoliths in dogs and cats: 176 cases (1999-2006). , 2008 .

[36]  G. Moore,et al.  Use of laser lithotripsy for fragmentation of uroliths in dogs: 73 cases (2005-2006). , 2008, Journal of the American Veterinary Medical Association.

[37]  P. Mayhew,et al.  Use of cystoscopic-guided laser ablation for treatment of intramural ureteral ectopia in male dogs: four cases (2006-2007). , 2008, Journal of the American Veterinary Medical Association.

[38]  P. Kass,et al.  Evaluation of trends in urolith composition in cats: 5,230 cases (1985-2004). , 2007, Journal of the American Veterinary Medical Association.

[39]  C. Lekcharoensuk,et al.  A case-control study of the effects of nephrolithiasis in cats with chronic kidney disease. , 2007, Journal of the American Veterinary Medical Association.

[40]  J. Bartges,et al.  Influence of hydrochlorothiazide on urinary calcium oxalate relative supersaturation in healthy young adult female domestic shorthaired cats. , 2007, Veterinary therapeutics : research in applied veterinary medicine.

[41]  E. Hardie,et al.  Management and outcome of cats with ureteral calculi: 153 cases (1984-2002). , 2005, Journal of the American Veterinary Medical Association.

[42]  B. Gerber,et al.  Retrospective study of indications for and outcome of perineal urethrostomy in cats. , 2005, The Journal of small animal practice.

[43]  DM Snyder,et al.  Diagnosis and surgical management of ureteral calculi in dogs: 16 cases (1990–2003) , 2005, New Zealand veterinary journal.

[44]  J. Lulich,et al.  Effects of dietary supplementation with sodium chloride on urinary relative supersaturation with calcium oxalate in healthy dogs. , 2005, American journal of veterinary research.

[45]  S. Gibbons-Burgener,et al.  Evaluation of modified Wright-staining of urine sediment as a method for accurate detection of bacteriuria in dogs. , 2004, Journal of the American Veterinary Medical Association.

[46]  J. Hilton,et al.  Evaluation of the efficacy of a commercial diet in the dissolution of feline struvite bladder uroliths. , 2004, Veterinary therapeutics : research in applied veterinary medicine.

[47]  A. E. Stevenson,et al.  Effect of dietary moisture and sodium content on urine composition and calcium oxalate relative supersaturation in healthy miniature schnauzers and labrador retrievers. , 2003, Research in veterinary science.

[48]  J. Jones,et al.  Predicting the crystallization potential of urine from cats and dogs with respect to calcium oxalate and magnesium ammonium phosphate (struvite). , 2002, The Journal of nutrition.

[49]  C. Lekcharoensuk,et al.  Associations between dry dietary factors and canine calcium oxalate uroliths. , 2002, American journal of veterinary research.

[50]  C. Lekcharoensuk,et al.  Association between dietary factors and calcium oxalate and magnesium ammonium phosphate urolithiasis in cats. , 2001, Journal of the American Veterinary Medical Association.

[51]  A. Hoppe,et al.  Cystinuria in the dog: clinical studies during 14 years of medical treatment. , 2001, Journal of veterinary internal medicine.

[52]  C. Lekcharoensuk,et al.  Effects of hydrochlorothiazide and diet in dogs with calcium oxalate urolithiasis. , 2001, Journal of the American Veterinary Medical Association.

[53]  M. Pierpont,et al.  Evaluation of urinary carnitine and taurine excretion in 5 cystinuric dogs with carnitine and taurine deficiency. , 2001, Journal of veterinary internal medicine.

[54]  D. Goldfarb,et al.  Clinical use of cystine supersaturation measurements. , 2000, Journal of Urology.

[55]  A. E. Stevenson,et al.  Effects of dietary potassium citrate supplementation on urine pH and urinary relative supersaturation of calcium oxalate and struvite in healthy dogs. , 2000, American journal of veterinary research.

[56]  D. Smeak Urethrotomy and urethrostomy in the dog. , 2000, Clinical techniques in small animal practice.

[57]  James R. Barsanti,et al.  Hypercalcemia and calcium oxalate urolithiasis in cats: a report of five cases. , 1999, Journal of the American Animal Hospital Association.

[58]  A. Shokeir,et al.  Recoverability of renal function after relief of chronic partial upper urinary tract obstruction , 1999, BJU international.

[59]  J. Bartges,et al.  Canine cystine urolithiasis. Cause, detection, treatment, and prevention. , 1999, The Veterinary clinics of North America. Small animal practice.

[60]  J. Bartges,et al.  Canine urate urolithiasis. Etiopathogenesis, diagnosis, and management. , 1999, The Veterinary clinics of North America. Small animal practice.

[61]  D. Polzin,et al.  Canine retrograde urohydropropulsion. Lessons from 25 years of experience. , 1999, The Veterinary clinics of North America. Small animal practice.

[62]  J. Djurhuus,et al.  Obstructive nephropathy: an update of the experimental research , 1999, Urological Research.

[63]  A. E. Stevenson,et al.  Urinary relative supersaturations of calcium oxalate and struvite in cats are influenced by diet. , 1998, The Journal of nutrition.

[64]  L. Truong,et al.  Urinary obstruction causes irreversible renal failure by inducing chronic tubulointerstitial nephritis. , 1997, Clinical nephrology.

[65]  J. Bartges,et al.  Bioavailability and pharmacokinetics of intravenously and orally administered allopurinol in healthy beagles. , 1997, American journal of veterinary research.

[66]  A. Shokeir,et al.  Partial ureteral obstruction: role of renal resistive index in stages of obstruction and release. , 1997, Urology.

[67]  O. Gofrit,et al.  Complete staghorn calculi: random prospective comparison between extracorporeal shock wave lithotripsy monotherapy and combined with percutaneous nephrostolithotomy. , 1997, The Journal of urology.

[68]  J. Lingeman,et al.  Use of extracorporeal shock wave lithotripsy for treatment of nephrolithiasis and ureterolithiasis in five dogs. , 1996, Journal of the American Veterinary Medical Association.

[69]  C. Franti,et al.  Evaluation of factors associated with development of calcium oxalate urolithiasis in cats. , 1995, Journal of the American Veterinary Medical Association.

[70]  J. Bartges,et al.  Diet effect on activity product ratios of uric acid, sodium urate, and ammonium urate in urine formed by healthy beagles. , 1995, American journal of veterinary research.

[71]  J. Bartges,et al.  Recurrent sterile struvite urocystolithiasis in three related English cocker spaniels , 1992 .

[72]  D. Harrold,et al.  Xanthine-containing urinary calculi in dogs given allopurinol. , 1991, Journal of the American Veterinary Medical Association.

[73]  MF Tarttelin Feline struvite urolithiasis: factors affecting urine pH may be more important than magnesium levels in food , 1987, Veterinary Record.

[74]  T. Fletcher,et al.  Evaluation of a calculolytic diet in female dogs with induced struvite urolithiasis. , 1984, American journal of veterinary research.

[75]  S. Shapiro,et al.  Recovery of renal function after prolonged unilateral ureteral obstruction. , 1976, The Journal of urology.

[76]  E. Vaughan,et al.  Recovery following complete chronic unilateral ureteral occlusion: functional, radiographic and pathologic alterations. , 1971, The Journal of urology.

[77]  J. Gillenwater,et al.  Experimental partial ureteral obstruction. I. Alteration in renal function. , 1971, Investigative urology.