Page 1366 - Cote clinical veterinary advisor dogs and cats 4th

Nephrolithiasis 689

2-7 g/day for each kilogram of anticipated • Avoid administering teratogenic drugs and ○ Preload 6-mL syringe with milk replacer,
adult weight and should double their birth • Avoid incompatible matings for cats, and empty all air out of the catheter by squeez-
chemicals to a pregnant dam or queen.
VetBooks.ir • Monitor color and amount of urine to assess • Ensure that neonates have ingested colostrum ○ Squeeze toe to make neonate cry just Diseases and Disorders
weight by 10 days of age.
ing the syringe until milk starts to drip
from the edge of the catheter.
check blood type before breeding.
for dehydration (sample can be obtained by
manual stimulation with a warm, wet cotton
immunity. Administer FFP if immunity
ball). within the first 24 hours to acquire passive before advancing catheter along the roof
of the mouth along the path of least
status is questionable. resistance until it reaches the mark.
PROGNOSIS & OUTCOME • Administer broad-spectrum anthelmintic ○ Pull back on the syringe to make sure
therapy to the dam/queen 2 weeks before there is negative pressure (no air in the
Supportive care is the cornerstone of successful birthing and then to neonates every 2-3 syringe, which would indicate intratracheal
treatment. weeks starting at 3 weeks of age and continu- location [contraindicated]).
ing until 12 weeks old. ○ Feed appropriate amount of milk replacer
PEARLS & CONSIDERATIONS • Administer appropriate vaccination proto- over 5-10 seconds, kink the catheter, and
cols. pull it out.
Comments • Maintain excellent hygiene in whelping and ○ This technique can also be used for FFP
• Instituting intensive early treatment is the nesting areas. administration if colostral ingestion is
key because neonates can deteriorate rapidly. questionable.
• FFP is salty. If given PO, it should be fol- Technician Tips ○ If sepsis is suspected, look at the color of
lowed with a little drop of sugar, honey, • Urine collection: touch the vulva/prepuce the abdomen and tips of nail beds, which
or STAT solution (concentrated nutritional with a warm, wet cotton ball. will be red.
supplement; PRN Pharmacal, FL) on the • Fecal sample collection: gentle insertion and
tongue. removal of a soft thermometer with manual SUGGESTED READING
stimulation over the anus with a warm, wet Peterson ME: Neonatal mortality. In Peterson ME,
Prevention cotton ball et al, editors: Small animal pediatrics, St. Louis,
Incidence of neonatal problems is reduced • Tube feeding guidelines 2011, Saunders, pp 82-87.
when clinicians ○ Use a 5-Fr or 8-Fr red rubber catheter. AUTHOR: Valeria Rickard, DVM
• Avoid administering modified live vaccines ○ Measure from the nose to last rib, and EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
during pregnancy. mark 75% of that distance.

Nephrolithiasis Client Education
Sheet

BASIC INFORMATION RISK FACTORS • Polyuria and polydipsia (PU/PD)
• Struvite: pyelonephritis • Stranguria
Definition • Calcium oxalate: hyperadrenocorticism, • Vomiting
Deposition of crystallized minerals in the kidney hypercalcemia (any cause), diet • Weight loss
occurs less commonly than in the lower urinary • Urate: portosystemic shunt, breed
tract, but the incidence (or recognition) is PHYSICAL EXAM FINDINGS
increasing. ASSOCIATED DISORDERS Physical exam may be unremarkable or may
• Hydronephrosis/hydroureter reveal
Synonyms • Ureteral obstruction • Signs of abdominal pain
Kidney stones, renal urolithiasis, renolithiasis • Pyelonephritis • Dehydration
• Renal failure/CKD • Renomegaly or small kidneys
Epidemiology • Acute kidney injury • Halitosis/oral ulcers (uremia; rare)
SPECIES, AGE, SEX
• Feline: prevalence increases with age; up to Clinical Presentation Etiology and Pathophysiology
47% of cats with chronic kidney disease DISEASE FORMS/SUBTYPES • Nephroliths (1%-4% of analyzed uroliths)
(CKD) may be affected. • Unilateral or bilateral are less common than cystoliths. The
• Canine: middle-aged to older dogs • Unobstructed or obstructed (partial or actual prevalence is likely higher because
complete) nephroliths are less frequently removed for
GENETICS, BREED PREDISPOSITION • Urolith type: calcium oxalate, struvite, urate analysis.
Dogs (data extrapolated from general uroliths): and other purines, xanthine, silica, cystine, • The most common nephrolith types in dogs
• Oxalate: miniature schnauzer, Lhasa apso, compound/mixed are calcium oxalate (≈40%), struvite (≈33%),
Yorkshire terrier, Bichon frisé, Pomeranian, and urate (≈12%). The most common
shih tzu, miniature poodle (p. 1014) HISTORY, CHIEF COMPLAINT nephroliths in cats are calcium oxalate.
• Struvite: miniature schnauzer, shih tzu, Clinical signs may be absent or may include
Bichon frisé, miniature poodle, cocker • Abdominal pain DIAGNOSIS
spaniel, and Lhasa apso (p. 1016) • Anorexia
• Urate: Dalmatian, English bulldog, miniature • Depression Diagnostic Overview
schnauzer, shih tzu, Yorkshire terrier (urate/ • Hematuria Nephrolithiasis may be an incidental finding
biurate [p. 1019]) • Pollakiuria or may be associated with urinary tract

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