struvite and Hematuria

Topics: Calcium; Child; Child, Preschool; Cystine; Female; Hematuria; Humans; Kidney Calculi; Magnesium Compounds; Male; Metabolic Diseases; Oxalates; Phosphates; Struvite; Uric Acid; Urinalysis; Urinary Calculi; Urinary Tract Infections

Lower urinary tract disease (LUTD) occurs commonly in cats, and idiopathic cystitis (FIC) and urolithiasis account for >80% of cases in cats <10 years of age. Although several strategies have been recommended, a common recommendation is to induce dilute urine resulting in more frequent urination and to dilute calculogenic constituents. In addition to conventional therapy using modified diets, traditional Chinese and Western herbs have been recommended, although only one - choreito - has published data available. We evaluated three commonly used herbal treatments recommended for use in cats with LUTD: San Ren Tang, Wei Ling Tang and Alisma. We hypothesized that these three Chinese herbal preparations would induce increased urine volume, decreased urine saturation for calcium oxalate and struvite, and differences in mineral and electrolyte excretions in healthy cats.. Six healthy spayed female adult cats were evaluated in a placebo-controlled, randomized, crossover design study. Cats were randomized to one of four treatments, including placebo, San Ren Tang, Wei Ling Tang or Alisma. Treatment was for 2 weeks each with a 1 week washout period between treatments. At the end of each treatment period, a 24 h urine sample was collected using modified litter boxes.. Body weights were not different between treatments. No differences were found in 24 h urinary analyte excretions, urine volume, urine pH or urinary saturation for calcium oxalate or struvite between treatments.. The results of this study do not support the hypothesis; however, evaluation of longer-term and different dosage studies in cats with LUTD is warranted.

Topics: Animals; Calcium Oxalate; Cat Diseases; Cats; Drugs, Chinese Herbal; Female; Hematuria; Magnesium Compounds; Male; Pilot Projects; Struvite; Urolithiasis; Urologic Diseases

We present our experience with micropercutaneous cystolithotripsy (mPCCL) using transillumination-guided access in children with bladder stones and evaluate the safety and efficacy of this procedure.. Twelve children who underwent mPCCL for bladder stone removal in our department between January 2011 and September 2013 were included in this study. Percutaneous access was performed using the transillumination technique. The chief complaint, age and sex of the patients, stone size, operative time, complications, stone-free rate, and stone composition as determined by radiography diffraction analysis were recorded.. The mean age of the patients was 2.6 (1-7) years. One out of 12 patients was a girl. The mean stone size was 14 mm (7-32 mm). The mean mPCCL procedure time was 38.7 (15-65) minutes. The mean hospital stay was 1.4 (0.5-4) days. The stone-free rate after one mPCCL intervention was 91.6% and increased to 100% after two sessions of mPCCL. The notable complications were transient macroscopic hematuria in one patient, acute urinary retention in one patient, and the need for a second session of mPCCL in another patient. The stones were composed of calcium oxalate (3), ammonium acid urate (1), calcium phosphate (1), cystine (1), struvite (1), and unknown (5).. Transillumination-guided mPCCL is a safe and effective technique, does not require the use of ionizing radiation, is technically easy, and is a minimally invasive alternative for the management of bladder stones. It has many advantages, especially in pediatric patients, such as decreased urethral injury, no need for postoperative catheter insertion in most cases, and shorter operative time.

Topics: Calcium Phosphates; Catheterization; Child; Child, Preschool; Cystine; Female; Hematuria; Humans; Infant; Length of Stay; Magnesium Compounds; Male; Operative Time; Phosphates; Postoperative Complications; Struvite; Transillumination; Uric Acid; Urinary Bladder Calculi

To identify the underlying cause of clinical signs in cats with nonobstructive diseases of the bladder and urethra.. Prospective case series.. 109 cats examined by the urology service of The Ohio State University's veterinary teaching hospital because of stranguria, hematuria, pollakiuria, or urination in inappropriate locations.. History was obtained and a CBC, serum biochemical analyses, serologic tests for FeLV and feline immunodeficiency virus, urinalysis, bacterial culture of urine, and contrast radiography or urethrocystoscopy (females only) were performed.. 16 cats had cystic calculi: 8 had struvite uroliths, 7 had calcium oxalate uroliths, and 1 had a urolith of unknown composition in conjunction with an anatomic defect. Anatomic defects, including diverticulae, urethral strictures, and a malpositioned urethra, were identified in 12 cats. A urinary tract infection was identified in 1 cat, and neoplasia was diagnosed in 2. One of the cats with neoplasia also had a struvite urolith. The remaining 80 cats did not have an anatomic defect, urolith, or tumor. Ten of these cats also did not have radiographic or cystoscopic abnormalities and were presumed to have a behavioral disorder. The remaining 70 cats had radiographic or cystoscopic abnormalities, and idiopathic cystitis was diagnosed. In 14 of the cats with idiopathic cystitis, results of a urinalysis were normal. Cats with idiopathic cystitis were significantly more likely to eat dry food exclusively (59%) than were cats in the general population (19%).. Results suggest that idiopathic cystitis occurs commonly in cats with stranguria, hematuria, pollakiuria, or inappropriate elimination and is associated with consumption of dry foods. Contrast radiography or cystoscopy is necessary for differentiating idiopathic cystitis from behavioral disorders in some cats.

Topics: Animal Feed; Animals; Cat Diseases; Cats; Cystitis; Cystoscopy; Diverticulum; Female; Hematuria; Hydrogen-Ion Concentration; Magnesium Compounds; Male; Phosphates; Prospective Studies; Proteinuria; Specific Gravity; Struvite; Urethra; Urethral Stricture; Urinary Bladder Calculi; Urinary Bladder Diseases; Urine; Urologic Diseases

To investigate the effect of choreito consumption (500 mg/kg of body weight/d) on struvite crystal formation and signs of lower urinary tract disease (LUTD) in cats consuming a commercial canned diet with 0.5% added inorganic magnesium.. 6 male and 6 female adult cats, all considered to be clinically normal on the basis of physical examination findings; results of CBC, serum biochemical analyses, urinalyses, and urine cultures; and freedom from urolithiasis on the basis of urethrocystoscopic (females) or urethrocystographic (males) findings.. Diets were fed for 12 weeks, or until appearance of signs of LUTD, including dysuria, hematuria, urine pH > 7.0, and severe struvite crystalluria. Presence of at least 2 of these signs was required for removal from study. Urine specimens were examined for electrolytes, struvite crystal content, and hematuria.. Results for urine variables were compared between groups at 4 weeks, because of reduction in cat numbers attributable to removal from study. Struvite crystal content of 24-hour urine specimens was significantly lower for cats fed the choreito-containing diet. Moreover, frequency and severity of hematuria were significantly decreased in cats fed the choreito-containing diet. Correlation between hematuria and struvite crystal content was not observed in either group. Additionally, all 6 cats fed the diet without choreito had been removed from study by day 58 because of signs of LUTD. Of the 6 cats fed the choreito-containing diet, 2 completed the 12-week study.. Choreito may be beneficial for relief of some signs of struvite-associated LUTD disease in cats.

Topics: Analysis of Variance; Animal Feed; Animals; Cats; Diuretics; Drugs, Chinese Herbal; Female; Food, Fortified; Hematuria; Magnesium; Magnesium Compounds; Male; Phosphates; Struvite; Time Factors

Aggregates of struvite crystals caused urethral obstruction in a high percentage of cats fed moist and dry diets supplemented with Mg oxide. Some of the diets were associated with cystolith formation as well. The percentage of Mg in the experimental diets was a misleading indicator of Mg intake because of differences between moist and dry diets in their caloric density. Magnesium homeostasis was maintained in cats ingesting large quantities of Mg. Tissue (kidney, muscle, and rib) concentrations of Mg were the same in cats fed high Mg and control diets. Plasma Mg concentration was increased only in cats ingesting the largest amount of Mg. Magnesium homeostasis was maintained by a marked increase in urine Mg excretion. However, urine Mg concentration was not directly related to Mg intake, apparently because of differences between diets in intestinal absorption of Mg. Urethral obstruction of experimental cats was not associated with a transient increase in Mg intake, nor did obstructing cats have higher urine Mg concentrations than did nonobstructing cats fed the same diet. This observation indicates that factor(s) other than urine Mg concentration are important in urethral obstruction. Cats with urethral obstruction due to naturally occurring disease, feline urological syndrome (FUS), had markedly lower urine Mg concentrations than cats fed high Mg diets. This finding refutes the theory that cats develop FUS because of primary Mg hyperabsorptive phenomena or because of a primary urinary leak of Mg. It also indicates that factors other than urine Mg concentration are involved in the genesis of naturally occurring urethral obstruction. Another difference between the natural and the induced disease was related to the character of the urinary precipitates. Experimental diets higher in Mg concentration caused urolith formation, which is uncommon with FUS. Lower Mg diets caused obstruction with aggregates of crystals, but mucus was not observed. However, in the experimental disease induced in the present study, urinary precipitates were predominantly or exclusively struvite, as has been reported in the natural disease. Many similarities were seen between the diet-induced disease and FUS, but factors in addition to Mg intake are involved in the natural disease. The importance of Mg, compared with the undefined factors, remains to be established.

Topics: Animals; Cat Diseases; Cats; Food, Fortified; Hematuria; Magnesium; Magnesium Compounds; Magnesium Oxide; Male; Minerals; Phosphates; Struvite; Syndrome; Urethral Obstruction; Urination Disorders