struvite and Urolithiasis

The prevalence of urolithiasis is steadily increasing worldwide in both genders. Diet and lifestyle, such as the rising prevalence of obesity and other metabolic syndrome traits, are considered key factors in this trend. Gender differences as a result of interventional therapy for urolithiasis have not been observed. However, iatrogenic injury to the male urethra is considered the most common reason for urethral strictures after endourologic (stone) therapy. In contrast, sepsis, as the major cause of urinary stone-related mortality, is more frequently reported in women after ureterorenoscopy and percutaneous nephrolithotomy. There are also differences in the frequency of various types of stones between men and women. Calcium oxalate and uric acid stones are more commonly observed in men, while carbonate apatite and struvite are diagnosed more often in women. Urinary stone analysis is therefore paramount for successful recurrence prevention. Diagnosis is based on the assignment of patients to the low-risk or high-risk group. The medical nutrition and pharmacological measures for the therapy of the respective type of stone are based on the risk factors in 24 h urine samples. A personalized approach that accounts for gender differences could further improve treatment, and recurrence prevention decisions for urinary stones.. Die Prävalenz der Urolithiasis nimmt weltweit bei beiden Geschlechtern stetig zu. Ernährung und Lebensstil, wie die zunehmende Prävalenz der Adipositas und weitere Komponenten des metabolischen Syndroms, gelten als Schlüsselfaktoren für diese Entwicklung. Geschlechtsspezifische Unterschiede als Ergebnis der interventionellen Therapie der Urolithiasis wurden bisher nicht beobachtet. Iatrogene Verletzungen der männlichen Harnröhre gelten jedoch als häufigster Grund für Harnröhrenstrikturen nach endourologischer (Stein)therapie. Dagegen wird eine Sepsis, als Hauptursache der harnsteinbedingten Mortalität, nach Ureterorenoskopie und perkutaner Nephrolithotomie häufiger bei Frauen konstatiert. Zudem bestehen Unterschiede in der Häufigkeit verschiedener Steinarten zwischen Männern und Frauen. Kalziumoxalat- und Harnsäuresteine werden häufiger bei Männern beobachtet, während Karbonatapatit und Struvit bevorzugt bei Frauen diagnostiziert werden. Die Harnsteinanalyse ist daher die wichtigste Voraussetzung für eine erfolgreiche Rezidivprävention. Die Diagnostik richtet sich nach der Zuordnung der Patienten zur Niedrig- oder Hochrisikogruppe. Die ernährungsmedizinischen und pharmakologischen Maßnahmen zur Therapie der jeweiligen Steinart orientieren sich dabei an den Risikofaktoren im 24-h-Harn. Ein personalisierter Ansatz, der geschlechtsspezifische Unterschiede berücksichtigt, könnte Therapie und Entscheidungen zur Rezidivprävention von Harnsteinen weiter verbessern.

Topics: Calcium Oxalate; Female; Humans; Male; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

Kidney stone disease is one of the oldest diseases known to medicine; however, the mechanisms of stone formation and development remain largely unclear. Over the past decades, a variety of theories and strategies have been developed and utilized in the surgical management of kidney stones, as a result of recent technological advances. Observations from the authors and other research groups suggest that there are five entirely different main mechanisms for kidney stone formation. Urinary supersaturation and crystallization are the driving force for intrarenal crystal precipitation. Randall's plaques are recognized as the origin of calcium oxalate stone formation. Sex hormones may be key players in the development of nephrolithiasis and may thus be potential targets for new drugs to suppress kidney stone formation. The microbiome, including urease‑producing bacteria, nanobacteria and intestinal microbiota, is likely to have a profound effect on urological health, both positive and negative, owing to its metabolic output and other contributions. Lastly, the immune response, and particularly macrophage differentiation, play crucial roles in renal calcium oxalate crystal formation. In the present study, the current knowledge for each of these five aspects of kidney stone formation is reviewed. This knowledge may be used to explore novel research opportunities and improve the understanding of the initiation and development of kidney stones for urologists, nephrologists and primary care.

Topics: Apatites; Calcinosis; Calcium Oxalate; Calcium Phosphates; Gastrointestinal Microbiome; Humans; Kidney; Kidney Calculi; Struvite; Uric Acid; Urolithiasis

The prevalence of urolithiasis in humans is increasing worldwide; however, non-surgical treatment and prevention options remain limited despite decades of investigation. Most existing laboratory animal models for urolithiasis rely on highly artificial methods of stone induction and, as a result, might not be fully applicable to the study of natural stone initiation and growth. Animal models that naturally and spontaneously form uroliths are an underused resource in the study of human stone disease and offer many potential opportunities for improving insight into stone pathogenesis. These models include domestic dogs and cats, as well as a variety of other captive and wild species, such as otters, dolphins and ferrets, that form calcium oxalate, struvite, uric acid, cystine and other stone types. Improved collaboration between urologists, basic scientists and veterinarians is warranted to further our understanding of how stones form and to consider possible new preventive and therapeutic treatment options.

Topics: Animals; Biomedical Research; Calcium Oxalate; Cats; Cystine; Disease Models, Animal; Dogs; Dolphins; Ferrets; Genetic Predisposition to Disease; Hyperuricemia; Otters; Risk Factors; Struvite; Uric Acid; Urolithiasis

Compared to adults, urolithiasis is less common in children, with a definite rise in incidence, especially among young adults (Tasian et al. in Clin J Am Soc Nephrol 11:488, 2016). In the last 25 years, the incidence in children has increased by approximately 6-10% annually, for reasons still unknown, with an associated significant increase in related health care-related expenditures (Hyams and Matlaga in Transl Androl Urol 3(3):278-83, 2014). It has been shown that there is twice as high a risk of chronic kidney disease (CKD) or end stage renal disease (ESRD) in stone formers compared to non-stone formers (Tasian et al. 2016). While calcium-containing stones are by far the most common category of stone encountered in both children and adults, non-calcium stones are more common in children than adults and have been shown in several studies to be associated with greater morbidity and lower renal function than calcium stones (Issler et al. in BMC Nephrol 18(1):136, 2017; Gambaro et al. in J Urol 198:268-273, 2017). This could be related to the challenges in the management of non-calcium-containing stones due to associated infection or metabolic derangements, further leading to recurrence and loss of renal function. There is currently a gap in our understanding of how to appropriately and effectively encounter and manage patients with non-calcium-containing stones, as such cases are encountered less frequently. Identification of stone composition and appropriate management is very important to reduce serious complications and recurrence, especially in non-calcium stones. We present a review of diagnosis and management of non-calcium-containing stones in the pediatric population, in hopes of providing more clarity to providers and promoting a consideration of non-calcium stone composition with all children presenting with urolithiasis.

Topics: Calcium Oxalate; Calculi; Disease Management; Female; Humans; Kidney Calculi; Lithotripsy; Male; Pediatrics; Prognosis; Severity of Illness Index; Struvite; Treatment Outcome; Uric Acid; Urolithiasis

Struvite is one of the most common urinary/kidney stones, composed of magnesium ammonium phosphate (MgNHPO. This review summarizes various reports on the factors responsible for inducing struvite stones in the kidney and gives a detailed account of studies on inhibition of growth of struvite crystals.. The presence of urea-splitting bacteria such as Proteus mirabilis and alkaline pH plays a crucial role in struvite formation. In vitro inhibition of struvite stones by various chemical agents were examined mainly in artificial urine whereas inhibition by herbal extracts was studied in vitro by gel diffusion technique. Herbal extracts of curcumin, Boerhaavia diffusa Linn, Rotula aquatica and many other plants, as well as some chemicals like pyrophosphate, acetohydroxamic acid, disodium EDTA and trisodium citrate, were reported to successfully inhibit struvite formation.. The present review recapitulates various factors affecting the growth of struvite urinary stones and the inhibitory role of certain chemicals and herbal extracts. Most of the tested plants are edible hence can be easily consumed without any adverse effects whereas the side effects of chemicals are unknown due to lack of toxicity studies. Thus, the use of herbal extracts might serve as an alternate and safe therapy for prevention of struvite stones.

Topics: Animals; Crystallization; Humans; Kidney; Plant Preparations; Struvite; Urinary Calculi; Urinary Tract Infections; Urolithiasis

Archeological findings give profound evidence that humans have suffered from kidney and bladder stones for centuries. Bladder stones were more prevalent during older ages, but kidney stones became more prevalent during the past 100 years, at least in the more developed countries. Also, treatment options and conservative measures, as well as 'surgical' interventions have also been known for a long time. Our current preventive measures are definitively comparable to those of our predecessors. Stone removal, first lithotomy for bladder stones, followed by transurethral methods, was definitively painful and had severe side effects. Then, as now, the incidence of urolithiasis in a given population was dependent on the geographic area, racial distribution, socio-economic status and dietary habits. Changes in the latter factors during the past decades have affected the incidence and also the site and chemical composition of calculi, with calcium oxalate stones being now the most prevalent. Major differences in frequency of other constituents, particularly uric acid and struvite, reflect eating habits and infection risk factors specific to certain populations. Extensive epidemiological observations have emphasized the importance of nutritional factors in the pathogenesis of urolithiasis, and specific dietary advice is, nowadays, often the most appropriate for prevention and treatment of urolithiasis.

Topics: Calcium Oxalate; Demography; Feeding Behavior; Humans; Lithotripsy; Magnesium Compounds; Nutritional Physiological Phenomena; Phosphates; Risk Factors; Struvite; Uric Acid; Urinary Bladder Calculi; Urolithiasis

Urolithiasis is a general term referring to the causes and effects of stones anywhere in the urinary tract. Urolithiasis should not be viewed conceptually as a single disease with a single cause, but rather as a sequela of multiple interacting underlying abnormalities. Thus, the syndrome of urolithiasis may be defined as the occurrence of familial, congenital, or acquired pathophysiologic factors that, in combination, progressively increase the risk of precipitation of excretory metabolites in urine to form stones (ie, uroliths). The following epidemiologic discussion is based on quantitative analysis of 350,803 canine uroliths, 94,778 feline uroliths, and 6310 feline urethral plugs submitted to the Minnesota Urolith Center from 1981 to 2007.

Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Breeding; Calcium Oxalate; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Minnesota; Phosphates; Risk Factors; Struvite; Urinary Calculi; Urolithiasis

Feline urolithiasis represents 15% of all cases of nonobstructive lower urinary tract disease in cats. Approximately 50% of feline uroliths are composed of struvite. Struvite urolithiasis commonly recurs, but optimal management may decrease its frequency. The pathophysiology and management of struvite urolithiasis are different in cats and dogs. This article focuses on struvite urolithiasis in cats, highlighting important aspects of pathophysiology, treatment, and prevention.

Topics: Age Factors; Animals; Breeding; Cat Diseases; Cats; Female; Hydrogen-Ion Concentration; Magnesium Compounds; Male; Phosphates; Risk Factors; Species Specificity; Struvite; Urolithiasis

Diagnostic imaging is usually required to determine the presence of urolithiasis. Double-contrast cystography is more accurate than survey radiography and approximately as accurate as ultrasonography. Knowledge of the mineral composition of calculi helps direct appropriate management of urolithiasis, and signalment can help predict composition with about 70% accuracy. In cats, about half of cystic calculi are struvite and half are calcium oxalate; most nephroliths and ureteroliths are calcium oxalate. In female dogs, struvite uroliths are the predominant type found in the bladder. In male dogs, breed plays a strong role in prediction of bladder urolith type. It is difficult to predict the composition of nephroliths and ureteroliths based on signalment alone in dogs. Urinalysis and imaging findings can help in predicting urolith composition, although chemical analysis is necessary for definitive diagnosis.

Topics: Animals; Calcium Oxalate; Cat Diseases; Cats; Diagnosis, Differential; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Pedigree; Phosphates; Radiography, Abdominal; Sex Factors; Struvite; Ultrasonography; Ureteral Calculi; Uric Acid; Urolithiasis

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

To compare the efficacy and safety of using 2 commercially available, low-magnesium, urine-acidifying dry foods to dissolve sterile struvite uroliths in cats.. Prospective, multicenter, randomized clinical trial .. 37 cats with presumed struvite uroliths.. Cats were randomly assigned to be fed 1 of 2 low-magnesium, urine-acidifying dry foods (food A or B). For each cat, physical examination, urinalysis, and abdominal radiography were performed weekly to assess treatment response.. 32 cats had complete urolith dissolution. Mean ± SD times for a 50% reduction in urolith size (0.69 ± 0.1 weeks) and complete urolith dissolution (13.0 ± 2.6 days) were significantly shorter for cats fed food A, compared with those (1.75 ± 0.27 weeks and 27.0 ± 2.6 days, respectively) for cats fed food B. At study termination, mean ± SD urine pH (6.083 ± 0.105) for cats fed food A was lower than that (6.431 ± 0.109) for cats fed food B. In 5 cats, uroliths did not dissolve and were subsequently determined to be composed of 100% ammonium urate (n = 4) or 100% calcium oxalate (1). Adverse events associated with diet were not observed in any of the cats.. Results indicated that dietary dissolution is safe and effective for eradication of sterile struvite uroliths in cats. Cats fed food A had faster urolith dissolution than did cats fed food B. Lack of a reduction in urolith size at 2 weeks after diet initiation was indicative of misdiagnosis or noncompliance.

Topics: Animal Feed; Animals; Cat Diseases; Cats; Diet; Female; Magnesium Compounds; Male; Phosphates; Struvite; Urolithiasis

Urolithiasis is a common clinical problem in dogs. Struvite and calcium oxalate are the predominant mineral types in dog urolithiasis. The aim of the present study was to compare the effect of two commercial dry foods formulated for the management of struvite urolithiasis with different anion-cation balance on urinary pH. For the trial, twelve privately owned adult dogs showing struvite urolithiasis were studied. The dogs were randomly divided into two groups (A and B) and fed two dissolving diets for 3 months. The analyses of urine were repeated six times. In both diets, the anion-cation balance was negative ( - 203 and - 192 for diets A and B, respectively). At the first urine analysis, pH values of all the dogs were close to 8.0, and bacteria were present in about 70 % of the samples and thus an antimicrobial was administered for 1 week. Both groups showed a progressive decrease in pH values, and after 2 months, in both cases, the recommended pH values for stone dissolution were achieved. From the sampling at 30 d, group A showed pH values significantly (P < 0.05) lower than group B, probably due to the lower anion-cation balance of diet A. The combination of antimicrobial and dietary therapy allowed the dissolution of struvite uroliths in both groups, even if the utilisation of the diet characterised by the lower anion-cation balance seems to decrease the urinary pH more rapidly. In this case, it seems necessary to interrupt the dietary treatment in order to avoid the risk of other diseases.

Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Anti-Bacterial Agents; Diet; Dog Diseases; Dogs; Fluoroquinolones; Hydrogen-Ion Concentration; Magnesium Compounds; Phosphates; Struvite; Urinary Tract Infections; Urolithiasis

 The aim of the study is to explore the relationship between clinical characteristics and urinary calculus in Xinjiang Uyghur children, and to provide clinical basis for the prevention as well as treatment of urinary stone..  In total, 236 urinary tract stone samples were collected from pediatric patients from February 2017 to April 2019, and those samples were analyzed by infrared spectroscopy. Stone compositions were compared with demographic data..  Among the 236 cases, 166 cases were boys (70.34%) and 70 cases were girls (29.66%), with a male-to-female ratio of 2.37:1. A total of 21 kinds of calculi were detected, including 107 cases with six kinds of simple calculi and 129 cases with 15 kinds of mixed calculi. In this study, magnesium ammonium phosphate hexahydrate was only found in boys, and the difference was statistically significant (6.6 vs. 0.0%,.  Uyghur pediatric patients with urolithiasis were young and the majority of stones was mixed, The main components of calculi were ammonium hydrogen urate, calcium oxalate and apatite carbonate, and there are differences in the localization of calculi between genders.

Topics: Ammonium Compounds; Apatites; Calcium Oxalate; Carbonates; Child; Female; Humans; Male; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

In this paper, we present the results of research on the physicochemical properties of two selected faces of the struvite crystal, which is the main component of infectious urinary stones. Two main faces, (001) and ([Formula: see text]), ending the c-axis, were selected for the study. These faces are not related by symmetry relations, which means, among other things, that they should have a different atomic structure, which was confirmed experimentally. In addition, the studies show that the tested surfaces have hydrophilic properties, however, the ([Formula: see text]) face is more hydrophilic compared to the (001) face. The physicochemical properties of the crystal as a whole, as well as the physicochemical properties of these faces influence the magnitude of adhesion. The adhesive force in both water and artificial urine is greater for face ([Formula: see text]) compared to face (001). The assessment of the adhesion of Proteus mirabilis bacteria in artificial urine also shows that the adhesion is greater for face ([Formula: see text]) than for face (001). The adhesion of bacteria to the examined faces of the struvite crystal, and in particular the increased adhesion of bacteria to the face ([Formula: see text]), may be the first stage of biofilm formation, which may result in a high rate of recurrence of infectious urinary stones after treatment.

Topics: Bacterial Adhesion; Humans; Struvite; Urinary Calculi; Urolithiasis

To determine the efficacy and safety of a urinary acidifier (d,l-methionine [Methio-Form]) and an antimicrobial agent (amoxicillin-clavulanic acid [Clavamox]) without changing diet for dissolving infection-induced struvite urocystoliths in dogs.. 14 dogs were recruited for this prospective study; 11 completed it and 3 dogs withdrew due to inability of the owners to administer the treatment (n = 2) or refusal of treatment by the dog (1).. All dogs were administered d,l-methionine (approx initial dose of 75 mg/kg, PO, q 12 h) and amoxicillin-clavulanic acid (22 mg/kg, PO, q 12 h) based on urine culture and sensitivity. Urine pH, urinalysis, urine culture, venous blood gas and serum biochemical analysis, and lateral survey abdominal radiographic images were evaluated initially and every 4 weeks until urolith dissolution (success) or lack of change in size and/or shape of urocystoliths on 2 consecutive reevaluation points (failure) occurred.. Uroliths dissolved in 8 of 11 dogs in a median of 2 months (range, 1 to 4 months) with a final effective dosage of d,l-methionine of approximately 100 mg/kg, PO, every 12 hours. In 3 dogs, uroliths failed to dissolve and were removed surgically; they contained variable amounts of calcium oxalate. No adverse events occurred.. Infection-induced struvite urolithiasis is 1 of the 2 most common minerals occurring in canine uroliths. Results of this study supported the use of d,l-methionine and amoxicillin-clavulanic acid without changing diet for dissolution of infection-induced struvite urocystoliths in dogs.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Dog Diseases; Dogs; Magnesium Compounds; Methionine; Phosphates; Pilot Projects; Prospective Studies; Struvite; Urinary Calculi; Urolithiasis

To assess the clinical outcome of a ferret undergoing a ureteroneocystostomy for treatment of urolithiasis.. A 10-month-old spayed female ferret.. The ferret was evaluated for straining to urinate and defecate, hematochezia, and a rectal prolapse. Plain radiographs revealed large cystic and ureteral calculi. Clinicopathologic analyses indicated the ferret was anemic with an elevated creatinine concentration. Exploratory laparotomy defined bilateral ureteral calculi that were unable to be successfully moved into the bladder. A cystotomy was performed to remove a large cystic calculus. Serial abdominal ultrasonographic examinations showed progressive hydronephrosis of the left kidney and persistent pyelectasia of the right kidney secondary to bilateral ureteral calculi. This confirmed a left ureteral obstruction secondary to the distal calculus while the right ureter remained patent.. A ureteroneocystostomy was performed to allow for left renal decompression. The ferret recovered well despite worsening hydronephrosis of the left kidney in the perioperative period. The ferret was discharged from the hospital 10 days after initial evaluation. At 3-week follow-up, abdominal ultrasonography confirmed resolution of hydronephrosis and ureteral dilation of the left kidney and ureter.. A ureteroneocystostomy successfully allowed renal decompression and ureteral patency in a ferret with urolithiasis. To the authors' knowledge, this is the first time this procedure has been reported in a ferret for treatment of a ureteral calculus obstruction and may result in good long-term outcome.

Topics: Animals; Female; Ferrets; Hydronephrosis; Struvite; Ureter; Ureteral Calculi; Ureteral Obstruction; Urolithiasis

The prevalence and disease burden of urolithiasis has increased substantially worldwide in the last decade, and intraluminal holmium laser lithotripsy has become the primary treatment method. However, inappropriate laser energy settings increase the risk of perioperative complications, largely due to the lack of intraoperative information on the stone composition, which determines the stone melting point. To address this issue, we developed a fiber-based fluorescence spectrometry method that detects and classifies the autofluorescence spectral fingerprints of urinary stones into three categories: calcium oxalate, uric acid, and struvite. By applying the support vector machine (SVM), the prediction accuracy achieved 90.28 % and 96.70% for classifying calcium stones versus non-calcium stones and uric acid versus struvite, respectively. High accuracy and specificity were achieved for a wide range of working distances and angles between the fiber tip and stone surface in an emulated intraoperative ambient. Our work establishes the methodological basis for engineering a clinical device that achieves real-time, in situ classification of urinary stones for optimizing the laser ablation parameters and reducing perioperative complications in lithotripsy.

Topics: Humans; Lithotripsy, Laser; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

With limited information available, the association among urinary tract infections, urease-producing bacteria and the presence of magnesium ammonium phosphate (MAP) urolithiasis in canines in Thailand requires more study.. This study aimed to investigate the association between demographic characteristics of canines and the presence of MAP urolithiasis in canines, and to evaluate antimicrobial susceptibility patterns of bacteria isolated from canine uroliths.. A total of 56 canines admitted for treatment with surgical removal of uroliths were recruited. Demographic characteristics and clinical chemistry data were recorded. Bacteria isolated from the removed uroliths were identified. Chemical compositions of the uroliths were analyzed by Fourier transform infrared spectrometer. Potential risk factors were determined with univariable and multivariable logistic regression analyses.. Of 56 canine urolithiasis, bacteria were isolated from uroliths of 38 canines (27 MAP and 11 non-MAP) but not from uroliths of 18 canines (5 MAP and 13 non-MAP). The most common bacteria found in nidus of MAP uroliths was. Our results indicate that

Topics: Animals; Anti-Infective Agents; Bacteria; Bacterial Infections; Dog Diseases; Dogs; Drug Resistance, Bacterial; Female; Phosphates; Risk Factors; Struvite; Urease; Urinary Calculi; Urolithiasis

Urolithiasis is the most common cause of urinary tract disease in small ruminants and has significant economic and production impacts worldwide. Urolithiasis is multifactorial in origin and generally begins with the formation of cystoliths followed by urethral obstruction. The condition is most common in males. Clinical signs are variable depending on the severity of the obstruction. Uroliths can be calcium, struvite, or silicate based; however, struvite and amorphous magnesium calcium phosphate are the most common urolith types observed in small ruminants. Although urethral process (vermiform appendage) amputation is widely considered the first line of treatment, reobstruction is common within the first 36 hours. Surgical interventions such as temporary tube cystostomy, perineal urethrostomy (PU), modified proximal perineal urethrostomy, vesico-preputial anastomosis (VPA), and urinary bladder marsupialization (BM) are reported to carry an improved prognosis for long-term survival. PU carries a lower proportion of long-term success (> 12-month survival time) when compared with VPA and BM. Stoma stricture and urine scald are the most commonly observed surgical complications. Currently, the literature provides minimal direction for clinician decision-making in managing these cases while accounting for patient history, client financial ability, composition of calculi, and potential treatment complications. Small ruminant urinary obstructions are challenging and complicated conditions to treat, due to their multifactorial etiology, ruminant urogenital anatomy, and the variety of imperfect treatment options available. The purpose of this article this article is to provide veterinary practitioners with decision trees to guide management and treatment of urolithiasis in small ruminants.

Topics: Animals; Decision Trees; Goat Diseases; Goats; Male; Ruminants; Struvite; Urethral Obstruction; Urinary Bladder Calculi; Urinary Calculi; Urolithiasis

A 4-month-old, 7 kg, intact male, Bernese mountain dog was presented for obstructive struvite ureterolithiasis. Multiple urethroliths, ureteroliths, and urocystoliths were present. Based on an abdominal ultrasound, there was severe left hydronephrosis and hydroureter from distal ureterolith obstruction, just proximal to the vesicoureteral junction. The dog was not azotemic. Successful treatment was accomplished

Topics: Animals; Dog Diseases; Dogs; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Struvite; Ureterolithiasis; Urinary Tract Infections; Urolithiasis

This study aimed to predict the composition of urolithiasis using deep learning from urinary stone images.. We classified 1,332 stones into 31 classes according to the stone composition. The top 4 classes with a frequency of 110 or more (class 1: calcium oxalate monohydrate [COM] 100%, class 2: COM 80%+struvite 20%, class 3: COM 60%+calcium oxalate dihydrate [COD] 40%, class 4: uric acid 100%) were selected. With the 965 stone images of the top 4 classes, we used the seven convolutional neural networks (CNN) to classify urinary stones and compared their classification performances.. Among the seven models, Xception_Ir0.001 showed the highest accuracy, precision, and recall and was selected as the CNN model to predict the stone composition. The sensitivity and specificity for the 4 classes by Xception_Ir0.001 were as follows: class 1 (94.24%, 91.73%), class 2 (85.42%, 96.14%), class 3 (86.86%, 99.59%), and class 4 (94.96%, 98.82%). The sensitivity and specificity of the individual components of the stones were as follows. COM (98.82%, 94.96%), COD (86.86%, 99.64%), struvite (85.42%, 95.59%), and uric acid (94.96%, 98.82%). The area under the curves for class 1, 2, 3, and 4 were 0.98, 0.97, 1.00, and 1.00, respectively.. This study showed the feasibility of deep learning for the diagnostic ability to assess urinary stone composition from images. It can be an alternative tool for conventional stone analysis and provide decision support to urologists, improving the effectiveness of diagnosis and treatment.

Topics: Calcium Oxalate; Deep Learning; Humans; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

In recent years, there has been a continuous increase in the incidence of urolithiasis, especially in highly developed countries. Therefore, the question arises which factors specific to these countries may be responsible for the increase in the incidence of this disease. In this article, we try to assess the effect of phosphoric acid, a component of various carbonated drinks, including Coca-Cola, on the nucleation and growth of struvite crystals, which are the main component of infectious urinary stones. The research was carried out in the environment of artificial urine with and without the presence of Proteus mirabilis bacteria. In the latter case, the activity of bacterial urease was simulated by adding an aqueous ammonia solution. The obtained results indicate that phosphoric acid present in artificial urine causes the nucleation of struvite to shift towards a lower pH, which means that struvite nucleates earlier in artificial urine compared to the control test. The amount of struvite formed is the greater the higher the concentration of phosphoric acid. At the same time, as the concentration of phosphoric acid increases, the growing struvite crystals are larger, which is disadvantageous because they are more difficult to remove from the urinary tract along with the urine. For the highest levels of phosphoric acid tested, large dendrites are formed, which are particularly undesirable as they can damage the epithelium of the urinary tract. The effect of phosphoric acid on the nucleation and growth of struvite is explained in base of chemical speciation analysis. This analysis indicates that the MgHCit and MgCit

Topics: Carbonated Beverages; Crystallization; Humans; Magnesium Compounds; Phosphates; Phosphoric Acids; Proteus mirabilis; Struvite; Urease; Urine; Urolithiasis

This article summarizes urinary stone submissions from foxes in human care to the Minnesota Urolith Center over 40 years. A previous report documented the analysis of uroliths from foxes that were submitted between 1981 and 2007.

Topics: Animals; Calcium Oxalate; Calcium Phosphates; Calculi; Cystine; Dog Diseases; Dogs; Humans; Magnesium Compounds; Male; Minnesota; Phosphates; Struvite; Urinary Calculi; Urolithiasis

This clinical case describes struvite urolithiasis in a pet chipmunk. Physical examination revealed the presence of two ovoid palpable masses in the caudal part of the abdomen, which were later confirmed by radiography as urinary bladder stone. The animal underwent ventral midline laparotomy and uroliths were successfully removed. Uroliths analysis revealed the presence of struvite and bacteriology showed the presence of Proteus mirabilis. Little is known about aetiology and incidence of urolithiasis in chipmunks. Client education about husbandry, dietary needs, and animal behaviour is necessary, especially when dealing with less commonly kept exotic companion mammals. This is the first report of struvite urolithiasis in a pet chipmunk.

Topics: Animals; Behavior, Animal; Phosphates; Proteus mirabilis; Rodent Diseases; Sciuridae; Struvite; Urolithiasis

the aim of the determination of the diagnostic information content of the qualitative analysis method - urinary calculus for use in medical practice in the study of the chemical structure of urolite. Materials, methods: Determination of the chemical composition of uroliths in the collection of urinary stones (n=2960), presented in "a Database of patients with urolithiasis who live in the territory of the Republic of Belarus" (2006-2019), made the developed method of qualitative analysisbased on the combined conduct of optical macroscopy of the sample, qualitative chemical reactions and chemical reactions of reprecipitation with subsequent microscopy of the crystals formed.. The developed method allowed identifying the following clinically most significant mineral components of urinary stones: vevellite (42.4%), weddellite (28.1%), Apatite (19.6%), carbonate Apatite (5.1%), struvite (13.2%), uric acid (17.6%), ammonium urate (0.4%), cystine (0.7%). The obtained data were consistent with the results of studying the elemental composition of urinary stones (n=24) by atomic emission spectrometry with inductively coupled plasma. The calcium level was highest in calcium stones (25.56% C oxalate and 19.73% C phosphate) with a minimum content (0.012%) in urate stones. The amount of magnesium prevailed in the group with magnesium-ammonium-phosphate stones (2.51%) at extremely low concentrations in urate samples (7.810-4%). The percentage of phosphorus was maximum (13.47%) in the group of uroliths, represented by phosphate salts of calcium and magnesium (with values of 0.67% - calcium oxalate and 0.013% urate). Identification of trace elements Al, Ba, Cu, Fe, Zn, Sr revealed a fluctuation in their content in the range from 0.037 to 546.3 ppm.. Considering the practical availability of implementation, low financial costs and sufficient information, the method of qualitative rapid analysis of urinary stone, based on a combined optical macroscopy of the sample, qualitative chemical reactions and chemical reactions of reindeposition with subsequent microscopy of the formed crystals, can be recommended for wide use in medical institutions of any regional level in the diagnosis of chemical types of uroliths in patients with ICD.

Topics: Humans; Phosphates; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

The aim of the study was to determine the efficacy of the low struvite relative supersaturation diet in dissolution of feline struvite cystoliths.. This was a prospective, open-label, two-center study. Twelve client-owned cats were enrolled based on the radiographic appearance of their uroliths and urinalysis parameters. Cats were fed the test diet exclusively for up to 56 days. Cats were radiographed every other week until radiographic evidence of dissolution occurred or the end of the study period was reached. Cats with radiographically apparent uroliths at the end of the study period underwent cystotomy for stone retrieval and analysis.. Nine of the 12 cats completed the study. Eight experienced radiographic dissolution; seven of these had complete dissolution within the first month of treatment. One cat, whose owner declined cystotomy after partial dissolution at day 56, had complete radiographic resolution at 70 days of treatment. Two calcium oxalate urolith cores were removed from a cat that had partial radiographic dissolution.. The test diet was successful in dissolving suspected struvite cystoliths. As this diet is suitable for maintenance feeding of adult cats, it may be a suitable choice for long-term prevention of feline struvite urolithiasis.

Topics: Animals; Cat Diseases; Cats; Diet; Magnesium Compounds; Phosphates; Prospective Studies; Solubility; Struvite; Urinary Bladder Calculi; Urolithiasis

Analysis of large datasets of uroliths is necessary to illustrate the prevalence and risk factors of urolithiasis. Furthermore, it may help to improve treatment and prevention of urolithiasis. In this study, 7866 uroliths (44.5% feline and 55.5% canine) from veterinary practitioners in the Netherlands between 2014 and 2020 were analysed. Between 2014 and 2020 the distribution over the different types of uroliths remained similar over time. Female cats, obese cats, Domestic Shorthair cats, female dogs, and large breed dogs had an increased risk for struvite. Neutered cats, all cat breeds except Domestic Shorthair, neutered dogs, male dogs, intact male dogs, and small breed dogs had an increased risk for calcium oxalate urolithiasis. Cystine and urate were found predominantly in male dogs. Dalmatians were at highest risk for urate urolithiasis. The findings of this study in the Netherlands were similar to findings in previous studies from different countries. However, urate urolithiasis in the English Cocker Spaniel and cystine urolithiasis in the Yorkshire Terrier were new associations. Body condition score, information about recurrence of urolithiasis, medical history, and diet history should be included in submission sheets in the future to explore other possible associations.

Topics: Animals; Calcium Oxalate; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Netherlands; Phosphates; Risk Factors; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

To evaluate the characteristics of urinary stone composition in a Korean population using a large database of stone composition.. From January 1, 2014, to June 30, 2019, a total of 33,078 urinary stone composition data were analyzed. Stone composition was classified into four main groups: calcium oxalate (CaOx), struvite, uric acid (UA), and calcium phosphate (CaP). We examined the relationship between stone composition and sex, age, geographic region, calendar month, and season.. The CaOx group (46.41%) was the largest, followed by the struvite group (29.66%), UA group (19.61%), and CaP group (4.32%). The CaOx group tended to decrease with age, but the UA group increased with age. Also, the CaOx group had the highest percentage in summer and the lowest in spring (p<0.001). The struvite and CaP groups had higher percentages of females than males (struvite: 36.6% vs. 25.7%, p<0.001; CaP: 6.2% vs. 3.3%, p<0.001). Conversely, the UA stones were more common in males than in females (24.5% vs. 11.0%, p<0.001). The UA group had the lowest percentage in the capital region (p<0.001). The total male-to-female ratio decreased over time from 1.95:1 in 2014 to 1.67:1 in 2018 (p<0.001).. There were differences for each stone composition in the percentages according to sex, age, geographic region, month, and season. Identifying these differences based on the stone composition is vital for the treatment and prevention of urinary stones.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Calcium Oxalate; Calcium Phosphates; Child; Child, Preschool; Databases, Factual; Female; Geography; Humans; Infant; Infant, Newborn; Male; Middle Aged; Republic of Korea; Seasons; Sex Factors; Struvite; Uric Acid; Urinary Calculi; Urolithiasis; Young Adult

Bacterial infection has long been recognized to contribute to struvite urinary stone deposition; however, its contribution to the development of chronic kidney stones has not been extensively investigated. In the present study, we hypothesized another possible method of bacteria contributing to the formation of calcium oxalate (CaOx) that accounts for the biggest part of the kidney stone. Bacteria may play important roles by influencing renal Ca

Topics: Animals; Calcium Channels; Gene Expression Regulation; Immunity, Innate; Kidney; Kidney Calculi; Proteus Infections; Proteus mirabilis; Rats; RNA, Messenger; Struvite; Urinary Bladder; Urolithiasis

Poorly crystalline and amorphous precipitate (PCaAP) is one of the components of the so-called infectious urinary stones, which are the result of the activity of urease-producing microorganisms, mainly from the Proteus species, in particular Proteus mirabilis. The main component of this kind of stones is crystalline struvite (MgNH

Topics: Apatites; Durapatite; Humans; Lipopolysaccharides; Proteus mirabilis; Struvite; Urinary Calculi; Urinary Tract Infections; Urine; Urolithiasis

Incidence of pediatric urolithiasis is decreasing in most developing countries where endemic bladder stones are less prevalent than in the past years. In parallel, stone composition has changed. Only few data are available in North Africa, except for Tunisia. We report stone composition in the Moroccan pediatric population.. Composition of 432 stones from children (302 boys, 130 girls) was determined by infrared spectroscopy. The samples were collected during the period 1999-2016. Stone morphology, which is an important aspect for etiology was determined by examination of each stone under a stereomicroscope. Stone composition was compared to patients' age and gender.. The global male-to-female ratio was 2.32. Regarding stone composition, calcium oxalate was the main component in 51.6% of the stones, followed by struvite (18.1%), ammonium urate (9.5%) and carbapatite (9%). Significant differences were found between males and females: calcium oxalate accounted for 72.3% of stones in girls and 42.7% in boys (P<10. This is the largest series of pediatric stones in Morocco studied by infrared analysis and morphological examination.. 3.

Topics: Adolescent; Age Factors; Apatites; Calcium Oxalate; Child; Child, Preschool; Female; Humans; Incidence; Infant; Male; Morocco; Sex Factors; Spectrophotometry, Infrared; Struvite; Urinary Calculi; Urolithiasis

The present study aimed to investigate the chemical composition of urinary calculi in people living in the northern border area of Saudi Arabia and to formulate suggestions for prevention of renal stones. Urinary stones were obtained from patients attending the Urology Departments of Prince Abdul Aziz Bin Musaad Hospital and Central Hospital, Arar, Saudi Arabia. Stones were analyzed using kit for semi-quantitative colorimetric determination of carbonate, calcium, magnesium, ammonium, oxalate, phosphate, uric acid and cysteine; manufactured by LTA s.r.l. Milano 15/F, 20060 Bussero (Milano), Italy. From a total of 55 urinary stones, 49 (89%) were retrieved from males, while 6 (11%) from females. Ages of patients ranged from 15 to 75 years with the mean of 50.22}14.46 and majority of patients were between 31-50 years (69.08%). Most of the patients were overweight (70.91 %) in both the genders. Calcium oxalate stones were 60%, uric acid 18.18% and calcium phosphate 10.90%, while other forms of stones were scarce. It is concluded that upper urinary tract stones were predominant, comprising mostly of calcium oxalate and urate, which could be prevented by control of obesity; moderate intake of meat, dairy products, fruit vegetables (with minimal oxalates); and plenty of fluids.

Topics: Adolescent; Adult; Aged; Calcium Carbonate; Calcium Oxalate; Calcium Phosphates; Female; Humans; Male; Middle Aged; Phosphates; Prospective Studies; Saudi Arabia; Struvite; Uric Acid; Urinary Calculi; Urolithiasis; Young Adult

Struvite urolithiasis with bacterial urinary tract infection (UTI) is commonly reported in dogs; few data exist to describe successful dissolution protocols in dogs with naturally occurring disease. We hypothesized that a dry therapeutic urinary diet combined with targeted antimicrobial therapy can effectively dissolve presumptive struvite cystolithiasis in dogs with naturally occurring urease-producing bacterial UTI.. Ten dogs with presumed infection-induced struvite cystolithiasis based on lower urinary tract signs (LUTS), radiodense cystoliths, and urease-producing bacterial UTI were enrolled. At enrollment, antimicrobials and dry therapeutic urinary diet were dispensed. In addition to lack of radiographic resolution of urolithiasis, dogs with persistent clinical signs were considered non-responders. There was no significant difference in pH between responders and non-responders; USG was significantly higher in the responder group. Recheck visits continued until radiographic dissolution or failure was documented. Five of the 10 dogs achieved radiographic dissolution of cystolithiasis within a median of 31 days (range 19-103). In the other 5 dogs, surgical urolith removal was necessary due to persistent LUTS (3 dogs within 2 weeks) or lack of continued dissolution noted radiographically (1 dog with numerous cystoliths failed at day 91; 1 dog failed by day 57 with questionable owner compliance).. Dissolution of urinary tract infection induced struvite cystoliths can be accomplished in some dogs fed this dry therapeutic urinary diet in conjunction with antimicrobial therapy. Case selection could increase the likelihood of successful dissolution; however, if calcium phosphate is present, this could also prevent stone dissolution. If clinical signs persist despite diet and antimicrobials, stone removal is advised.

Topics: Animals; Anti-Infective Agents; Dog Diseases; Dogs; Struvite; Treatment Outcome; Urinary Bladder Calculi; Urinary Tract Infections; Urolithiasis

A 7-year-old female spayed shih tzu dog was presented with hematuria of 4 weeks' duration. Radiographs revealed 1 cystic calculus. A polypoid mass was found incidentally during cystotomy and was removed by partial cystectomy. Histopathology revealed eosinophilic polypoid cystitis and urolith analysis reported struvite. A urinary tract infection was treated.

Topics: Animals; Cystitis; Dog Diseases; Dogs; Eosinophilia; Struvite; Urolithiasis

Female nude mice (J:NU-Foxn1nu; age, 6 wk) were injected with 1 million MCF7 human breast cancer cells in the fourth mammary fat pads and received a 21-d sustained-release estrogen pellet (0.25 mg) subcutaneously in the dorsum of the neck. All mice were maintained in sterile housing and provided sterile water and irradiated rodent chow. Approximately 6 wk after implantation, 4 of the 30 mice showed clinical signs of depression and dehydration. The 2 animals most severely affected were euthanized and presented for necropsy. The urinary bladders of these animals were distended with variable sized white, opaque uroliths. Urinalysis revealed coccal bacteria, erythrocytes, neutrophils and struvite crystals. Urine cultures from both necropsied animals grew heavy, pure growths of Staphylococcus xylosus. The organism was sensitive to all antibiotics tested except erythromycin (intermediate). Analysis of the uroliths revealed 100% struvite composition. Remaining mice in the study were evaluated clinically for hydration status, the ability to urinate, and the presence of palpable stones in the urinary bladder; one additional mouse had a firm, nonpainful bladder (urolithiasis suspected). Given the sensitivity of the organisms cultured from urine samples, the remaining mice were placed on enrofloxacin in the drinking water (0.5 mg/mL). All remaining mice completed the study without further morbidity or mortality. Previous studies have reported the association of estrogen supplementation with urinary bladder pathology, including infection and urolithiasis. Here we present a case of urolithiasis and cystitis in nude mice receiving estrogen supplementation that was associated with Staphylococcus xylosus, which previously was unreported in this context. When assessing these nude mice for urolithiasis, we found that visualizing the stones through the body wall, bladder palpation, and bladder expression were helpful in identifying affected mice.

Topics: Animals; Cystitis; Estrogens; Female; Humans; MCF-7 Cells; Mice; Mice, Nude; Staphylococcus; Struvite; Urolithiasis

Urolithiasis affects primarily the urinary tract and complications as debilitating as renal failure may develop. Determining the chemical composition of uroliths can aid management and prevention of recurrence in patients.. To determine the chemical composition and anatomical distribution of uroliths in Nigeria.. This descriptive cross-sectional study was conducted between March 2014 and February 2016, in a tertiary hospital in Nigeria. We reviewed the outcomes of uroliths of adult patients sent to our laboratory for chemical analyses. Samples were analyzed using simple qualitative tests.. 52 adult patients were included with a mean age (SD) of 46.6 (12.6) years. Males (76.9%) were more affected than females (23.1%). For both sexes, highest occurrence of stones was in bladder (85.7%). Calcium-containing stones had the highest occurrence (85.2%) and predominated in the renal, ureter and urethra, followed by struvite stones (59.5%). In the bladder, struvite stones were predominant (85.8%), with calcium-containing stones accounting for 71.4%.. This study showed that struvite and calcium phosphate-containing stones constitute majority of uroliths in our setting with low occurrence of calcium oxalate stones. This indicates that urinary tract infection most likely plays a substantial role in the formation of uroliths in Nigerians. Modern methods of stone analysis is advocated to further define management options.

Topics: Adult; Aged; Calcium Phosphates; Cross-Sectional Studies; Female; Humans; Magnesium Compounds; Male; Middle Aged; Nigeria; Struvite; Tertiary Care Centers; Urinary Calculi; Urinary Tract Infections; Urolithiasis

A dog was referred for nutrition consultation after surgical removal of struvite uroliths from the bladder. Inspection of the dog's current ration revealed a pronounced vitamin-A deficiency together with a marked deficiency of protein, phosphorus and magnesium. Therefore, a supersaturation of the urine with ammonium, magnesium and phosphate, the three constituents of struvite, as a cause of struvite calculi formation appears rather unlikely. Vitamin-A deficiency can promote urinary infections and consequently struvite stone formation because of the lack of the protective effect of vitamin A on the epithelia of the urinary tract. Not only common causes for struvite urolith formation, including urinary supersaturation with stone-forming constituents and urinary tract infection, but also less common causes, including vitamin-A deficiency, which was the presumed trigger in the present case study, have to be taken into consideration. Dietetic measures appear to be a useful tool in such cases to prevent uroliths from reoccurring.

Topics: Animals; Dogs; Magnesium Deficiency; Phosphorus; Protein Deficiency; Struvite; Urolithiasis; Vitamin A Deficiency

In Morocco, as in many countries, a large number of patients use medicinal plants to treat their disease including urinary lithiasis. The aim of the present work is to study the antilithiasic effect of Erica multiflora aqueous extract, purported for its antilithiasic effect in the oriental region of Morocco.. E. multiflora aqueous extract was studied in two oxalo-calcic models of rats rendered experimentally lithiasic. Urinary biochemistry parameters were measured and histological slides of kidneys were analyzed. The effect of the extract was also tested in a magnesium ammonium phosphate crystallization model in vitro. The number of crystals and their size in presence and absence of extract were compared.. E. multiflora extract did not inhibit the development of parenchymal and papillary calcifications and therefore did not prevent calcium oxalate crystallization into kidneys. Even if there was an increase in urinary pH and diuresis, the plant extract did not show a significant inhibitory activity against calcium oxalate crystallization. However, the plant extract exerted an efficient antilithiasic activity toward struvite crystallization inhibiting the formation of crystals by reduction of their size and numbers as well as their aggregation.. E. multiflora aqueous extract need to be used in the inhibition and elimination of magnesium ammonium phosphate crystals rather than calcium oxalate ones.. 3.

Topics: Animals; Calcium Oxalate; Ericaceae; Male; Phytotherapy; Plant Extracts; Rats; Rats, Wistar; Struvite; Urolithiasis

Understanding urolith trends and risk factors is important for understanding urolithiasis, which is a common problem in dogs. This study evaluated 75 674 canine cystolith submissions to the Canadian Veterinary Urolith Centre between 1998 and 2014. Struvite and calcium oxalate uroliths comprised 80.8% of all uroliths, with calcium oxalate outnumbering struvite. There were significant increases in the proportions of calcium oxalate, mixed and cystine uroliths, and significant decreases in struvite, urate, silica, and calcium phosphate carbonate over the study period. Breeds associated with increased risk of calcium oxalate urolithiasis tended to be small breeds, while those that were at increased risk of struvite urolith formation were larger breeds. Dalmatians were at increased risk of forming both urate and xanthine uroliths while Scottish deerhounds had a remarkably high association with cystine urolithiasis. Males were more likely to form calcium oxalate and metabolic uroliths and females were more likely to develop struvite and mixed uroliths.

Topics: Animals; Calcium Oxalate; Dog Diseases; Dogs; Female; Male; Retrospective Studies; Risk Factors; Struvite; Urolithiasis

The present investigation is focused on exploring the anti-urolithiatic potential of aqueous leaf extract of Tragia involucrata (TIA) and its silver nanoparticles (AgNPs) and to quantify the total phenol, flavonoid, terpenoid and sterol contents present in TIA. Quantification results suggested TIA to be a rich source of phenol, flavonoid and terpenoid and less of sterol content. The AgNPs were synthesized by a simple green method using aqueous extract of T. involucrata. The formation of AgNPs was confirmed through UV spectroscopy, particle size analysis, zeta potential, X-ray diffraction and transmission electron microscopy. The in vitro struvite growth inhibitory activity of the extract was performed using a single gel diffusion method. Samples incorporated with higher concentration of 2% TIA and AgNPs (200 μg mL

Topics: Animals; Calcium Oxalate; Euphorbiaceae; Gout Suppressants; Kidney; Male; Metal Nanoparticles; Plant Extracts; Plant Leaves; Rats, Wistar; Silver; Struvite; Urolithiasis

In this study data on composition of uroliths collected from cats and epidemiologic data of affected cats in Switzerland from 2002 to 2009 are summarised. Of 884 stones analysed 50% (n=441) were composed of calcium oxalate, 45% (n=398) of struvite, 3% (n=18) of ammonium urate, 1% (n=12) were mixed stones, 1% (n=9) were composed of silica, 3 stones were solidified blood, 2 consisted of cystine and 1of xanthine. 40% of the ureteral stones were composed of struvite. Domestic cats had significantly less calcium oxalate stones compared to British Shorthair or Persian cats. Cats with calcium oxalate stones were older and cats with struvite stones were younger than other affected cats. Female and male cats were equally affected with stones. Compared to studies from other countries, in Switzerland silica stones occurred more often and ureteral stones were more often composed of Struvite. The present study shows that occurrence and prevalence of urinary calculi of cats from Switzerland exhibited only slight differences to studies from other countries.. In dieser Arbeit werden Daten zur Zusammensetzung von Harnsteinen bei Katzen und epidemiologische Daten dieser Katzen in der Schweiz in den Jahren 2002 bis 2009 zusammengefasst. Von allen 884 analysierten Steinen bestanden 50% (n=441) aus Kalziumoxalat, 45% (n=398) aus Struvit, 3% (n=18) aus Ammoniumurat, 1% (n=12) waren gemischte Steine, 1% (n=9) bestanden aus Silikat, 3 Steine waren aus verfestigtem Blut, 2 bestanden aus Cystin und einer aus Xanthin. 40% der Uretersteine bestanden aus Struvit. Hauskatzen hatten signifikant seltener Kalziumoxalatsteine als British Shorthair oder Perser Katzen. Katzen mit Kalziumoxalatsteinen waren älter und Katzen mit Struvitsteinen waren jünger als andere betroffene Katzen. Weibliche und männliche Katzen waren gleich häufig von Steinen betroffen. Im Vergleich zu Studien aus anderen Ländern, kamen in der Schweiz Silikatsteine häufiger vor und Uretersteine bestanden häufiger aus Struvit. Die vorliegende Untersuchung zeigt, dass Vorkommen und Häufigkeit von Harnsteinen bei Katzen in der Schweiz nur geringe Unterschiede zu Studien aus anderen Ländern aufweisen.. Dans le présent travail, on résume les données relatives à la composition des calculs urinaires chez les chats en Suisse ainsi que les données épidémiologiques de ces animaux entre 2002 et 2009. Parmi les 884 calculs analysés, 50% (n=441) étaient composés d’oxalate de calcium, 45% (n=398) de struvite, 3% (n=18) d’urate d’ammonium, 1% (n=12) étaient des calculs mixtes 1% (n=9) se composaient de silicate, 3 calculs étaient formé de sang aggloméré, 2 étaient composés de cystine et un de xanthine. 40% des calculs urétraux se composaient de struvite. Les chats de maison avaient significativement moins de calculs d’oxalate de calcium que les British Shorthair ou les Persans. Les chats présentant des calculs d’oxalate de calcium étaient plus âgés et ceux présentant des struvites plus jeunes que tous les autres chats atteints. Les femelles et les mâles souffraient de calculs de façon équivalente. En comparaison avec des études menées dans d’autres pays, les calculs de silicate étaient plus fréquents en Suisse et les calculs urétraux se composaient plus souvent de struvite. Cette étude démontre que la survenue et la fréquence de calculs urinaires chez les chats en Suisse ne présente que peu de différence avec les études faites dans d’autres pays.. In questo studio vengono riassunti i dati sulla composizione degli uroliti nei gatti e i dati epidemiologici degli stessi in Svizzera dal 2002 al 2009. Il 50% (n=441) degli 884 calcoli analizzati era composto di ossalato di calcio, il 45% (n=398) di struvite, il 3% (n=18) di urato di ammonio, l’1% (n=12) di calcoli misti, l’1% (n=9) di silicati, 3 calcoli erano di sangue coagulato, 2 di cisteina e 1 di xantina. Il 40% dei calcoli nell’uretere erano composti da struvite. I gatti domestici avevano significativamente meno calcoli composti da ossalato di calcio che il British Shorthair o i gatti persiani. Paragonando i gatti colpiti, quelli affetti da calcoli di ossalato di calcio erano anziani mentre quelli con calcoli di struvite giovani. Il sesso dei gatti non era un fattore che influenzava più o meno la presenza di calcoli. Rispetto agli studi di altri Paesi, in Svizzera i calcoli urinari più comuni sono composti da silicati mentre quelli dell’uretere da struvite. Il presente studio dimostra che la prevalenza e l’incidenza dei calcoli urinari nei gatti in Svizzera è solo di poco differente che in altri Paesi.

Topics: Animals; Calcium Oxalate; Cat Diseases; Cats; Female; Kidney Calculi; Male; Silicon Dioxide; Struvite; Switzerland; Uric Acid; Urolithiasis

Struvite or magnesium ammonium phosphate hexahydrate (MAPH) are biological crystals, found in the kidney, which are formed due to the infection caused by urea splitting bacteria in the urinary tract. The struvite crystals observe different morphologies and were developed using single diffusion gel growth technique. The crystalline nature and its composition were studied from different characterization techniques like X-ray Diffraction (XRD) and FTIR. The dielectric behavior of the developed crystal was studied by varying temperature and at different frequencies. The parameters like dielectric constant, dielectric loss, ac conductivity, ac resistivity, impedance and admittance of the struvite crystals were calculated. The studies proved that the dielectric loss or dissipation heat is high in lower frequencies at normal body temperature, which develops a plasma state in the stones and in turn leads to the disintegration of urinary stones. The dielectric nature of the stones leads to the dielectric therapy, which will be a gateway for future treatment modality for urolithiasis.

Topics: Crystallization; Electric Conductivity; Electric Impedance; Humans; Magnesium Compounds; Phosphates; Spectroscopy, Fourier Transform Infrared; Struvite; Urolithiasis; X-Ray Diffraction

Topics: Aged; Anti-Bacterial Agents; Biofilms; Catheter-Related Infections; Corynebacterium; Corynebacterium Infections; Humans; Male; Opportunistic Infections; Recurrence; Struvite; Urinary Catheterization; Urinary Tract Infections; Urolithiasis

Urinary stasis is a risk factor for recurrent urinary tract infection (UTI). Homozygous mutant Megabladder (Mgb-/-) mice exhibit incomplete bladder emptying as a consequence of congenital detrusor aplasia. We hypothesize that this predisposes Mgb-/- mice to spontaneous and experimental UTI.. Mgb-/-, Mgb+/-, and wild-type female mice underwent serial ultrasound and urine cultures at 4, 6, and 8 weeks to detect spontaneous UTI. Urine bacterial isolates were analyzed by Gram stain and speciated. Bladder stones were analyzed by x-ray diffractometry. Bladders and kidneys were subject to histologic analysis. The pathogenicity of coagulase-negative Staphylococcus (CONS) isolated from Mgb-/- urine was tested by transurethral administration to culture-negative Mgb-/- or wild-type animals. The contribution of urinary stasis to CONS susceptibility was evaluated by cutaneous vesicostomy in Mgb-/- mice.. Mgb-/- mice develop spontaneous bacteriuria (42%) and struvite bladder stones (31%) by 8 weeks, findings absent in Mgb+/- and wild-type controls. CONS was cultured as a solitary isolate from Mgb-/- bladder stones. Bladders and kidneys from mice with struvite stones exhibit mucosal injury, inflammation, and fibrosis. These pathologic features of cystitis and pyelonephritis are replicated by transurethral inoculation of CONS in culture-negative Mgb-/- females, whereas wild-type animals are less susceptible to CONS colonization and organ injury. Cutaneous vesicostomy prior to CONS inoculation significantly reduces the quantity of CONS recovered from Mgb-/- urine, bladders, and kidneys.. CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice.

Topics: Animals; Bacteriuria; Cystitis; Disease Susceptibility; Female; Hydrogen-Ion Concentration; Magnesium Compounds; Mice; Mice, Mutant Strains; Phosphates; Pyelonephritis; Staphylococcus; Struvite; Urinary Bladder; Urinary Diversion; Urinary Tract; Urinary Tract Infections; Urolithiasis

Struvite urinary calculi, which are composed of magnesium, ammonium, and phosphate, can cause complications including sepsis and renal failure. Struvite calculi were identified within the urinary bladder and renal pelvis of 2 Long-Evans rats that died within days after arrival from a commercial vendor. The remaining rats in the shipment were screened by physical examination, radiography, and ultrasonography, revealing an additional 2 animals that were clinically affected. These rats were euthanized, necropsied, and yielded similar findings to those from the first 2 rats. In addition, urine samples had an alkaline pH and contained numerous bacteria (predominantly Proteus mirabilis), leukocytes, and crystals. All calculi were composed completely of struvite. Another 7 rats in the shipment had alkaline urine with the presence of blood cells; 6 of these rats also had abundant struvite crystals, and P. mirabilis was cultured from the urine of 3 rats. Further investigation by the vendor identified 2 of 100 rats with struvite calculi from the same colony. Although no specific cause could be implicated, the fact that all the affected rats came from the same breeding area suggests a genetic or environmental triggering event; a contribution due to diet cannot be ruled out. Our findings suggest that the affected rats had metabolic disturbances coupled with bacterial infection that predisposed them to develop struvite calculi. During sudden increases of struvite urinary calculi cases in rats, urine cultures followed by appropriate surgical intervention and antibiotic therapy is warranted. Additional factors, including diet, merit attention as well.

Topics: Animals; Magnesium Compounds; Male; Phosphates; Radiography; Rats; Rats, Long-Evans; Struvite; Ultrasonography; Urolithiasis

Information on composition of uroliths collected between 2003 and 2009 from dogs in Switzerland and epidemiologic data of affected dogs are summarised in this paper. Of 490 stones analysed 44% were composed of calcium oxalate, 330% of struvite, 80% of silica, 7% of urate, 3% of cystine, 3% were mixed stones and 1% each were calcium phosphate and xanthine stones. Compared to other dogs, Norwich Terriers, Norfolk Terriers, Miniature Schnauzers, Miniature Pinscher and Yorkshire Terriers had a significantly increased risk to suffer from calcium oxalate stones, Dalmatians and Continental Bulldogs from urate stones and English Bulldogs from cystine stones. No breed had an increased risk of struvite or silica stones. Stones composed of silica were more prevalent in Switzerland compared to other countries and were more common in the eastern part than in the western part of Switzerland. This study shows that there are differences in occurrence and prevalence of uroliths between Switzerland and surveys of other countries.

Topics: Animals; Breeding; Calcium Oxalate; Calcium Phosphates; Cystine; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Phosphates; Prevalence; Risk Factors; Silicon Dioxide; Struvite; Switzerland; Uric Acid; Urinary Calculi; Urolithiasis; Xanthine

To characterize patients who form nonstruvite stones associated with infection (secondarily infected calculi), and to define the bacteria associated with these.. Patients undergoing percutaneous nephrolithotomy were prospectively recruited. Medical records were reviewed, and stones were analyzed using micro computed tomography and infrared spectroscopy. A fragment of each stone was sent for bacterial culture. Patients were categorized by stone culture results (SC ±) and the presence of struvite (ST ±). The Fisher exact test was used for comparison of proportion. Sterility of intraoperative SC was established with independently collected controls.. In total, 125 patients were enrolled: 24 SC+/ST-, 19 SC+/ST+, and 82 SC-/ST-. Proportions of patients with prior urologic surgery, diabetes, and immunodeficiency were similar between groups. Patients with neurogenic bladder were more likely to have SC+/ST+ stones or SC+/ST- stones than SC-/ST- stones (26% vs 8% vs 0%, respectively; P <.01). Among patients with metabolic evaluations, hypocitraturia was found in 31.6% (6 of 19) SC+/ST- patients, 46.7% (7 of 15) SC+/ST+ patients, and 26.0% (19 of 73) of SC-/ST- patients (P = .28). Approximately 40% of cultured organisms in the secondarily infected calculi possessed urease and another 40% citrate lyase activities.. Secondarily infected stones were detected in approximately 20% of this surgical cohort and may be more common than previously appreciated. Neurogenic bladder appeared to predispose patients to either struvite or secondarily infected stones. The role of bacterial infection in stone formation is unclear but may include alteration of urinary components, acting as a nidus for crystallization, or inducing inflammation.

Topics: Adult; Aged; Calcium Oxalate; Calcium Phosphates; Cohort Studies; Female; Humans; Incidence; Magnesium Compounds; Male; Middle Aged; Nephrostomy, Percutaneous; Phosphates; Postoperative Care; Preoperative Care; Prognosis; Prospective Studies; Risk Assessment; Struvite; Uric Acid; Urinalysis; Urinary Tract Infections; Urolithiasis

Struvite calculi, composed of magnesium ammonium phosphate, have existed for thousands of years in human medicine and are a leading cause of calculi in companion animals. Struvite stones have also been called urease, infection-induced, phosphatic, and triple phosphate stones. They are the most common uroliths in dogs, in which most cases of struvite urolithiasis are associated with infection. Management of struvite urolithiasis requires a multimodal approach that addresses the presence of the urolith(s) and associated infection while identifying risk factors that predispose to the development of infection.

Topics: Animals; Anti-Bacterial Agents; Diet; Dietary Proteins; Dog Diseases; Dogs; Female; Genetic Predisposition to Disease; Humans; Lithotripsy; Magnesium Compounds; Male; Phosphates; Sex Factors; Struvite; Urolithiasis

Topics: Animal Feed; Animal Nutrition Sciences; Animal Nutritional Physiological Phenomena; Animals; Calcium Oxalate; Cat Diseases; Cats; Magnesium Compounds; Nephrolithiasis; Phosphates; Prevalence; Struvite; Urolithiasis

To identify factors associated with development of struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.. Retrospective case-control study.. 508 dogs with a first-time diagnosis of struvite urolithiasis and 7,135 control dogs.. Electronic medical records of all dogs evaluated at 787 general care veterinary hospitals in the United States between October 2007 and December 2010 were reviewed to identify dogs that developed struvite urolithiasis and 2 groups of control dogs with no history of urolithiasis. Information extracted included diet, age, sex, neuter status, breed size category, hospital location, and date of diagnosis. Urinalysis results, urolith composition, and other disease conditions were recorded if applicable. Potential risk factors were assessed with univariable and multivariable regression analysis.. Toy- or small-sized breeds had significantly greater odds of struvite urolithiasis, compared with medium- or large-sized breeds. Neutering significantly increased the odds of this outcome in females only; sexually intact females were more likely to develop struvite urolithiasis than were sexually intact males, but only up to 5 years of age. Urinary factors significantly associated with the outcome were basic (vs acidic) pH, presence of RBCs or WBCs, protein concentration > 30 mg/dL, and ketone concentration ≥ 5 mg/dL.. Evaluation of demographic characteristics and urinalysis results may be useful in the early identification of struvite urolithiasis in dogs. Periodic urinalysis in dogs is recommended because of the potential health impact of a late diagnosis of urolithiasis.

Topics: Aging; Animals; Case-Control Studies; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Multivariate Analysis; Phosphates; Retrospective Studies; Risk Factors; Sex Factors; Struvite; United States; Urolithiasis

Epidemiological surveys are important tools to identify emerging trends in disease. The Minnesota Urolith Centre has been tracking the occurrence of uroliths for over 30 years. To evaluate global changes in the frequencies of canine uroliths, submissions to the Minnesota Urolith Centre in 1999 and 2000 (n = 39,965) were compared with submissions in 2009 and 2010 (n = 99,598). The proportion of calcium oxalate uroliths rose on every continent except in Europe. Seventy-five per cent of dogs with calcium oxalate uroliths were between 5 and 11 years old. The proportion of struvite uroliths decreased on every continent except in Australia-Oceania. Seventy-seven per cent of all struvite formers were between two and eight years old. The proportion of purine uroliths has declined slightly. Worldwide, uroliths composed of cystine, calcium phosphate, calcium phosphate carbonate and silica remain uncommon. Epidemiological studies of urolithiasis are essential for constructing effective experimental designs and selecting appropriate cases and controls to conduct clinical trials with meaningful results.

Topics: Age Factors; Animals; Calcium Oxalate; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Phosphates; Sentinel Surveillance; Species Specificity; Struvite; Urinary Calculi; Urolithiasis

To identify breed-associated risk factors for urolithiasis in dogs from the UK.. Records of all canine uroliths submitted to Hills Pet Nutrition UK for analysis at the University of Minnesota Urolith Centre over 10 years (1997 to 2006) were reviewed. The results, along with the request forms completed by the submitting veterinarian, were analysed. The most commonly affected breeds, age and gender of the dogs were identified for each of the most common types of uroliths (struvite, calcium oxalate, urate, cystine and mixed). Pearson's chi-squared tests were performed to assess whether certain breeds of dogs were over-represented relative to a reference population (from an insurance database).. The records of 14,008 urolith submissions were analysed. The relative frequency of struvite remained stable over time, whereas calcium oxalate decreased over the study period. Breeds found to be significantly over-represented for calcium oxalate uroliths included the Chihuahua, miniature poodle and Yorkshire terrier. Staffordshire bull terriers and English bulldogs were at increased risk for cystine uroliths.. Associations between breed, gender, age and urolith formation were similar to those reported elsewhere. However, temporal trends and novel breed predispositions were identified.

Topics: Animals; Calcium Oxalate; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Phosphates; Retrospective Studies; Risk Factors; Species Specificity; Struvite; United Kingdom; Urinary Calculi; Urolithiasis

The qualitative and quantitative analyses of crystalluria have clinical significance in the diagnosis and prognosis of urolithiasis. The aim of this paper is to provide a new accurate methodology to get qualitative and quantitative data on urine particulate in patients with renal stone disease.The procedure involves a urine collection, the separation of the solid residual by centrifugation, and its analysis by X-ray diffraction, utilizing a micro-diffractometer in order to analyze very low amounts of residual. The spectrum obtained was converted into 2 θ -I profiles and quantitatively refined by Rietveld method. The proposed methodology has the advantage to accurately quantify all crystalline phases and the amorphous component of the urine; anyway urine samples have to be centrifuged and analysed as soon as possible, because the quantitative results obtained by the X-ray microdiffraction showed that after some days and at room temperature urine increased significantly both amorphous and crystalline phases.

Topics: Adult; Aged; Calcium Oxalate; Case-Control Studies; Female; Humans; Magnesium Compounds; Male; Middle Aged; Phosphates; Reproducibility of Results; Struvite; Temperature; Time Factors; Uric Acid; Urolithiasis; X-Ray Diffraction

The mineral composition of 7819 small animal uroliths in the UK was determined by semi-quantitative X-ray diffraction over a period of 90 months from 2002 to 2010. Canine and feline uroliths constituted 97% of the study population and the mineral phase detected most frequently was struvite (43%), followed by calcium oxalate (41%). Uroliths from crossbreeds, Dalmatians, Yorkshire terriers and Shih Tzus accounted for almost 30% of all canine uroliths, with the highest frequency in Dalmatians, which had a predominance of urate uroliths. The average ages of dogs and cats with uroliths were 7.0 years and 7.4 years, respectively. The ratio of the number of dogs presenting with struvite compared to oxalate phases reached a maximum at 3years of age.

Topics: Age Factors; Animals; Breeding; Calcium Oxalate; Cats; Dogs; Female; Ferrets; Guinea Pigs; Magnesium Compounds; Male; Phosphates; Rabbits; Risk Factors; Species Specificity; Struvite; United Kingdom; Urinary Calculi; Urolithiasis

The objective of the study was to evaluate epidemiological data derived from 2735 canine uroliths received by Hill's Pet Nutrition from Spain and Portugal between January 2004 and December 2006. The results of quantitative analysis from Minnesota Urolith Center (MUC) were compared with that from other countries and interrelations of mineral composition, age, breed, and gender were determined. The most frequent calculus was calcium oxalate (38.1%) followed by struvite (32.9%). Eighty-three breeds plus crossbreeds (25%) were identified. In all of them, but Dalmatians, calcium oxalate and struvite accounted for 71-78%. The mean age of urolith appearance was 7.6 years. There was a significant difference in the frequency of different uroliths composition among the six most common breeds presenting urolithiasis in Spain and Portugal (Yorkshire terrier, Miniature Schnauzer, Cocker Spaniel, Poodle, Shih Tzu and Dalmatian). This is the first report on xanthine urolithiasis found in Spain. Prevalence of cystine calculi was significantly lower (3.2%) than that reported previously in parts of Spain (26%).

Topics: Age Factors; Animals; Breeding; Calcium Oxalate; Cystine; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Phosphates; Portugal; Retrospective Studies; Sex Factors; Spain; Struvite; Urinary Calculi; Urolithiasis; Xanthine

Kidney stones are a potential risk factor for chronic kidney disease. The impact of different urinary stone components on renal function is unknown. In this study, we retrospectively reviewed 1,918 medical records of patients with urolithiasis. The renal function was evaluated as estimated glomerular filtration rate. All the stones were analyzed by Fourier transform infrared spectroscopy. The patients were divided into five groups according to the stone components. Statistical analysis was performed with analysis of variance. All the patients with stones had Stage 2-3 chronic kidney disease. The patients with uric acid and struvite stones had significantly lower estimated glomerular filtration rate compared with those having other stone components (p<0.01). Furthermore, the patients with calcium-containing stones (calcium oxalate and calcium phosphate) had significantly better renal function than those with non-calcium-containing stones (struvite and uric acid, p<0.01). Patients with urolithiasis had decreased renal function, and the impact of renal function varied depending on the stone components. We conclude that stone analysis is important in predicting the change in renal function in patients with urolithiasis. Moreover, the patients with non-calcium-containing stones, such as struvite and uric acid stones, should be carefully evaluated and treated to preserve their renal function.

Topics: Adult; Aged; Calcium Oxalate; Calcium Phosphates; Female; Glomerular Filtration Rate; Humans; Kidney Calculi; Magnesium Compounds; Male; Middle Aged; Phosphates; Retrospective Studies; Spectroscopy, Fourier Transform Infrared; Struvite; Uric Acid; Urolithiasis

To confirm that the predominant mineral type in naturally occurring uroliths in ferrets is struvite; to determine whether age, breed, sex, reproductive status, geographic location, season, and anatomic location are risk factors associated with urolith formation in ferrets; to compare features of struvite uroliths in cats with those in ferrets; and to determine whether there is a logical evidence-based rationale for clinical trials of the safety and efficacy of diet-induced dissolution of struvite uroliths in ferrets.. Retrospective case-control study.. 408 ferrets with uroliths (272 struvite uroliths) from the Minnesota Urolith Center, and 6,528 control ferrets from the Veterinary Medical Database.. Historical information was obtained about each ferret. The association between proposed risk factors and outcome (struvite urolith formation) was assessed.. Sterile struvite was the predominant mineral in uroliths in ferrets. Neutered male ferrets had a significantly increased risk of developing sterile struvite uroliths. A significant association was also found between increasing age and the detection of struvite uroliths. Struvite uroliths in ferrets were more likely to be retrieved from the lower urinary tract than from the upper urinary tract.. Knowledge of predominant mineral type in uroliths along with insight into etiologic, demographic, and environmental risk and protective factors for urolithiasis may facilitate development of surveillance strategies that result in earlier detection of uroliths in ferrets. Modification of risk factors, including dietary risk factors, may help to minimize urolith formation, dissolve existing uroliths, and minimize urolith recurrence.

Topics: Animals; Case-Control Studies; Cat Diseases; Cats; Female; Ferrets; Logistic Models; Magnesium Compounds; Male; Odds Ratio; Phosphates; Retrospective Studies; Risk Factors; Seasons; Struvite; Urolithiasis

The chemical composition and ultrastructure of urinary calculi obtained from male Boer goats were studied using qualitative chemical analysis, scanning electron microscopy, X-ray diffraction, X-ray energy dispersive spectrometry and Fourier transform infra-red spectroscopy. The calculi came from 10 naturally-occurring cases of urolithiasis and from seven cases of urolithiasis experimentally-induced by feeding a cottonseed meal-rice straw diet supplemented with magnesium oxide. The results indicated that the major component of urinary calculi collected from naturally-occurring and experimentally-induced cases of urolithiasis was struvite (magnesium ammonium phosphate). The study also identified previously unreported prismatic crystals in the uroliths of goats, similar to struvite but rich in potassium. The characteristic ultrastructure of struvite uroliths is described along with a brief discussion of their formation.

Topics: Animals; Crystallization; Goat Diseases; Goats; Magnesium Compounds; Male; Phosphates; Struvite; Urinary Calculi; Urolithiasis

To learn more about the biomineralization process of struvite in ruminants, a seldom noticeable crystal, struvite-K, was investigated in six goats in which urolithiasis was induced by feeding a cottonseed meal and rice straw diet supplemented with MgO. The compositions of crystals and calculi were studied by chemical qualitative analysis and X-ray energy dispersive spectrometry (EDS). The activity product (AP) and relative supersaturation (RSS) of magnesium ammonium phosphate (MAP) and potassium magnesium phosphate (MKP) were calculated to compare the difference of crystals formed in this process. The results showed that calculi consisted of MAP with a little MKP. Crystals in the urine consisted of MAP and MKP before stone formation, but crystals in urine after stone formation mainly consisted of MKP. The AP and RSS of MAP and MKP significantly decreased after stone formation. It was concluded that MAP and MKP may coexist in the crystals of urine before struvite calculi formation but MKP did not precipitate to struvite calculi and was separated out as crystal sedimentation of urine. The changes of crystallization of MAP and MKP contributed partially to the supersaturation status of MAP and MKP during struvite stone formation.

Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Goat Diseases; Goats; Magnesium Compounds; Magnesium Oxide; Phosphates; Potassium Compounds; Struvite; Urolithiasis

To evaluate trends in urolith composition and urolithiasis in dogs during the past 21 years.. Retrospective case series.. 25,499 uroliths and the dogs from which they were obtained.. Database of the Gerald V. Ling Urinary Stone Analysis Laboratory was searched from January 1985 through December 2006. All uroliths from dogs and the accompanying submission forms were evaluated. Age, sex, breed, and urolith location were recorded.. Minerals identified in uroliths included struvite, calcium oxalate (CaOx), urate, apatite, brushite, cystine, silica, potassium magnesium pyrophosphate, sulfa drug, xanthine, and newberyite. Although more struvite-containing uroliths were submitted during this period, a significant decrease in the proportion of struvite-containing uroliths submitted as a percentage of all uroliths submitted was detected. Also, a significant increase in the proportion of CaOx-containing uroliths submitted over time was detected. There was a significant nonlinear decrease in submission of urate-, silica-, and cystine-containing uroliths. The CaOx-, cystine-, and silica-containing uroliths were obtained significantly more often from male dogs; struvite- and urate-containing uroliths were obtained significantly more often from female dogs.. An increase in the proportion of CaOx uroliths submitted over time was detected. Reasons for long-term changes in this trend were likely multifactorial and could have included alterations in diet formulations and water consumption and possibly the fact that people favor ownership of breeds more prone to developing CaOx-containing uroliths. The decrease in metabolic uroliths could have been related to better breeding practices and increased awareness of results of genetic studies.

Topics: Animals; Apatites; Calcium Oxalate; Calculi; Cystine; Dog Diseases; Dogs; Female; Genetic Predisposition to Disease; Magnesium Compounds; Male; Phosphates; Retrospective Studies; Silicon Dioxide; Struvite; Time Factors; Uric Acid; Urolithiasis

Using the spatial scan statistic with a Bernoulli model, in a comparison of the two most common canine uroliths, calcium oxalate (CaOx) and magnesium ammonium phosphate (struvite) we determined whether there was evidence of spatial and/or temporal clustering of each urolith type based on canine submissions from Ontario to the Canadian Veterinary Urolith Centre (CVUC) between 1998 and 2006. During this period, there were 10,478 canine submissions, excluding cases that were identified as recurrent. We were able to georeference approximately 93% of these incident cases. After adjusting for spatial and temporal distributions of dogs based on the demographic risk factors of age, sex, and breed-type, statistically significant spatial and temporal clusters were present for both CaOx and struvite urolith types. A purely temporal struvite cluster occurred between February 10, 1998 and December 20, 2001, whereas, a purely temporal CaOx cluster occurred between September 2, 2005 and December 21, 2006. Hypotheses to explain the spatial clustering of uroliths include variation in the spatial distribution of water hardness, diet-type, access to veterinary care, and the use of surgical versus medical therapies to treat these uroliths. Based on the cluster locations, water hardness was unlikely to explain the spatial difference between the two cluster types whereas variables related to human population density were more consistent with our findings; the CaOx cluster occurred in the highest population density area of Ontario, and the struvite cluster occurred in the lowest population density area of southern Ontario. The temporal struvite cluster at the beginning and CaOx cluster at the end of the study period reflect a similar trend away from struvite towards CaOx urolithiasis among both canines and humans in the developed countries of North America and Europe.

Topics: Animals; Calcium Oxalate; Cluster Analysis; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Ontario; Phosphates; Risk Factors; Struvite; Urinary Calculi; Urolithiasis; Water

To investigate individual- and community-level contextual variables as risk factors for submission of calcium oxalate (CaOx) uroliths or magnesium ammonium phosphate (ie, struvite) uroliths for dogs to a national urolith center, as determined on the basis of urolith submission patterns.. Records of 7,297 dogs from Ontario, Canada, with CaOx or struvite uroliths submitted to the Canadian Veterinary Urolith Centre from 1998 through 2006.. Data were analyzed via multilevel multivariable logistic regression.. Individual-level main effects and interactions significantly associated with the risk of submission of CaOx uroliths rather than struvite uroliths included age, sex, breed group, neuter status, body condition, dietary moisture content, diet type, sex-neuter status interaction, sex-age interaction, body condition-age interaction, and breed group-dietary moisture content interaction. In addition, median community family income and being located within a major urban center (ie, Toronto) were significant risk factors for submission of CaOx uroliths, compared with submission of struvite uroliths.. Individual-level and dietary factors for dogs affected the risk of submission of CaOx uroliths, relative to that of struvite uroliths. Interactions among these variables need to be considered when assessing the impact of these risk factors. In addition, community-level or contextual factors (such as community family income and residing in a densely populated area of Ontario) also affected submission patterns, although most of the variance in the risk for submission of CaOx uroliths, compared with the risk for submission of struvite uroliths, was explained by individual-level factors.

Topics: Animals; Calcium Oxalate; Dog Diseases; Dogs; Female; Incidence; Magnesium Compounds; Male; Ontario; Phosphates; Regression Analysis; Species Specificity; Struvite; Urolithiasis

The crystallites in urine are related closely with the formation of urolithiasis. In the present paper the composition, morphology and Zeta potential of crystallites of twenty calcium oxalate stone formers were comparatively studied using X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, nanoparticle size analyzer, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results showed that calcium oxalate calculi usually coexisted with a little of uric acid, calcium phosphate, and magnesium ammonium phosphate. By contrast, the compositions of urine crystallites of the patients with calcium oxalate calculi were mainly uric acid, phosphate, calcium oxalate and so on. Most of them had sharp angularity with a particle size distribution ranging from tens of nanometers to tens of microns; and obvious aggregation was observed. The negative value of Zeta potential of urine crystallites in the twenty stone formers (average value -5.92 mV) was less than that in the twenty normal subjects (-12.9 mV). However, there was no obvious difference in the urine pH between stone formers (average pH 6.03) and normal subjects (average pH 5.92). The study on the relationship between urine crystallites and urinary calculi components will be helpful for finding out the causes of urolithiasis and providing an important basis for the scientific prevention methods and reasonable treatments in clinic.

Topics: Calcium Oxalate; Calcium Phosphates; Humans; Magnesium Compounds; Microscopy, Electron, Scanning; Microscopy, Electron, Transmission; Nanoparticles; Particle Size; Phosphates; Spectroscopy, Fourier Transform Infrared; Struvite; Uric Acid; Urinary Calculi; Urolithiasis; X-Ray Diffraction

In carcinogenicity studies with PPAR gamma and alpha/gamma agonists, urinary bladder tumors have been reported in Harlan Sprague-Dawley (HSD) and Charles River Sprague-Dawley (SD) but not Wistar (WI) rats, with urolithiasis purported to be the inciting event. In two 3-month studies, the authors investigated strain-related differences in urine composition by sampling urine multiple times daily. Urine pH, electrolytes, creatinine, protein, citrate and oxalate levels, and serum citrate were assessed; urine sediment was analyzed by scanning electron microscopy and energy dispersive x-ray spectroscopy. HSD rats had significantly higher urine calcium than SD or WI rats, primarily as calcium phosphate-containing precipitate. When compared to SD rats, HSD rats had lower urine volume, higher urine protein, and a comparable (week 4) to lower (week 13) burden of MgNH(4)PO(4) aggregates. Relative to WI rats, HSD rats had higher urine protein and magnesium and lower serum and urine citrate. Overall, the susceptibility to urolithiasis in male rats was HSD > SD > WI; this was likely due to strain-related differences in the amount of urine protein (a nidus for crystal formation), lithogenic ions, citrate (an inhibitor of lithogenesis), and/or volume. Strain-related differences in urine composition need to be considered when interpreting the outcome of studies with compounds that alter urine composition.

Topics: Animals; Calcium; Calcium Phosphates; Citrates; Creatinine; Electrolytes; Hydrogen-Ion Concentration; Magnesium; Magnesium Compounds; Male; Microscopy, Electron, Scanning; Oxalates; Phosphates; Proteinuria; Rats; Rats, Sprague-Dawley; Rats, Wistar; Species Specificity; Spectrometry, X-Ray Emission; Struvite; Urinalysis; Urolithiasis

The epidemiologic characteristics are significant to take into account in order to determine the etiology of the paediatric urinary calculi. In this study we studied the composition of stones according to the sex and the age.. Our study focuses on 205 tunisian children aged between three months and 16 years, admitted in our service between 1993-2007. A first urinary metabolic balance was conducted among 126 patients. The physical and chemical stones analysis was performed respectively by a stereomicroscope and infrared spectroscopy. Statistical analysis of the results was made using the software SPSS11.0.. Bladder stone was present in 30.7%. It was more frequent in infants than children over 10 years (p<0.02). The Whewellite was present in 72.7% and predominant in older children stones (59.3% vs 42.9% in infants) (p<0.05). Purines stones were more common among infants. Struvite has been the major compound in only 7.8% of cases where it was more common in infants (p<0.05) male (p<0001).. The higher prevalence of calcium oxalate stones and weaker purin ones in old children suggested the presence of different lithogenous factors of risk according to the age. A modification of the food practices is probably in question.

Topics: Adolescent; Age Factors; Calcium Oxalate; Child; Child, Preschool; Female; Humans; Infant; Magnesium Compounds; Male; Phosphates; Prevalence; Purines; Struvite; Tunisia; Urinary Bladder Calculi; Urolithiasis

The aim of this study is to assess the clinical and biological characteristics of renal stone disease among children living in the coastal region of Tunisia. This retrospective multi-center study included 100 children under the age of 16 years, who presented with urinary stones. The patients' charts were reviewed with regard to age at diagnosis, sex, history and physical examination as well as laboratory and radiologic findings. Stone analysis was performed by infrared spectrophotometry. The male/female sex ratio was 1.5 to 1. The clinical presentation of this pathology was dominated by dysuria. Stones were located in the upper urinary tract in 76 cases (76%). A total of 13% of the study subjects had positive urine cultures. Metabolic investigations were performed in all patients and were normal in 80 cases. Whewellite (calcium oxalate) was found in 77 stones (77.0%). Stone section was made of whewellite in 69.0% of cases and ammonium urate in 47.0%. Struvite stones were more frequently seen in the lower urinary tract. Our study suggests that the epidemiological profile of renal stones in Tunisia has changed towards a predominance of calcium oxalate stones and upper tract location. Also, the male predominance of pediatric urolithiasis is becoming less obvious in Tunisia.

Topics: Abdominal Pain; Adolescent; Calcium Oxalate; Child; Child, Preschool; Dysuria; Female; Flank Pain; Humans; Infant; Magnesium Compounds; Male; Phosphates; Physical Examination; Retrospective Studies; Sex Distribution; Spectrophotometry, Infrared; Struvite; Tunisia; Uric Acid; Urinary Calculi; Urinary Tract Infections; Urolithiasis

To determine frequency of and interval until recurrence after initial ammonium urate, calcium oxalate, and struvite uroliths in cats and whether breed, age, or sex was associated with increased risk for urolith recurrence.. Case-control study.. 4,435 cats with recurrent uroliths.. To identify recurrence of uroliths in cats for which uroliths were submitted for analysis at the Minnesota Urolith Center in 1998, the facility's database was searched for urolith resubmissions from the same cats between 1998 and 2003. Risk factors and differences in mean interval until recurrence were assessed.. Of 221 cats with ammonium urate uroliths in 1998, 29 (13.1%) had a first and 9 (4.1%) had a second recurrence. Mean interval until recurrence was 22 and 43 months for the first and second recurrence, respectively. Of 2,393 cats with calcium oxalate uroliths in 1998, 169 (7.1%) had a first, 15 (0.6%) had a second, and 2 (0.1%) had a third recurrence. Mean interval until recurrence was 25, 38, and 48 months for the first, second, and third recurrence, respectively. Of 1,821 cats with struvite uroliths in 1998, 49 (2.7%) had a first and 3 (0.2%) had a second recurrence. Mean interval until recurrence was 29 months for first and 40 months for second recurrences.. These results provided insights into the frequency of urolith recurrence in cats. Because some uroliths associated with recurrent episodes probably were not submitted to our facility, our data likely represented an underestimation of the actual recurrence rate.

Topics: Animals; Calcium Oxalate; Case-Control Studies; Cat Diseases; Cats; Magnesium Compounds; Odds Ratio; Phosphates; Recurrence; Struvite; Uric Acid; Urinary Calculi; Urolithiasis

This study reports on trends in canine and feline urolithiasis in Canada during the past 10 years. Age, sex, breed of animals and mineral composition from 40 637 canine and 11 353 feline bladder uroliths submitted to the Canadian Veterinary Urolith Centre between 1998 and 2008 were recorded. Struvite and calcium oxalate uroliths comprised > 85% of all uroliths submitted. In dogs, the number of struvite submissions has declined and the number of calcium oxalate submissions has increased. Struvite uroliths were most common in female dogs and calcium oxalate uroliths in male dogs. The shih tzu, miniature schnauzer, bichon frisé, lhasa apso, and Yorkshire terrier were the breeds most commonly affected for both struvite and calcium oxalate uroliths. Urate uroliths were most common in male dalmatians. In cats, struvite submissions declined and calcium oxalate submissions remained constant. Struvite and calcium oxalate uroliths were common in domestic, Himalayan, Persian, and Siamese cats. Urate uroliths were over-represented in Egyptian maus.

Topics: Age Factors; Animals; Breeding; Calcium Oxalate; Canada; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Phosphates; Risk Factors; Species Specificity; Struvite; Urinary Calculi; Urolithiasis

Urolithiasis has been reported in veterinary literature in some species of the Mustelidae family, including ferrets. In this species, the most common form of urolithiasis is that caused by struvite. The current study examined the case of mixed urolith in an 8-month-old female ferret (Mustela putorius furo) with antecedents of strangury and hematuria. A cystotomy was carried out to remove the urolith, which had a rough surface and a homogeneously porous interior and was formed by a mixture of struvite (60%) and calcium oxalate dehydrated (40%).

Topics: Animals; Calcium Oxalate; Female; Ferrets; Magnesium Compounds; Phosphates; Struvite; Treatment Outcome; Urolithiasis

Factors affecting struvite, a magnesium-ammonium-phosphate complex (MgNH(4)PO(4).6H(2)O), in feline urine were evaluated. Incubation of just "urine mineral (UM)" solution, in which mineral concentrations are compatible with those in feline urine, for 4 h at 37 degrees C did not induce the formation of crystals. Similarly, incubation of urine alone did not produce crystals. However, struvite crystals were formed by the addition of urine to UM solution. Mg, NH(3) and P were all required for urine-induced struvite crystallization. The lower molecular weight (LMW) fraction of urine was essential for struvite crystal formation, and the higher molecular weight (HMW) fraction enhanced formation of LMW-induced struvite crystals. The effects of urine proteins further fractionated by column chromatography were examined. A protein at >250 kDa and cauxin, a major urine protein recently identified as a regulator of felinine production, potentiated struvite crystal formation induced by the LMW fraction. In contrast, Tamm-Horsfall glycoprotein, a urine protein thought to promote struvite crystallization, did not have this activity. The present study reveals a novel mechanism of feline struvite crystallization.

Topics: Ammonia; Animals; Carboxylesterase; Cat Diseases; Cats; Crystallization; Magnesium; Magnesium Compounds; Male; Molecular Weight; Phosphates; Phosphorus; Proteins; Struvite; Urolithiasis

From 1994 to 2004, Hill's Pet Nutrition received 4495 canine (65%) and feline (35%) uroliths from Benelux veterinary practitioners. They were sent to the Minnesota Urolith Center, USA for analysis. In 1994, 110 uroliths were analysed - 85% from dogs - and in 2003, 1067 uroliths were analysed - 59% from dogs. During this period, substantial changes were observed in composition. In 1994, 77% of the cats had uroliths composed of struvite, and 12% had uroliths composed of calcium oxalate. In 2003, feline uroliths were composed of 32% struvite, and 61% calcium oxalate. The same evolution was observed in the dogs. In 1994, 51% of canine uroliths were composed of struvite, and 33% of calcium oxalate. In 2003, 40% had struvite uroliths, and 46% had calcium oxalate uroliths. A significant effect of the size, the breed, and the gender were noticed in the dogs. The mean age of uroliths appearance was 7.3 years in the dogs and 7.2 years in the cats. The findings are similar to those previously published in the USA.

Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Belgium; Breeding; Calcium Oxalate; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Luxembourg; Magnesium Compounds; Male; Netherlands; Phosphates; Retrospective Studies; Sex Factors; Struvite; Urinary Calculi; Urolithiasis

To determine trends in urolith composition in cats.. Retrospective case series.. 5,230 uroliths.. The laboratory database for the Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from cats from 1985 through 2004. Submission forms were reviewed, and each cat's age, sex, breed, and stone location were recorded.. Minerals identified included struvite, calcium oxalate, urates, dried solidified blood, apatite, brushite, cystine, silica, potassium magnesium pyrophosphate, xanthine, and newberyite. During the past 20 years, the ratio of calcium oxalate stones to struvite stones increased significantly. When only the last 3 years of the study period were included, the percentage of struvite stones (44%) was higher than the percentage of calcium oxa-late stones (40%). The most common location for both types of uroliths was the bladder. The number of calcium oxalate-containing calculi in the upper portion of the urinary tract increased significantly during the study period. The number of apatite uroliths declined significantly and that of dried solidified blood stones increased significantly, compared with all other stone types. No significant difference in the number of urate stones was detected.. The increasing proportion of calcium oxalate uroliths was in accordance with findings from other studies and could be a result of alterations in cats' diets. However, the decreased percentage of calcium oxalate calculi and increased percentage of struvite calculi observed in the last 3 years may portend a change in the frequency of this type of urolith.

Topics: Age Factors; Animal Feed; Animals; Breeding; Calcium Oxalate; Calcium Phosphates; Cat Diseases; Cats; Female; Magnesium Compounds; Male; Phosphates; Retrospective Studies; Sex Factors; Struvite; Ureteral Calculi; Urolithiasis

Topics: Aluminum; Calculi; Humans; Magnesium; Magnesium Compounds; Phosphates; Struvite; Urinary Bladder; Urolithiasis