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

• Published in: Journal of veterinary internal medicine 2024-11, Vol.38 (6), p.3095-3104
• Main Authors: Manoharan, Sindumani A., Berent, Allyson C., Weisse, Chick W., Purdon, Kira, Bagley, Demetrius
• Format: Article
• Language: English
• Subjects: Abdomen; ammonium; Animals; Anti-Bacterial Agents - therapeutic use; antibiotic; Antibiotics; Blood tests; canine; Diet; Dog Diseases; Dogs; Endoscopy; Female; Hematuria; infection; Kidney stones; Lithotripsy; magnesium; Medical records; Nephrolithiasis - veterinary; phosphate; Retrospective Studies; SMALL ANIMAL; Stents - veterinary; Struvite; Ultrasonic imaging; Ureterolithiasis - veterinary; Urinalysis; Urinary tract diseases; Urinary tract infections; Urine; Urogenital system; Urolithiasis - veterinary; Urological surgery
• ISSN: 0891-6640; 1939-1676; 1939-1676
• DOI: 10.1111/jvim.17204

Background Minimally invasive approaches are the standard for treatment of upper urinary tract uroliths in humans. Objective To describe the medical dissolution of upper urinary tract uroliths in a series of dogs and report clinical outcomes. Animals 6 female dogs (9 kidneys). Methods Retrospective case series. A review of medical records in dogs that underwent medical dissolution of upper urinary tract uroliths utilizing diet, administration of antibiotics, and double‐pigtail ureteral stent(s) placement, when indicated, was performed. Medical management was generally continued for 4 weeks beyond urolith dissolution. Information on biochemical, microbiological, imaging, and clinical outcomes before and after dissolution were recorded. Results Six dogs (9 kidneys) were included with bilateral (3) or unilateral (3) nephrolithiasis, ureterolithiasis, or a combination. A ureteral stent(s) was placed endoscopically in 5/6 dogs (6/9 kidneys) for obstructive ureterolithiasis (n = 5) or a nonobstructive massive nephrolith (n = 1). All dogs had a positive urine culture of Staphylococcus pseudintermedius with a median urine pH of 7.25 (range, 6.5‐8) and 4/5 had pyonephrosis. All dogs had initial evidence of urolith dissolution at a median of 1.1 months (range, 0.42‐5.9), with complete dissolution of ureteroliths at a median of 3.9 months (range, 1.5‐7.6), nephroliths at 5.3 months (range, 1.5‐7.6), and lower urinary tract uroliths at 0.87 months (range, 0.42‐5.9). Stents were removed in 3/6 once dissolution was documented. The median follow‐up time was 519 days (range, 177‐2492 days). Conclusion and Clinical Importance Medical dissolution and decompression of upper urinary tract struvite uroliths should be considered a minimally invasive treatment for dogs before more invasive options.