By the term urolithiasis or urolithiasis, doctors mean the formation urinary stones(or sand) in the kidneys, bladder or their retention in the lumen of the ureters and urethra.

Urinary stones occur in all domestic animals, but are more common in cats and dogs. The chemical composition of such stones is very diverse, for example, they may include uric acid, urates, oxalates, carbonates, phosphates, cystine, xanthine, etc. Along with this, the number of stones formed in urinary organs, ranges from one to one hundred or more. Their size also varies widely (from a millet grain to the size of a large walnut).

The causes of salt precipitation can be 2 main factors:
1) Violation metabolic processes as a result of acute or chronic diseases of internal organs, as well as as a result of imbalance of nutrients, including mineral salts. It could be:

- If there is an imbalance in the diet, for example, an excess of mineral salts with a simultaneous insufficient supply of protein from the feed. Thus, the acidity of urine and salts, which are normally dissolved, change and precipitate.

- With balanced feeding, but insufficient water supply, the concentration increases, i.e. the density of urine and due to this, salts can also precipitate
- In case of disruption of the functioning of internal organs, accompanied by changes acid-base balance in the blood, etc.

2) Inflammatory diseases of the urinary system (existing or past) in the animal.
Unfortunately, there is no answer to this factor. specialists pay the least, but in vain! Microbes that provoke inflammation in the urinary organs ALWAYS disrupt the acidity of the environment. Diagnosis is difficult here due to the fact that urine for analysis should not be taken from a tray or even through a catheter, but directly from Bladder, i.e. by cystocentesis.

The most common stones in animals are:

Tripelphosphates

Crystal uric acid

Calcium oxalate crystals

Triple phosphate (struvite) crystals in the form of clothespins with a urine pH of 7 or higher

Amorphous phosphates and calcium carbonate crystals

Myths:

Myth No. 1 - urolithiasis is easily treated.
If your doctor told you this, I advise you to consult another specialist. As I already said, urolithiasis is a CHRONIC disease and the doctor’s main task is to eliminate all the factors that led to its occurrence and maximize the period of remission. Subject to all recommendations this period can reach 10-12 years, but with chronic metabolic diseases and the influence of hereditary factors it can be significantly reduced.

Myth No. 2 - urolithiasis occurs from dry food.
The food itself can never cause illness - either you feed it incorrectly, or the animal does not drink enough water, or look for an infection in it!
Urolithiasis disease can occur acutely, subacutely and chronically.

Acute course (partial or complete blockage of the urethra) is accompanied by acute pain, difficulty urinating or lack of urination for a period of more than 12 hours. In this case, the amount of urine produced is always less than the amount released into the environment. The danger lies in the development of acute renal failure, painful shock, and acute inflammation urethral canal. Even after the patency of the urethral canal is restored, difficulty urinating is observed for several days.

Subacute course (without blockage or with partial blockage of the urethra) can be identified as frequent urination, accompanied by pain and often the appearance of blood in the animal’s urine. In this case, the amount of urine produced is slightly less than the amount released into the environment. The risk is that, if untreated, acute urolithiasis develops.

The chronic course (formation of salts without blockage of the urethra) is practically asymptomatic and can only be diagnosed in a laboratory. Development risk chronic inflammation The urine excretory tract is very large, inflammatory products (dead cells, bacteria, leukocytes) form conglomerates (stones) with salts, which is the cause of acute urolithiasis.

Diagnostics .
When diagnosing veterinarian takes into account clinical signs, results of a survey of animal owners, laboratory urine tests, and mandatory performs X-ray and ultrasound examination, because similar symptoms may occur: when the lumen of the urethra is compressed by a tumor, inflammatory edema, and blood in the urine and pain may occur when acute cystitis, hymolysis, etc.

Treatment of urolithiasis comes down to the following principles:

1 . Relieving an acute condition and restoring the outflow of urine. To do this, it is necessary to remove stone or sand from the urethra with a catheter and rinse the urethral lumen antiseptic solution(done under general anesthesia). In advanced cases, doctors are forced to resort to urethrostomy surgery (creation of an artificial outlet channel to the area of ​​obstruction). It seems even more difficult abdominal surgery- cystotomy, the purpose of which is the complete removal of large uroliths (the diameter of which is larger than the lumen of the urethra) from the bladder.

2 . After restoration of urine outflow during the first few days, infusion therapy (dropper) is necessary to restore water-electrolyte balance and relieve intoxication. Anti-inflammatory and antibacterial therapy is also carried out (up to two weeks).

3 . After stabilization of the condition, lifelong prevention is required: diet therapy - medicinal food, if necessary, antibiotic therapy, herbal medicine (diuretics, etc.), as well as regular medical examination: urine analysis and ultrasound of the kidneys and bladder.
In each case, treatment is selected individually, taking into account gender, age, type of animal, degree of damage, presence concomitant diseases, and must necessarily rely on detailed diagnostics.

Most the right approach To the problem of urinary stones is the prevention of this pathology. For this purpose, the conditions for feeding and watering the animal are improved. Avoid prolonged use of monotonous products rich in salts (fish, milk, various seafood, mineral supplements, etc.), as well as hard drinking water. The diet is enriched with vitamins, and when feeding a pet dry food, food marked “for castrated animals” or “for the prevention of urolithiasis” is used.

Moscow Veterinary Clinic "Alisavet"

ICD occupies one of the leading places in the structure of urological morbidity in animals.

Urolithiasis (urolithiasis) in cats and dogs - a disease manifested by the formation of stones in the organs of the urinary system.

Urolithiasis refers to polyetiological diseases with complex physicochemical processes occurring not only in the urinary system, but also in the whole organism, both congenital and acquired.

The causes of urolithiasis are not fully understood and not fully understood

Involved in the development of urolithiasis the following factors: Risk factors for the development of ICD, a description of which can be found in the works of Hippocrates. Currently, they are divided into three main groups: demographic, external factors environment and pathophysiological. Urolithiasis is characterized by endemic distribution.

There are more than 200 known conditions that can potentially lead to the formation of stones in the urinary system.
For example:

• physical inactivity ( home image life of cats and dogs)
• hypoxia
• no reception large quantity fluids (mixed food, various treats affect the animal’s fluid intake)
• disruption of the regular normal flow of urine through the urinary tract
• oversaturation of urine with salts
• change in urine pH
• the appearance of difficultly soluble salts
• infections urinary tract
• consuming foods with excess substances that promote stone formation
• Stress, etc.

Modern urology has many ways to treat patients with urolithiasis. In human medicine they are used less and less often open methods removal of stones. They are inferior to the remote method shock wave lithotripsy And endoscopic methods treatment: contact endoscopic and percutaneous removal of kidney and urinary tract stones. The introduction of new minimally invasive technologies has undoubtedly made a significant contribution to the effectiveness of urinary stone removal, minimizing the number of traumatic complications. However, none of these methods is a method of treating ICD and does not guarantee complete recovery, and often introduces additional negative factors for the development of relapse of the disease.

Etiology and pathogenesis of ICD

One of important reasons urolithiasis in animals is a violation of water-salt metabolism. Metabolic (dysmetabolic) nephropathy unites a group of diseases in which metabolic disorders occur, accompanied by changes in the kidneys. These are toxic diseases such as shock, dehydration, drug injuries, electrolyte disturbances; chronic, hereditary and acquired (sugar diathesis, hypovitaminosis, hypervitaminosis) diseases.

Of great importance is also the change in the chemical composition of the blood that occurs when infectious diseases, intoxications, liver diseases and gastrointestinal tract(hepatitis, gastritis, colitis). Diseases of the endocrine glands, such as the thyroid gland, play a role in the formation of urolithiasis. epithelial body, pituitary gland

Main hypothesis The basis of urolithiasis in animals (stone formation) is a decrease in the content of protective colloids in the urine. Under these conditions, a group of molecules is formed - a micelle, which can become the core of the future stone. It is joined by fibrin, blood cells, bacteria, remnants of epithelial cells and, finally, sparingly soluble salts when they are found in excess in the urine.

Stones form in the collecting ducts. If the urine is oversaturated with salts and the pH of the urine changes, then crystallization and retention of stones at the mouths of the tubules increases. Violation of urodynamics will contribute to the formation of large stones - single and multiple. The sizes of stones can vary from 0.1 to 10-15 mm or more, and their number sometimes reaches several hundred.

Urinary stones are observed, as a rule, in one of the kidneys (usually in the right) and only in 15-30% of patients are they bilateral. In the practice of the ALISA veterinary clinic over the past five years, this fact of the medical hypothesis has not been definitively confirmed. In the course of collecting data and summarizing the available material, we established the fact, as a rule, of bilateral formation of stones, in both kidneys at once. It is not uncommon for stones to form in the non-pelvis, not in the intracanalicular lumens, but in the intracapsular localization of calcifications, which in turn complicates treatment, surgery in such cases it is excluded completely.

With sharp and frequent fluctuations in pH and uncontrolled use of litholytic (stone-dissolving) drugs, complex compositions, the so-called “coral-shaped” stones, are formed. Stones injure the kidneys and urinary tract, contribute to their infection, and further disrupt the outflow of urine.

Small stones located in the renal pelvis or ureter obstruct the outflow of urine from the kidney, causing its gradual expansion and subsequent death of the kidney tissue that produces urine.

Often large stones exist for a long time without causing significant damage.

The matrix theory can explain the process of stone formation. She claims that there is a protein composition of a certain dead cell, then salts are deposited on it. The core of stones is always an organic substance, which can either be the material for the formation of the entire stone (cystine stones) or, as we note most often, only a matrix on which various salts are deposited.

Numerous factors contributing to the formation of stones can be divided into exogenous and endogenous, and the latter - into general (characteristic of the entire body) and local (directly related to changes in the normal state of the kidney and urinary tract). Exogenous pathological factors include climatic, geochemical conditions, and nutritional characteristics etc. Temperature, air humidity, the nature of the soil, the composition of drinking water and its saturation with mineral salts play an important role. The nature of feeding of dogs and cats is of great importance, which in turn affects the composition of urine and its pH. Plant and dairy foods contribute to the alkalization of urine, meat – to its oxidation. Drinking water oversaturated with lime salts reduces the acidity of urine and causes an excess of calcium salts in the body. Endogenous factors that contribute to the occurrence of urolithiasis include hyperfunction of the parathyroid gland (hyperparathyroidism) and cause disturbances in phosphorus-calcium metabolism. The presence of vascular abnormalities of the liver is important, usually in the form of shunts between portal vein and the general venous system, which affects the synthesis of purines, resulting in increased formation of lactic acid. Local endogenous factors play an important role in pathogenesis - changes in the normal state of the kidney and urinary tract, primarily factors leading to stagnation of urine, impaired secretion and reabsorption of its constituent elements, and the development of uropathogenic infection. Inflammatory processes in the kidney also contribute to the process of stone formation. This is confirmed by studies that have established the presence of a number of microorganisms capable of breaking down urea, which leads to its alkalization and precipitation of salts - phosphates. Depending on the chemical composition of the salts that form stones in urolithiasis, they are distinguished:

• urates
• calcium oxalates
• calcium phosphates
• calcium carbonates
• Urolite
• Mixed
• Matrix

Causes of lower urinary tract disease in cats without urethral obstruction (statistics for 3 years)

Reason % percentage of cases

Idiopathic 64.2

Stone in urinary tract 12,8

Stone in the urinary tract -

+ them infectious lesion 1,8

Urinary tract infection 0.9

Neoplasms 1.8

Anatomical deviation 9.2

Behavioral disorders 9.2

You can begin treatment for urolithiasis after establishing the nature of the accumulated salts, since inadequate dietary and therapeutic measures can contribute to the formation of complex stones.

Surgical removal of stones, as well as extracorporeal lithotripsy (crushing), do not provide recovery and do not eliminate the causes and conditions of stone formation. These methods are applicable when life-threatening situations, for example, when the ureter is blocked by a large stone, which cannot be removed by emergency conservative therapy and threatening the development of hydronephrosis and anemia.

An approximate algorithm for a doctor’s actions during an examination of an animal with a problem with the urinary system.

Contrast cysto and pyelography, cystourethroscopy

Laboratory diagnostics of OKA, General biochemistry + potassium, phosphorus, calcium

Urinalysis, if necessary, urine protein/creatinine ratio

Tank. Urine culture (centesis only)

Urine density using a refractometer only

In older cats, a T4 level is desirable

Treatment of urolithiasis should be comprehensive and individual.

The regimen should help restore the tone of the smooth muscles of the urinary tract. (avoid hypothermia). You should pay attention to regular bladder emptying.

Diet, pharmacotherapy and herbal medicine should be focused on the specific form of urolithiasis.

Treatment and prevention of struvite formation

A properly selected type of nutrition is one of the main, if not the main, requirements when organizing activities aimed at preventing the possibility of struvite formation in the lower parts of the urinary tract of animals.

1. Acidification of urine
2. Increasing the volume of urine and reducing its density (increasing the volume of urine also reduces the time it takes for crystals to pass through the urinary tract and, thus, the time for crystal growth)
3. Reduce intake of potential sources of struvite crystals in feed.

From theory and practice it follows that urine pH plays a significantly more important role important role for the formation of struvite than the amount of magnesium in the diet!!!

1a. Achieving a urine pH of 6.0-6.5 (measurement with a pH meter in fresh urine samples is advisable)

2a. Increase in urine volume and density (preferably to 1.035 and below)

3a. Reduced consumption minerals with food (magnesium - up to 20-40 mg, phosphorus - up to 125-250 mg for every 100 kcal of metabolic energy)

Good food and watch the pH. (this indicator varies greatly in cats), and then bring the urine pH to the specified values ​​by adding one of the urine acidifiers (ammonium chloride or DL-methionine) to the food. Unlike dogs, struvite uroliths in cats are usually sterile. Therefore, antibiotics are prescribed to cats only if a urinary tract infection concomitant with urolithiasis is detected.

Among all types of urolithiasis, calcium oxalate urolithiasis ranks first in frequency of occurrence and is found in 75-75% of cases of the disease

Treatment and prevention of urolith formation from calcium oxalate

The pathogenesis of uroliths with calcium oxalate uroliths has been studied much less thoroughly than in the case of struvite. There is information obtained during clinical trials However, it should be kept in mind that in humans (unlike cats), calcium-containing stones (from calcium oxalate or calcium phosphate) in the urinary tract are more common.

In practice, we are increasingly encountering such problems in dogs and cats when urine pH, density, etc. are within normal limits, and stones in the bladder and kidneys form quickly. Upon examination of the stone, it turns out that it is calcium oxalate.

The crystal-forming agents are calcium and oxalate (oxalic acid).

Diets that stimulate urination and increase urine volume should prevent crystallization of calcium oxalate in the urinary tract AFTER surgical removal of uroliths.

Most often, the following metabolic disorders are detected with nephrolithiasis:

Hypercalciuria (36.7-60.9%) pathologically increased calcium content in the urine

Hyperuricuria (23-35.85) increased content uric acid in the blood

Hypocitraturia (28-44.3%) Alkalosis, alkaline food excess

Hyperoxaluria - (8.1-32%) is one of the forms of anomaly in the metabolism of oxalic acid - oxalose.

Hypomagnesium (6.8-19%) Disorders of magnesium metabolism

As a rule, hypercalciuria is combined with hyperoxaluria. Moreover, the latter, along with hypocitraturia, is considered by some authors to be more important metabolic risk factors for the development of calcium oxalate urolithiasis than hypercalciuria.

We need to rethink the theory of urolith formation. For a very long time there has been no clear doctrine for the treatment of this pathology. We must try to study all the mistakes of previous years and understand the new direction in the etiology and pathogenesis of the disease.

KSD of the oxalate type usually appears in animals aged five years and older. It affects both sterilized and non-sterilized animals. Urine pH may be within normal limits or less than 6.0.

Tactics of allopathic medicine and its possibilities for at this stage do not give visible result cure. This means that we should look for treatment options in other areas of pharmacology.

Homeopathy, naturopathy, herbal medicine, nosodetherapy, peptidotherapy are probably the right way out of this situation.

The Alice Veterinary Clinic is constantly working on the methodological implementation of new algorithms for the treatment of urolithiasis in animals.

New trends in the treatment of oxalate type uroliths.

Let's take a closer look at oxalate metabolism and the role of oxalobacter formigenes in the development of urolithiasis

In the human body, the contribution of nutritional oxalate to total urine excretion is 10-15%, the rest is endogenous oxalate.

The effect of dietary oxalates on urinary excretion of oxalic acid depends on calcium intake. Several population-based studies have found an inverse association between the amount of calcium intake and the risk of stone formation. So, according to a prospective study by Curhan G. et al. In a study of 45,000 men, low calcium intake (less than 850 mg/day) significantly increased the risk of kidney stones. The protective effect of calcium, according to the authors, is due to the fact that it binds oxalates and phosphates in the intestine, preventing their excess excretion in the urine, which contributes to the formation of stones. One of the common methods of preventing the formation of calcium oxalate stones is to reduce the amount of oxalate taken from food. However, dietary oxalate restriction cannot be reliable method preventing the development of calcium oxalate urolithiasis. In this regard, some authors have proposed the concept of reducing the absorption of oxalate in the gastrointestinal tract. Recently, results have been obtained indicating the influence of the gram-negative obligate anaerobe Oxalobacter formigenes on the concentration of oxalate in the urine. The human body is characterized by two groups of strains. During its life, this microorganism uses exogenous oxalate as an energy source for its survival. The habitat of the anaerobes is the large intestine.

While not pathogenic for the human body, O. formigenes establishes a symbiosis using oxalates as a food source, as a result of which the absorption of oxalates in the lumen of the large intestine is reduced in humans. O. formigenes has a unique role in the daily catabolism of 70-100 mg of dietary oxalate. It has been proven that it is nutritional oxalate that is the substrate for maintaining the colonization of O. formigenes in the intestine when following a diet with reduced content calcium.

Data from various authors show a direct relationship between the level of urinary oxalate excretion and O. formigenes colonization. So Gnanandarajah J. et al. Fecal samples from healthy dogs and those with calcium oxalate urolithiasis were examined for anaerobe colonization. The results showed that colonization was present in 25% of dogs with KSD, versus 75% in healthy dogs. The authors suggested that the lack of O. formigenes colonization is a predisposing factor for the development of calcium oxalate urolithiasis.

The experiment studied the effect of the microbe on the severity of the level of oxalate excretion in colonized and non-colonized rats, taking into account a calcium diet. The result also confirmed the hypothesis.

It is known that a number of antibiotics affect the preservation of O. formigenes.

The strain has demonstrated resistance to amoxicillin, ceftriaxone, doxycyline, gentamicin, levofloxacin, metronidazole and tetracycline.

But the antibiotic combinations amoxicillin/clarithromycin and metronidazole/clarithromycin destroy O. formigenes colonization.

Studying the colonization of the colon by this microorganism and its correction may improve the results of anti-relapse therapy for oxalate urolithiasis.

Veterinary clinic "Alisavet" Moscow

Data on O. formigenes was kindly provided by the State Educational Institution of Higher Professional Education “Military Medical Academy named after. CM. Kirov", Department of Urology, St. Petersburg. A.Yu. Shestaev, M.V. Paronnikov, V.V. Protoshchak, P.A. Babkin, A.M. Gulko.

02 February 2017

Urolithiasis in animals

Urolithiasis (Urolitiasis) is a disease accompanied by the formation and deposition of urinary stones or sand in the renal pelvis, bladder or urethra. The disease progresses quickly and leads to the death of the animal.

The causes of urolithiasis in different patients are different, that is, this disease is polyetiological.

Currently, the number of sick cats has increased sharply and relapses are observed in 50-70% of cases.

According to some researchers, one-year-old cats are most often affected; according to others, it is more often observed in the 2-3rd year of life.

The disease is equally common in both male and female cats. Cats, due to the specifics anatomical structure(narrowness of the urethra), are more predisposed to the disease, and it is more severe, as it is often complicated by bladder obstruction.

There are several predisposing exogenous factors leading to the disease:

crystallization requires a high concentration of magnesium in the urine and an alkaline reaction of the urine (pH above 6.8). Normally, cats have slightly acidic urine. Alkalinization of urine can occur with the consumption of certain foods and with a urinary tract infection. Theoretically, acidic urine prevents crystallization processes and has antibacterial properties. But with a high concentration of ions involved in the formation of stones, it can also begin in an acidic environment;

hypermagnesemia - occurs when consuming food rich in magnesium salts, with psycho-emotional retention of urination into a dirty toilet tray, with physical inactivity of the animal, in the absence of water or its low quality, which is why the cat limits itself to water;

the Ca:P ratio in the diet is below 1, as a result of which the diet has an increased relative content phosphorus;

feed moisture affects the formation of stones only when, when consuming dry food, the animal is limited in drinking water;

a risk factor may be reduced energy saturation of feed. Such a non-physiological composition of the feed stimulates its consumption in excess quantities, which can lead to a critically high intake of minerals;

predisposing factor - overweight in cats leading a sedentary lifestyle.

Endogenous factors leading to the disease:

hyperfunction of the parathyroid glands, when calcium is released and its concentration in the blood and urine increases;

disruption of the normal function of the gastrointestinal tract ( chronic gastritis, colitis, peptic ulcer). This is also explained by the influence of hyperacid gastritis on the acid-base state of the body, as well as a decrease in excretion from small intestine and binding calcium salts in it;

Clinical signs of the disease

Before a blockage of the urinary tract occurs, the disease occurs without obvious clinical signs, but the results of laboratory tests of urine and blood indicate its occurrence. IN latent period During the course of urolithiasis, symptoms can be identified that indicate not only its development, but also presumably the localization of the stone. Animals' appetite decreases, depression and drowsiness may occur. Salt crystals are deposited on the hair of the prepuce. At times, hematuria is detected, especially after active movements of the animal. The presence of stones in the bladder is manifested by a frequent urge to urinate, shifting, raising and lowering the tail. The animal lies down carefully.

When the urinary tract is blocked, the disease manifests itself with a classic triad of symptoms: urinary colic, urinary disturbance and changes in the composition of urine.

Attacks of severe anxiety suddenly appear. Sick animals lie down and quickly get up, step with their pelvic limbs, look back at their stomachs, and take a position for urination. The duration of attacks can reach several hours. Between attacks, the animal is sharply depressed, lies indifferently, rises with difficulty, carefully, with a hunched back.

During an attack, the pulse and breathing rates will decrease, but the body temperature rarely rises to low-grade fever. Urination is frequent and painful. Urine is released with difficulty, in small portions and even drops.

Hematuria is observed very often. It can be microscopic, when there are 20-30 red blood cells in the urine sediment, and macroscopic. Macroscopic hematuria caused by a kidney stone or a stone in the ureter is always total.

When the urethra is completely blocked, anuria appears. Palpation of the kidneys and bladder is painful. Sometimes it is possible to feel stones in the bladder; in cats they are usually pinched at the end of the urethra.

As pressure builds up in the upper urinary tract, the kidneys stop producing urine. Toxic metabolic products accumulate in the blood, leading to uremia. The cat may vomit. In a sick animal, the abdomen increases in volume, becomes hard and painful. If help is not provided, he falls into a coma and dies.

Bladder rupture may occur, leading to peritonitis and uremia. When the urethra ruptures, urine infiltrates subcutaneous tissue abdominal cavity, pelvic limbs, perineum, and uremia also develops.

In most animals, the course of the disease is complicated by an associated infection, which aggravates the disease and worsens the prognosis. The most common infection is coli, staphylococci, proteus. Therefore, pyuria (pus in the urine) common symptom of this disease.

In a sick animal, the urine is cloudy with an admixture of urinary sand, which quickly precipitates. The color of the urine is dark with a reddish tint caused by blood.

The course of the disease from the moment the blockage occurs is no more than 2-3 days.

Diagnosis of the disease

Stones can be found in any part of the urinary system. They are most often found in the kidneys, ureters, bladder and urethral canal.

Diagnosis of urethral stones is not difficult. The stone can also be identified using a catheter that encounters an obstruction in the urethra. Diagnosing bladder stones is also not particularly difficult.

General clinical examination methods can identify signs of damage to the kidney and urinary tract: pain and palpation in the kidney area.

Urinalysis - the main method for diagnosing urolithiasis, detects a small amount of protein, single cylinders, fresh red blood cells and salts. Leukocyturia appears when nephrolithiasis is complicated by pyelonephritis. The presence of crystals in the urine allows us to judge the type of urolithiasis, which is important when choosing treatment.

X-ray examination occupies a leading place in the recognition of kidney and ureteral stones. The most common method is survey urography. With its help, you can determine the size and shape of the stone, as well as approximately its location.

A survey urogram should cover the entire area of ​​the kidneys and urinary tract on both sides. Not all stones cast a shadow in a survey photo. The chemical composition of stones, size and location are extremely diverse. In 10% of cases, stones on the observation x-ray are not visible, since the density is relative to x-rays approaches the density of soft tissues.

Can be used in the diagnosis of stones ultrasound scanning kidney This method, based on the different ability of media to absorb and reflect ultrasonic waves, contributes to the successful identification of stones - formations whose density significantly exceeds the density of surrounding tissues

With pronounced clinical signs, it is not difficult to make a diagnosis. It is important to diagnose urolithiasis during the period of latent course, for which it is recommended to systematically selectively examine urine (titration density and alkalinity, calcium, phosphorus, urine sediment and the level of mucoproteins, which in healthy animals does not increase 0.2 units of optical density) and blood (calcium, phosphorus and reserve alkalinity)

As a rule, it is not easy to cure KSD because it is a systemic disease. But with strict adherence to the doctor’s instructions, you can achieve stable remission, and in the happiest cases, recovery.

Treatment of urolithiasis comes down to the following principles:

• Relieving an acute condition and restoring the outflow of urine.
• anti-inflammatory and antibacterial therapy is carried out
• lifelong prevention is mandatory: diet therapy - medicinal food,

Urolithiasis is the formation of urinary stones in the kidneys, pelvis, bladder or their retention in the lumen of the ureters and urethra.
Urinary stones are found mainly in carnivores (dogs, cats), sheep, fur-bearing animals and less often in cattle and horses.
The chemical composition of stones varies among different animal species; in herbivores, they consist mainly of calcium carbonate, magnesium carbonate and calcium oxalate.
Urate and phosphate stones are found in dogs and cats. Phosphate stones and sand form very quickly, especially in neutered cats.
The etiology of urinary stones is still not entirely clear. It is believed that their formation in most cases is caused by a violation of the regulation of salt metabolism on the part of the central nervous system due to improper, monotonous feeding, as well as A-hypovitaminosis.
One of the leading factors in the formation of urinary stones is a violation of the ratio between acidic and basic feed equivalents. Microorganisms (staphylococci, streptococci, proteus) play an important role in the formation of stones in dogs and cats.
Stone formation is often caused by the use of various medicinal substances, sometimes polyhypovitaminosis.
Excessive use of feedstuffs rich in phosphates, in particular bran, bone meal, and beets, is essential in the formation of stones. Factors of stone formation include long-term periodic stagnation of urine with subsequent alkalization, precipitation of salts and the formation of stones.
Play a certain role in the development of the disease individual characteristics animal, climatic factors, In Russia, urolithiasis is more common in the North Caucasus, Urals, and Don and Volga river basins. This is due to the nature of flora, fauna, soil, and the composition of drinking water. The development of urolithiasis may also be associated with inflammation of the urinary tract.
Some authors associate the origin of urinary stones with dysfunction of the endocrine organs (hyperparathyroidism, changes in the function of the gonads, etc.).
A predisposing factor for stone formation may be the relatively small diameter of the urethra in bulls, bulls, males and cats, especially castrated ones.
The occurrence of the disease is associated with metabolic disorders, which, in turn, results from irrational and unbalanced feeding of animals. This is noted in cases where the diet of sick animals contains an excess of protein, phosphorus, calcium, silicon, magnesium, with a simultaneous lack of vitamins and carbohydrates.
Pathogenesis. Currently, there are two theories of stone formation: crystallization and matrix. According to the crystallization theory, the primary basis of the stone is the crystallization core, on which sprouts of radially arranged crystals appear. Organic matter becomes part of the rock as it grows.
According to the matrix theory, the primary basis of stones is organic matter - a core consisting of carbohydrate and protein components.
The primary matrix of the stone, the core, is formed from urine proteins when its proteolytic properties change. The crystalline part of the stone is determined by the pH of the urine. It has been established that the formation of the crystalline part of stones depends on the pH of the urine; uric acid - at pH up to 6; oxalate - up to 6-6.5; phosphoric acid - at pH 7 and above.
Changes in the pH of urine largely depend on the state of the acid-base balance of the body. Violation of it entails changes in redox processes, mineral metabolism (increased excretion of calcium, phosphorus, magnesium, sodium, potassium, chlorine, etc. by the kidneys).

Inflammatory-dystrophic processes develop in the kidneys and bladder, the pH and relative density of urine changes, which leads to disruption of the colloid-crystalline balance in the urine, precipitation of mucoprotein salts and the formation of urinary stones. Predisposing factors are the presence foreign bodies in the urinary tract or kidneys in the form of epithelial cells, cylinders, blood clots, pus, fibrin, necrotic tissue, etc. Under such conditions, precipitation of salt crystals and protein-like substances occurs.
A urine stone is a colloidal matrix (base) with crystals of mineral salts deposited around the matrix on its surface.
The process of urinary stone formation occurs in two phases. First, peptides, proteins and mucoproteins form the organic material of the stone. Having both positive and negative ions, the matrix attracts and binds both anions and cations. In the second stage, crystals of mineral salts are deposited on the matrix, its mass increases and stones of various sizes are formed, consisting of a mixture of phosphates, magnesium and ammonium.
Large stones located in the kidney cavities sit tightly. Small and medium-sized stones of the renal pelvis or bladder can change their position, enter the ureter, urethra and cause them to clog.

Bladder stones, according to their chemical composition, are urate, phosphate and oxalate (Fig. 130). Phosphates are soft, white or grayish in color, round in shape, with a smooth or slightly rough surface. Urats are dense, brick-colored, round in shape. Oxalates are also dense and have a spiky, bumpy surface. Cystine stones are the softest light yellow color.
Urinary stones are often caused mechanical damage mucous membrane of the urinary tract, causing bleeding. The development of urolithiasis may also be associated with inflammation of the urinary tract.
Blockage and damage to the mucous membrane by urinary stones is accompanied by stagnation of urine, penetration into the urinary tract along the ascending line of secondary infection, which may result in the development of catarrhal inflammation of the bladder (urocystitis), renal pelvis and kidneys (pyelonephritis).
Symptoms Clinical picture The disease depends on the location of urinary stones, their size, surface condition and mobility (Fig. 131).
The main signs are pain and hematuria. The pain can be constant and temporary
menami is manifested by sharp attacks of colic. Urination is frequent and painful. When a stone forms in the renal pelvis, symptoms characteristic of pyelitis appear, and subsequently pyelonephritis. -

Rice. 131
Urine stones in the bladder and kidney of a dog (X-ray)

During this period of illness, there may be an increase in body temperature by 0.5-1.0°C. The urine contains a large amount of inorganic sediments, protein, leukocytes, epithelium of the renal pelvis, and microbes. Frequent, painful urination, interrupted by false urges.
When the urinary tract is blocked, the disease manifests itself with a classic triad of symptoms: urinary colic, urinary disturbance and changes in the composition of urine.
Flow. Urolithiasis lasts a long time and tends to recur. Its course depends on the size of the stone, the painful and inflammatory phenomena that it causes, as well as on the effectiveness of treatment.
When the bladder ruptures, peritonitis develops and the animal usually dies.
Pathological changes. The mucous membrane of the pelvis, ureter or bladder is hyperemic, edematous, and often covered with hemorrhages. The integrity of its endothelial cover is disrupted. The edema gradually spreads deeper into the underlying tissue, leading to damage to the renal parenchyma and atrophy.
When the urinary tract is blocked, hydronephrosis is observed. Pyelonephritis often occurs.
The number of stones can be from one to several hundred. Small erosions with symptoms of purulent urethritis are noted.
Diagnosis. Anamnestic data (feeding, drinking water), clinical signs (pain, hematuria) and laboratory tests of urine (titrated acidity and alkalinity, urine sediment) are taken into account. In some cases, they carry out X-ray studies and ultrasound.
Despite the characteristic signs of the disease, it should be differentiated from pyelitis, cystitis and chronic hematuria in cattle (Table 3).
Forecast. In cases where the urinary tract contains only sand, the prognosis is favorable, but in cases of urethral blockage it is often unfavorable, since bladder rupture is possible.
Treatment. The most appropriate symptomatic therapy using painkillers and antispasmodics, physiotherapy, probing and surgical removal stones.

Table 3
Differential diagnostic criteria for recognizing urinary tract diseases

	Main signs of the disease
illnesses	clinical	laboratory
Pyelitis	General state oppressed animal. Body temperature is increased. When palpating the kidney area, pain is noted. The act of urination is frequent and painful. Little urine is released.	Urine is alkaline and contains mucus, pus and protein. The sediment contains a lot of leukocytes, microbes and epithelium of the renal pelvis, leukocytes, erythrocytes are found, crystals are often found
Urolithiasis disease	Sick animals are depressed, inactive, and move reluctantly and cautiously. Urinary colic is noted. Body temperature is increased. On rectal examination, bladder tenderness is often observed. A small amount of urine is released.	Urine is acidic, cloudy and often contains blood. Urine sediment contains urinary sand, leukocytes, epithelium of the renal pelvis or bladder. Triple phosphates, oxalates and phosphates are found in inorganic sediments in the urine.
Urocystitis	The general condition of the animals is depressed, body temperature is elevated. The act of urination is frequent and painful. Rectal examination of the bladder shows pain	Urine has an ammonia odor, contains mucus, and a small amount of protein. The sediment contains epithelial cells of the bladder, leukocytes, erythrocytes and triple phosphate
Bladder spasm	There is severe anxiety in animals, frequent urge to urination. A rectal examination reveals an enlarged bladder, which does not empty during palpation. Difficulty inserting a catheter into the bladder	Urine does not change.
Paralysis and paresis of the bladder	The animal is worried, often takes a posture for urination, but excretes small quantities urine. Rectal examination establishes strong filling of the bladder.	Urine does not change.
Chronic hematuria in cattle	As the disease progresses, general depression, weakness develops, appetite decreases, and exhaustion develops. The visible mucous membranes are anemic. The act of urination is frequent.	On the part of the blood, it is noted - zhitropenia, leukopenia. Cap reaction urine contains protein, red blood cells, hemoglobin and epithelial cells

When the urethra is blocked by stones, the following measures are recommended:
relieving spasm of smooth muscles or overirritation of the mucous membrane with stones;
displacement of the stone located in the center using a catheter;
elimination of pain attacks;
flushing the bladder using anti-inflammatory drugs;
destruction and removal of urinary stones and sand from the urinary tract.
Relief of urinary tract spasm is achieved intramuscular injection no-shpa, analgin, antispasmodic, baralgin, etc.
If the urethra is blocked, a 0.5% solution of novocaine from 2 to 10 ml is injected through a catheter and then after a few minutes the stone is dislodged with a catheter into the bladder.
The catheter is advanced into the bladder, and subsequently inserted through it isotonic solution sodium chloride (50-150 ml) in combination with penicillin at a dose of 5000-6000 units/kg body weight. If the solution does not flow through the catheter, then it is aspirated with a syringe. Washing is repeated the next day.
Painful reactions can be eliminated using lumbar novocaine blockade with a 0.25% solution in a dose of 1 ml per 1 kg of live weight.
To relieve the inflammatory reaction in the urinary tract, the use of penicillin drugs and sulfonamides is indicated.
In combination with these substances, medications that disinfect the urinary system can be prescribed: a decoction of bearberry leaves, creeping wheatgrass roots, parsley root; as well as trichopolum, biseptol, urosulfan, furadonin, etc.
Urodane and cystone are used internally to destroy and remove urinary stones and sand. In urgent cases, urinary stones are removed surgically (cystotomy, urethrotomy) depending on the indications.
Prevention comes down to improving the maintenance, feeding and watering of animals. Avoid long-term use of monotonous feed rich in salts, as well as hard drinking water. Diets are enriched with vitamins. Carry out systematic exercise. In some cases, urine sediment is examined to identify diseases of the kidneys (pyelonephritis), bladder (cystitis) and early stages urolithiasis (presence of sand).

Urolithiasis disease(urolithiasis)

Urolithiasis disease(urolithiasis) – the disease is characterized by the formation of urinary stones and sand in the kidneys and genitourinary tract. Animals of all kinds are affected, but most often young sheep, cattle and minks.

The disease often spreads massively among bulls in specialized cattle fattening complexes. Sick animals are difficult to treat and must be culled.

Etiology . The main cause of urolithiasis is a violation of vitamin and mineral metabolism in the body, especially a lack of retinol and a violation of the drinking regime.

Desquamated epithelium with hypo- and vitamin A deficiency serves as the basis for the crystallization of salts in it and the formation of stones. These disorders are usually observed with a concentrated type of feeding with the inclusion in the diet of a large amount of meat and bone or fish meal and various mineral premixes.

Symptoms . Clinical signs depend on the location of the stones and their size. When small stones and sand form, painlessly exiting the urethra, severe symptoms not noted. Vivid clinical signs of the disease appear when stones cover an area of ​​the urinary tract. With partial blockage, there is periodic pain when urinating, urine is released intermittently, in a thin stream or drops. When the blockage is complete, severe colic occurs, the animals groan and grind their teeth.

In the urine of urolithiasis, leukocytes, red blood cells, deflated epithelium, small stones, and urinary sand are found.

With the development of inflammation, symptoms of pyelitis, urocystitis, and urethritis appear, and the number of leukocytes in the urine increases.

Diagnosis and differential diagnosis . Diagnosis is based on characteristic clinical symptoms And laboratory research urine, in necessary cases X-ray and rectal examination are performed.

Urolithiasis must be differentiated from nephritis, pyelitis and urocystitis.

Treatment . Small stones and sand can be removed using various diuretics and antispasmodics. In some cases, the removal of stones is facilitated by catheterization and lavage of the bladder and urethra. Large stones are removed surgically. For complications of urolithiasis inflammatory process treatment is prescribed as for pyelitis and urocystitis. In all cases, to prevent re-formation of stones, it is necessary to organize adequate feeding and provide plenty of water.

Prevention is based on compliance with the technology of feeding, watering and keeping animals, providing them with active exercise. In addition, it should be treated promptly inflammatory diseases bladder and urinary tract.