Urolithiasis/Cystic Calculi

Urolithiasis/Cystic Calculi



Basic Information image



Definition


Cystic calculi are usually singular, round or egg-shaped stones found in the bladder.



Synonym(s)




• Cystic urolith


• Bladder stone



Epidemiology



Species, Age, Sex


Cystic calculi are more frequently found in male horses.



Risk Factors


Horses previously treated for bladder stones or pyelonephritis are at increased risk of developing cystic calculi.



Associated Conditions and Disorders


Horses with urolithiasis of the lower urinary tract should be examined for disease of the upper urinary tract because pyelonephritis can be a predisposing cause of cystic calculi.



Clinical Presentation



Disease Forms/Subtypes




• Type I urolith: Most common urolith, yellow to green and spiculated; composed primarily of calcium carbonate. Type I uroliths are often imbedded in mucosa and tend to be larger and more friable than type II uroliths.


• Type II urolith: Smooth, firm, and white; composed of calcium carbonate, phosphate, and magnesium



History, Chief Complaint


Hematuria observed after exercise is the most common clinical sign and is virtually pathognomonic for a cystic calculus. Other clinical signs of cystic or urethral calculi include pollakiuria, dribbling of urine, dysuria, and prolonged periods of penile protrusion. The hindlimbs are often stained with urine or blood. A cystic calculus may cause a stilted hindlimb gait.



Physical Exam Findings


The presence of a cystic calculus can usually be confirmed by palpation of the bladder per rectum. The pelvic portion of the urethra should be palpated, as well as the bladder, so that a calculus in this location is not overlooked. A cystic calculus is more likely to be detected if only the hand and wrist are inserted into the rectum to palpate the bladder.



Etiology and Pathophysiology


Horses excrete a large amount of calcium carbonate crystals in their urine. Mineralization of these crystals around a nidus is thought to be the initiating event. In other species, the nidus is often desquamated epithelial cells. Exfoliated epithelial cells may also act as a nidus for formation of cystic calculi because some horses with urinary calculi are found to have infection of the upper urinary tract.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Urolithiasis/Cystic Calculi

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