- 12 yr mn DSH with no clinical signs other than intermittent hematuria seen on U/A
- Abominal US and repeat scan done 1 month later showed persistent bladder stone despite dietary tx
- Rx diet was discontinued
- Cystotomy done 3 weeks after the last US scan revealed a small number of 1mm mineraliths and no large stones
- 3 view pre-operative radiographs showed faint outline of a stone
- Was there never a stone in the first place?
- 12 yr mn DSH with no clinical signs other than intermittent hematuria seen on U/A
- Abominal US and repeat scan done 1 month later showed persistent bladder stone despite dietary tx
- Rx diet was discontinued
- Cystotomy done 3 weeks after the last US scan revealed a small number of 1mm mineraliths and no large stones
- 3 view pre-operative radiographs showed faint outline of a stone
- Was there never a stone in the first place?
Comments
Melissa I have seen struvite
Melissa I have seen struvite stones forma and dissolve and form again over 10 day serial rechecks. Oxalates are there to stay however. The diet dissolution tx is a nebulous imprecise science in my opinion but more effective with struvites but if they have an oxalate shell then they wont dissolve easily either.
Bottom line is scan it right before surgery so you dont go into a sand pit as opposed to a suspected rock. Its important to prepare the owner appropriately as well.
Melissa I have seen struvite
Melissa I have seen struvite stones forma and dissolve and form again over 10 day serial rechecks. Oxalates are there to stay however. The diet dissolution tx is a nebulous imprecise science in my opinion but more effective with struvites but if they have an oxalate shell then they wont dissolve easily either.
Bottom line is scan it right before surgery so you dont go into a sand pit as opposed to a suspected rock. Its important to prepare the owner appropriately as well.
Thanks Eric. This cat
Thanks Eric. This cat actually belonged to a vet clinic. I was unable to scan him immediately prior to sx as I was busy with the other patients. But I agree, I would have like to have done it first. At least now they can submit the sand particles for stone analysis.
Thanks Eric. This cat
Thanks Eric. This cat actually belonged to a vet clinic. I was unable to scan him immediately prior to sx as I was busy with the other patients. But I agree, I would have like to have done it first. At least now they can submit the sand particles for stone analysis.
Since the strongly echogenic
Since the strongly echogenic body that is seen in the urinay bladder doesn’t have much of a shadow to it, would this lead you to believe that it is more likely a mucus ball with sand particles present or a blood clot?
Would you not expect it to have a really strong shadow if this was a solid stone?
I had a similar case lately and didn’t get too excited about it as there was not a strong shadow present. We cultured the urine, got rid of the infection and the “urolith-like” object went away. But could have also dissolved a urolith by treating the infection if it was struvite-based.
Since the strongly echogenic
Since the strongly echogenic body that is seen in the urinay bladder doesn’t have much of a shadow to it, would this lead you to believe that it is more likely a mucus ball with sand particles present or a blood clot?
Would you not expect it to have a really strong shadow if this was a solid stone?
I had a similar case lately and didn’t get too excited about it as there was not a strong shadow present. We cultured the urine, got rid of the infection and the “urolith-like” object went away. But could have also dissolved a urolith by treating the infection if it was struvite-based.
That is a good observation
That is a good observation and was a concern of mine. I believe that Mattoon states that the degree of shadowing can vary depending upon the stone’s composition. I have other pics where there is more shadowing, but not as strong as the majority of stones that I see. Wish that I had been able to scan it just prior to surgery as I am wondering if I would have seen the same presentation or something different. He was treated for 1 month with a prescription diet but no antibiotics. They did not see evidence of a UTI on urinalysis. I do not know if they cultured it anyways.
That is a good observation
That is a good observation and was a concern of mine. I believe that Mattoon states that the degree of shadowing can vary depending upon the stone’s composition. I have other pics where there is more shadowing, but not as strong as the majority of stones that I see. Wish that I had been able to scan it just prior to surgery as I am wondering if I would have seen the same presentation or something different. He was treated for 1 month with a prescription diet but no antibiotics. They did not see evidence of a UTI on urinalysis. I do not know if they cultured it anyways.
The best analogy I can make
The best analogy I can make is a sandball glued with a little tar. Another analogy is graphite and water. I would have bet struvite because they are often camelions, stone one day, sandball the next, sandy beach the next. Oxalates are bright and clean though. Struvite lives with proteus and staph and a couple of others so often tx the uti and recheck in 3 weeks regardless of culture results. Cultures are very imperfect and poorly sensitive.
The best analogy I can make
The best analogy I can make is a sandball glued with a little tar. Another analogy is graphite and water. I would have bet struvite because they are often camelions, stone one day, sandball the next, sandy beach the next. Oxalates are bright and clean though. Struvite lives with proteus and staph and a couple of others so often tx the uti and recheck in 3 weeks regardless of culture results. Cultures are very imperfect and poorly sensitive.