Non-medical management of urolithiasis

image of Non-medical management of urolithiasis
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Urolithiasis is a relatively common syndrome affecting canine and feline patients and both medical and non-medical treatment options are regularly employed. The use of non-medical therapies in the treatment of urolithiasis is dependent on the clinical scenario, the type of stone(s) present and their location within the urinary tract. This chapter covers nephrolithiasis, ureterolithiasis, cystolithiasis and urethrolithiasis.

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27.1 A ureteral stent has been placed in this 10-year-old neutered male Domestic Shorthaired Cat with a right ureteral obstruction. (a) Lateral radiograph and (b) ventrodorsal radiograph.
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27.2 Placement of a subcutaneous ureteral bypass (SUB™) device in a 12-year-old neutered female Domestic Longhaired Cat with a right ureteral obstruction. Fluoroscopic images: (a) An 18 G over-the-needle catheter is being inserted from the caudal pole of the kidney (K) and directed into the renal pelvis. (b) The needle has been removed and a 0.035-inch guide wire (black arrow) has been introduced into the renal pelvis through the over-the-needle catheter (white arrow). (c) The over-the-needle catheter has been removed, and a nephrostomy tube (*) has been introduced over the guide wire into the renal pelvis. (d) The guide wire has been removed, and the nephrostomy tube is now locked within the renal pelvis. (e) A postoperative ventrodorsal radiograph immediately after placement. The nephrostomy tube (arrowed), cystostomy tube (*) and connecting subcutaneous port (triangle) can all be seen in this image.
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27.3 Cystourethroscopic images obtained during a Holmium:YAG laser lithotripsy procedure in an 8-year-old neutered male Basset Hound being treated for calcium oxalate urolithiasis. (a) The laser fibre has been placed on to the stone to perform lithotripsy. (b) A stone has been grasped with an endoscopic retrieval basket for removal. (c) The stone has been removed from the urethra and an area of urethral erythema and oedema can be seen.
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