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Urolith lithotripsy
PA G E 8
A D VA N C E S
lithotripsy is performed by endoscopically delivering a wavelength of 2,100 nm through a flexible optical fiber to the urolith.
Objectives To determine the effectiveness of laser lithotripsy for removing urocystoliths, urethroliths, or both, from dogs, and to determine the influence of dog and urolith factors on outcome.
Procedure Twenty-five client-owned dogs with urocystoliths, urethroliths, or both were included in a prospective clinical trial. Male dogs weighed at least 6.8 kg. The endoscopy and laser delivery was performed under general anesthesia. Assessments were procedure success and lithotripsy time. Predictors of procedure success and lithotripsy time were investigated.
Results
UROLITH LITHOTRIPSY Background Two to three percent of hospitalized dogs have urolithiasis. Treatment options for lower urinary tract uroliths include dissolution, and surgical or nonsurgical removal. Nutritional changes and medication can be effective for dissolution of struvite, cystine, and ammonium urate uroliths. However, dissolution requires mineral analysis of the urolith and months of dietary therapy, radiographic monitoring, and often administration of antimicrobials. Nonsurgical methods of urolith removal include catheter-assisted retrieval, stone basket retrieval, and retrohydropropulsion. Nonsurgical techniques are limited by the size and shape of the urolith and the diameter of the urethra. Only select cases are viable candidates for nonsurgical methods. Laser lithotripsy with a holmium, yttrium, aluminum, garnett (Ho:YAG) lithotrite has been evaluated in dogs. Laser
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal • Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association • Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine
The procedure was successful in 21 of 25 dogs, more often and in less time in spayed female than in neutered male dogs. Gender was a predictor of procedure success. Gender, endoscope type, and chronological order in which the dog received lithotripsy were significantly associated with lithotripsy time. Gender, body weight, more than 10 uroliths, and larger urolith dimensions were predictors of lithotripsy time.
• Journal of Veterinary Dentistry
Author Conclusion
• Veterinary and Comparative Orthopaedics and Traumatology
Laser lithotripsy is an effective procedure for the removal of urocystoliths, urethroliths, or both. There were rare important adverse effects, but some limitations occurred in male dogs.
Inclusions Two tables, 19 references.
• Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal • Research in Veterinary Science
• Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record
Editor Annotation Laser lithotripsy is an alternative to incisional surgery for lower uroliths. General anesthesia is required, and male dogs need to be at least 6.8 kg for their urinary tract to be large enough to accommodate the procedure. The success rate is greater in female dogs. Gender, endoscope type and experience of the surgeon significantly affects outcome success. Procedure time is dependent on gender, body weight, number of uroliths, and largest urolith diameter. Clinicians should consider referring their urolithiasis canine patients for laser
• Veterinary Research Communications • Veterinary Surgery ... and more than 20 others
lithotripsy as it becomes more readily available. (MM) Grant DC, Werre SR and Gevedon ML. Holmium: YAG laser lithotripsy for urolithiasis in dogs. J Vet Intern Med 2008;22:534-539.
A D VA N C E S
lithotripsy is performed by endoscopically delivering a wavelength of 2,100 nm through a flexible optical fiber to the urolith.
Objectives To determine the effectiveness of laser lithotripsy for removing urocystoliths, urethroliths, or both, from dogs, and to determine the influence of dog and urolith factors on outcome.
Procedure Twenty-five client-owned dogs with urocystoliths, urethroliths, or both were included in a prospective clinical trial. Male dogs weighed at least 6.8 kg. The endoscopy and laser delivery was performed under general anesthesia. Assessments were procedure success and lithotripsy time. Predictors of procedure success and lithotripsy time were investigated.
Results
UROLITH LITHOTRIPSY Background Two to three percent of hospitalized dogs have urolithiasis. Treatment options for lower urinary tract uroliths include dissolution, and surgical or nonsurgical removal. Nutritional changes and medication can be effective for dissolution of struvite, cystine, and ammonium urate uroliths. However, dissolution requires mineral analysis of the urolith and months of dietary therapy, radiographic monitoring, and often administration of antimicrobials. Nonsurgical methods of urolith removal include catheter-assisted retrieval, stone basket retrieval, and retrohydropropulsion. Nonsurgical techniques are limited by the size and shape of the urolith and the diameter of the urethra. Only select cases are viable candidates for nonsurgical methods. Laser lithotripsy with a holmium, yttrium, aluminum, garnett (Ho:YAG) lithotrite has been evaluated in dogs. Laser
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal • Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association • Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine
The procedure was successful in 21 of 25 dogs, more often and in less time in spayed female than in neutered male dogs. Gender was a predictor of procedure success. Gender, endoscope type, and chronological order in which the dog received lithotripsy were significantly associated with lithotripsy time. Gender, body weight, more than 10 uroliths, and larger urolith dimensions were predictors of lithotripsy time.
• Journal of Veterinary Dentistry
Author Conclusion
• Veterinary and Comparative Orthopaedics and Traumatology
Laser lithotripsy is an effective procedure for the removal of urocystoliths, urethroliths, or both. There were rare important adverse effects, but some limitations occurred in male dogs.
Inclusions Two tables, 19 references.
• Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal • Research in Veterinary Science
• Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record
Editor Annotation Laser lithotripsy is an alternative to incisional surgery for lower uroliths. General anesthesia is required, and male dogs need to be at least 6.8 kg for their urinary tract to be large enough to accommodate the procedure. The success rate is greater in female dogs. Gender, endoscope type and experience of the surgeon significantly affects outcome success. Procedure time is dependent on gender, body weight, number of uroliths, and largest urolith diameter. Clinicians should consider referring their urolithiasis canine patients for laser
• Veterinary Research Communications • Veterinary Surgery ... and more than 20 others
lithotripsy as it becomes more readily available. (MM) Grant DC, Werre SR and Gevedon ML. Holmium: YAG laser lithotripsy for urolithiasis in dogs. J Vet Intern Med 2008;22:534-539.