Urolithiasis

Bladder stones • bladder sand • urethral stones

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Introduction

  • Ureterotomy: ureterolithiasisFig.1 Ureterotomy: ureterolithiasis
    Calculi may be found in the bladder, kidney, ureter   (Fig. 1)  , urethra or kidney although they occur most commonly in the bladder.
  • The formation of calculi may occur as a result of several factors including diet, anatomy and (rarely) infection.
  • Rabbits have an unusual calcium metabolism. Most mammals have a urinary fractional excretion of 2% whereas rabbits may have 45-60%.
  • The level of dietary calcium is directly related to the amount of calcium excreted into the urine. It is not unusual therefore to detect calcium carbonate crystals in rabbit urine.
  • Uroliths are usually of calcium carbonate and readily visible on radiography.

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Presentation

  • Hematuria.

If blood present, direct cytology may be useful in looking for bacteria, WBC, casts, etc although calcium crystals may get in the way. Ultrasonography can be used to look at bladder, kidneys, cystocentesis to check for post-cystic bleeding as rabbits have a number of glandular structures surrounding the pelvic urethra, genital tract bleeding (uterine adenocarcinoma, testicular infection/neoplasia depending on sex).

  • Dysuria.
  • Vocalization on urination.
  • Urine scald.
  • Frequent urination, incontinence.

Acute

  • Collapse.
  • Anuria.
  • Dysuria.
  • Enlarged abdomen.

History

  • Stranguria.

Incidence

Morbidity

  • Low: approximately 10%.
  • May be clinically silent and detected opportunistically on radiography.

Mortality

  • Rare unless associated with inability to urinate, bladder rupture or renal disease.
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