Treatment of renal calculi.
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The mineral composition of 150 calculi from the urinary tracts of Miniature Schnauzer dogs was determined by qualitative and quantitative methods. Struvite was the predominant mineral in 92% of the calculi. Other calculi contained predominantly apatite, calcium oxalate, ammonium urate, or silica. Most calculi were from the urinary bladder or urethra, or both. Four were from the renal pelves. Struvite calculi were more frequently encountered in females than males. The mean age of the dogs at the time of detection of calculi was 4.8 years. Qualitative analysis failed to detect some minerals that were identified by quantitative analysis.
We made a crystallographic analysis of 87 mixed-nucleus stones and found 4 groups of stones of this kind, which are as follow: urico-oxalic, oxalico-uric, phosphato-oxalic and oxalic-phosphatic. We did not find any mixed-nucleus, urico-phosphatic or phosphatico-uric stones and we explain this fact according to the known lithogenic, metabolic mechanisms, in which urinary pH has an important function.
We analyzed 48 renal calculi by X-ray powder diffraction and electron microprobe techniques. In 35 of these, the presence of a minor constituent, not detected by X-ray diffraction, was revealed--hydroxyapatite was found in 24 stones, struvite in 6, and calcium oxalate in 5. The results of this study, as well as others, show that incomplete assignment of the crystalline constituents of urinary calculi is an inherent risk of the X-ray method and that conclusions concerning total chemical composition should be based on X-ray diffraction analyses coupled with data obtained from other analytical procedures.
Enteroliths were obtained by laparotomy or necropsy of 11 horses, and a collection of smaller concretions was found on pasture. Following analysis by energy-dispersion x-ray analysis and x-ray diffraction, they were found to consist primarily of ammonium magnesium phosphate. Several minor elements were detected, including titanium in some concretions. From a farm with a history of enterolith obstructions, the well water contained a high proportion of magnesium in relation to the other cations.
In 542 old calculi belonging to the collection complied by Dr. P. Cifuentes Díaz, we have found newberyte in 81 calculi (14.9%). Newberyte appears in the struvite and apatite calculi in the form of small crystals looking like a mosaic. This results from the transformation of the struvite when it loses NH3 and H2O which we have only found in old urinary calculi.
We made a statistical study, by means of a computer, of 87 crystallographically-analysed stones, corresponding to 85 patients, assessing different clinical data with the mixed composition of the nucleus of these stones. We deduce that in general, the behaviour of these stones is determined by the interaction of their components, with the main substance predominating. The most significant correlations were obtained when we assessed the sex, age, urinary infection, simple or coralliform morphology of the stone, the number of stones formed, permanent, homolateral, kidney damage, overall kidney failure and procedure for removing the stone. We did not find any valid links when we compared the family record of lithiasis, affectation of the counterlateral kidney and the fact whether the stone was from the right or the left.
A single calculus from the bladder of a Beagle bitch has been analyzed by a multiple technique approach employing x-ray diffraction, infrared spectroscopy, scanning electron microscopy, x-ray fluorescence spectrometry, atomic absorption spectrophotometry and density gradient fractionation. The qualitative and quantitative data obtained showed excellent agreement, lending confidence to such an approach for the evaluation and understanding of stone disease.
Struvite (magnesium ammonium phosphate) uroliths are found more frequently in the urinary tracts, of dogs than are other types of uroliths. Infection of the urinary tract with urease-producing bacteria, especially staphylococci, plays an important role in urolith formation. An inherited predisposition to urinary tract infection may be associated with the high rat of occurrence of struvite uroliths in some dogs. Diagnosis of struvite urolithiasis should encompass analysis of the mineral composition of calculi and identification of concomitant urinary tract infection. Since urinary tract infections occur as sequelae to abnormalities in local or systemic host-defense mechanisms, appropriate effort should be directed toward detection of these abnormalities. Therapy of struvite urolithiasis should encompass relief of obstruction to outflow when necessary, elimination of existing calculi, eradication or control of urinary tract infection, and prevention of recurrence. Although surgical removal remains as the preferred method to eliminate struvite uroliths from dogs, nonsurgical methods of urolith dissolution should be considered. Recurrence of struvite uroliths may be prevented by various combinations of antimicrobial therapy, administration of urease inhibitors, acidification of urine, and induction of diuresis.
Contrast sensitivity was measured to quantify the glare-reducing effects of antireflective coatings of magnesium fluoride on spectacle lenses. Experiments were conducted on four subjects, who judged contrast thresholds while wearing corrective spectacles with noncoated and then coated lenses in both the absence and the presence of a source of glare (back-scattered reflection from the posterior surface of their lenses). Glare substantially reduced contrast sensitivity at all spatial frequencies; although the reduction was greater at higher spatial frequencies ther was no shift in peak contrast sensitivity. The coated lenses enhanced contrast sensitivity in the presence of glare between 1.5 and 5 times compared with the noncoated lenses. In the absence of glare, contrast sensitivity was greater with coated lenses than with noncoated lenses.
Visual fields were charted with the Goldmann perimeter for five subjects wearing corrective spectacles with noncoated lenses and then lenses with antireflective coatings of mmagnesium fluoride in both the absence and the presence of a source of glare (back-scattered reflection from the posterior surface of their lenses). There was a greater reduction in temporal isopters than nasal isopters in the presence of glare with both types of lenses, but the coated lenses were superior to the noncoated lenses in reducing the effect of glare on the visual field area.
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Magnesium ammonium phosphate calculi developed in the urinary bladders and urethras of four of five offspring of Miniature Schnauzer parents with recurrent struvite urolithiasis. Calculi were detected by radiograhy when the dogs were 12 to 15 months old. Males and females were affected. A significant number of urease-producing staphylococci were identified in the urine of three of four dogs before urolith formation, and in one dog after urolith formation. The dogs were evaluated until they were 26 months old. Serum concentrations of calcium, phosphorus, and magnesium were inside usual limits throughout the study. Abnormalities that might predispose to urinary tract infection were not identified by radiography or necropsy studies. In one dog, bladder calculi recurred after surgical removal of multiple cystoliths. In another, urethral obstruction and acute generalized pyelonephritis induced a lethal uremic crisis. Gross and microscopic lesions, detected after necropsy of all dogs with uroliths, were typical of bacterial infection.