Nephroliths and ureteroliths: a new stone age

Area of Science:

• Veterinary Medicine
• Nephrology
• Urology

Background:

• Nephroliths (kidney stones) can lead to severe complications including pyelonephritis and chronic kidney disease.
• Indications for nephrolith removal vary between dogs and cats, with obstruction being a primary concern in cats.
• Traditional surgical removal of uroliths can have high complication rates, particularly in cats.

Purpose of the Study:

• To review the indications for nephrolith removal in dogs and cats.
• To compare the efficacy and safety of different treatment modalities for nephroliths and ureteroliths.
• To highlight the benefits of minimally invasive options in veterinary urolithiasis.

Main Methods:

• Literature review of studies on canine and feline nephroliths and ureteroliths.
• Analysis of treatment approaches including surgical nephrotomy/ureterotomy, extracorporeal shock wave lithotripsy (ESWL), and ureteral stenting.
• Comparison of complication rates and outcomes for different procedures.

Main Results:

• Surgical removal of uroliths carries a >30% complication risk in cats undergoing ureterotomy.
• Extracorporeal shock wave lithotripsy (ESWL) is effective in dogs but not cats.
• Ureteral stents provide effective relief for ureteral obstruction in both species with lower morbidity and mortality than open surgery in cats.

Conclusions:

• Minimally invasive options, particularly ureteral stenting, should be considered for urolithiasis in cats due to lower complication rates.
• Treatment strategies for nephroliths and ureteroliths must be tailored to the species (dog vs. cat).
• Ureteral stenting offers a safe and effective long-term solution for ureteral obstruction in both dogs and cats.