Department of Population Medicine, University of Guelph, Guelph, ON, Canada.
Banfield Pet Hospital, 8000 NE Tillamook St, Portland, OR, USA.
Prev Vet Med. 2014 Aug 1;115(3-4):217-28. doi: 10.1016/j.prevetmed.2014.04.006. Epub 2014 Apr 29.
Calcium oxalate urolithiasis results from the formation of aggregates of calcium salts in the urinary tract. Difficulties associated with effectively treating calcium oxalate urolithiasis and the proportional increase in the prevalence of calcium oxalate uroliths relative to other urolith types over the last 2 decades has increased the concern of clinicians about this disease. To determine factors associated with the development of calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States, a retrospective case-control study was performed. A national electronic database of medical records of all dogs evaluated between October 1, 2007 and December 31, 2010 at 787 general care veterinary hospitals in the United States was reviewed. Dogs were selected as cases at the first-time diagnosis of a laboratory-confirmed urolith comprised of at least 70% calcium oxalate (n=452). Two sets of control dogs with no history of urolithiasis diagnosis were randomly selected after the medical records of all remaining dogs were reviewed: urinalysis examination was a requirement in the selection of one set (n=1808) but was not required in the other set (n=1808). Historical information extracted included urolith composition, dog's diet, age, sex, neuter status, breed size category, hospital location, date of diagnosis, and urinalysis results. Multivariable analysis showed that the odds of first-time diagnosis of calcium oxalate urolithiasis were significantly (P<0.05) greater for dogs<7 years, males (OR: 7.77, 95% CI: 4.93-12.26), neutered (OR: 2.58, 1.44-4.63), toy- vs. medium-sized breeds (OR: 3.15, 1.90-5.22), small- vs. medium-sized breeds (OR: 3.05, 1.83-5.08), large- vs. medium-sized breeds (OR: 0.05, 0.01-0.19), and those with a diagnosis of cystitis within the previous year (OR: 6.49, 4.14-10.16). Urinary factors significantly associated with first-time diagnosis of calcium oxalate urolithiasis were acidic vs. basic pH (OR: 1.94, 1.22-3.10), presence of RBCs (OR: 6.20, 3.91-9.83) or WBCs (OR: 1.62, 1.03-2.54), and protein concentration>30 mg/dL (OR: 1.55, 1.04-2.30). Patient demographics and urinalysis results are important factors that can support risk assessment and early identification of canine oxalate urolithiasis. Therefore, periodic urolith screening and monitoring of urine parameters should be encouraged for dogs at risk of developing these uroliths.
草酸钙尿石症是由于尿中钙盐聚集形成的。有效治疗草酸钙尿石症的困难以及在过去 20 年中相对于其他尿石类型，草酸钙尿石的患病率呈比例增加，这增加了临床医生对这种疾病的关注。为了确定与在美国普通兽医医院就诊的犬中发生草酸钙尿石症相关的因素，进行了一项回顾性病例对照研究。回顾了美国 787 家普通兽医医院 2007 年 10 月 1 日至 2010 年 12 月 31 日期间所有犬的全国性电子病历数据库。首次诊断为实验室确认的至少 70%为草酸钙组成的尿石（n=452）的犬被选为病例。在审查了所有剩余犬的病历后，随机选择了两组无尿石症诊断史的对照组犬：一组（n=1808）的选择要求进行尿液分析检查，但另一组（n=1808）则没有此要求。提取的历史信息包括尿石成分、犬的饮食、年龄、性别、去势状态、品种大小类别、医院位置、诊断日期和尿液分析结果。多变量分析显示，<7 岁、雄性（OR：7.77，95%CI：4.93-12.26）、去势（OR：2.58，1.44-4.63）、玩具-与中体型品种（OR：3.15，1.90-5.22）、小型-与中体型品种（OR：3.05，1.83-5.08）、大型-与中体型品种（OR：0.05，0.01-0.19）和在过去一年中诊断为膀胱炎的犬，首次诊断为草酸钙尿石症的可能性显著增加（OR：6.49，4.14-10.16）。与首次诊断为草酸钙尿石症相关的尿液因素是酸性与碱性 pH（OR：1.94，1.22-3.10）、存在红细胞（OR：6.20，3.91-9.83）或白细胞（OR：1.62，1.03-2.54）以及蛋白浓度>30mg/dL（OR：1.55，1.04-2.30）。患者的人口统计学和尿液分析结果是可以支持风险评估和早期识别犬草酸钙尿石症的重要因素。因此，应鼓励有发生这些尿石风险的犬定期进行尿石筛查和尿液参数监测。
