The work deals with evaluation of the incidence of individual types of urinary stones in dogs, and the effect of specialised clinical diets on the treatment of urolithiasis. The evaluted material consists of an aggregate of analytical results from extracted urinary stones from the Veterinary clinic Vltava, in the period from January 30, 2008 to September 12, 2011. The effect of administration of specialised clinical diets for urolithiasis was evaluated on the basis of case histories of sample patients with proven struvite urolithiasis and an occurence of calcium oxalates and urates. The analysed aggregate of laboratory results of tested urinary stones has shown that besides a high incidence of struvite, the frequency of occurence of calcium oxalates increases as well. In this analysis even up to an identical percentage with struvite occurence at 44,44 % (that is, 24) analysed concrements. A link has been established with overal greater proneness of males to the formation of urinary stones. In the patient group with analysed majority percentage of whewellite, only 12,5 % of the analysed aggregate were females. Considering the widely varied pedigrees of analysed patients, incidence of urolithiasis is expected with ever greater frequency even in dogs not predisposed by breed and crossbreeds. Specialised clinical diets are employed in the treatment and prevention of certain types of urinary stons with high success rate, which adjust the urine environment and thus reduce the risk of occurence of urinary stones. Given the possibility of recurrence of urinary stones, i tis necessary to perform regular urine testing, and eventual sonographic examinations of the bladder

The urolithiasis condition investigated occurred at a "hard water" hatchery in Utah after the trout were changed from a meat diet to a commercial pelleted fish feed as a sole sustaining diet in 1961. Numerous diet modifications proved unsuccessful in preventing urolithiasis at the hatchery. It was eventually determined that different commercial diets resulted in varied percentages of trout developing urolithiasis. The urolithic deposits found in the kidney tubules were amorphous and composed of calcium phosphate (apatite) and an organic matrix. Bacterial contamination of the kidneys was not an important factor in the formation of urolithiasis. Rainbow trout containing urolithic deposits showed gradual deposit regression when transferred into a "softer" water supply. Pelleted experimental diets containing sodium bicarbonate and/or sodium fluoride were fed to two strains of rainbow trout reared in a "softer" water supply normally causing no urolithiasis problems. The diets with the sodium bicarbonate added resulted in a significant occurrence of urolithiasis when fed to trout for 30 days. The addition of sodium fluoride to the diet was not significant in producing urolithiasis in trout. One experimental diet (low sodium bicarbonate-sodium fluoride) and one strain of fish (Soap Lake) appeared to influence the number of trout developing urolithiasis although the increase was not significant. All levels of statistical significance were tested at the 5 percent level.

The intent of this research is to identify a simple diagnostic test to detect abnormal calciuresis and predict calcium oxalate (CaOx) urolith presence in Miniature Schnauzers. We investigated the impact of postprandial time on the specificity of urine calcium:creatine (UCa/Cr) in identifying affected dogs. The hypotheses were: 1) Significant differences exist in fasted and postprandial UCa/Cr between urolith-forming and control schnauzers. 2) UCa/Cr increases significantly from fasted baseline at one or more postprandial time point(s). Urine samples were collected from Miniature Schnauzers with (urolith-formers) and without (controls) CaOx uroliths in a fasted state and 1, 2, 4, and 8 hours after feeding a standardized diet. The change in UCa/Cr from baseline was calculated for each postprandial time. Urolithiasis status and the time point were assessed for impact on the UCa/Cr and change in UCa/Cr using a mixed model ANOVA. Based on 9 urolith-forming and 15 control dogs enrolled, urolith-forming Miniature Schnauzers have significantly higher mean UCa/Cr at 1 hour and 8 hours postprandial timepoints indicating altered calciuresis. The change in UCa/Cr was not significant at any post-prandial time point between or within groups. This pilot study shows male urolith-forming Miniature Schnauzers have excessive calciuresis throughout the day, providing insight into the mechanism behind their formation of CaOx uroliths. If using the Ca/Cr ratio, the postprandial sampling time is not critical. This simple urine measurement has potential as a marker of urolith presence and possibly risk of urolith formation. / Master of Science

Ziel der Arbeit war eine Steigerung der Wasseraufnahme und Harndilution durch Supplementierung von Natriumchlorid (NaCl) oder pH-Wert-Senkung durch Zugabe von Ammoniumchlorid (NH4Cl) zur Reduktion des Harnsteinbildungspotenzials. Durch die NaCl-Zulage wurde die Harnmenge signifikant gesteigert und das spezifische Gewicht des Harns gesenkt. Eine NaCl-Gabe stellt somit einen möglichen ergänzenden therapeutischen Ansatz für eine vermehrte Ausscheidung von Kristallen dar. Eine Ansäuerung des Harns durch Zulage von NH4Cl ließ sich nicht erreichen.

Ziel der Arbeit war eine Steigerung der Wasseraufnahme und Harndilution durch Supplementierung von Natriumchlorid (NaCl) oder pH-Wert-Senkung durch Zugabe von Ammoniumchlorid (NH4Cl) zur Reduktion des Harnsteinbildungspotenzials. Durch die NaCl-Zulage wurde die Harnmenge signifikant gesteigert und das spezifische Gewicht des Harns gesenkt. Eine NaCl-Gabe stellt somit einen möglichen ergänzenden therapeutischen Ansatz für eine vermehrte Ausscheidung von Kristallen dar. Eine Ansäuerung des Harns durch Zulage von NH4Cl ließ sich nicht erreichen.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

La lithiase urinaire est une affection très répandue qui touche 4 à 18% de la population selon les pays. Cette pathologie nécessite beaucoup de recherches pluridisciplinaires. Le travail présenté dans cette thèse a pour objet de préciser la nature des calculs urinaires de l’Est Algérien et d’étudier ensuite le rôle de certains éléments traces ainsi que l’effet de quelques extraits de plantes médicinales sur la dissolution des calculs urinaires. Les techniques utilisées sont principalement les suivantes : la spectrophotométrie infrarouge à transformée de Fourier pour déterminer la composition chimique des calculs, la fluorescence X afin de déterminer la nature et la teneur des éléments traces et la microscopie électronique à balayage pour explorer la structure intime des cristallites à l’échelle mésoscopique. D’autres méthodes comme la microscopie optique ont été utilisées pour faire l’analyse morphoconstitutionnelle des calculs. Enfin, un modèle expérimental in vitro a été développé pour étudier l’effet des plantes médicinales. Bien que le nombre de calculs urinaires considérés soit faible, l’épidémiologie de la lithiase dans cette région de l’Algérie a été esquissée. Les calculs d’oxalate de calcium deviennent prépondérants en raison d’un changement des habitudes alimentaires avec toutefois une persistance des calculs d’origine infectieuse que l’infection soit urinaire ou digestive. Les données recueillies sur la distribution des éléments traces ne soulignent pas leur rôle catalytique mais sont en faveur d’un simple processus d’adsorption. Aucun des extraits de plantes testés, tous issus de la pharmacopée algérienne, n’a eu d’effet tangible pour dissoudre les calculs urinaires. / Urolithiasis is a widespread disease that affects 4-18% of the population according to the countries. This pathology requires a lot of multidisciplinary research. The work presented here aims firstly to clarify the nature of urinary stones in the eastern Algeria and then investigate the role of trace elements as well as the effect of some medicinal plants on the dissolution of urinary stones. The techniques used are mainly the following: Fourier transform infrared spectroscopy to determine the chemical composition of the calculi, X-ray fluorescence to determine the nature and content of trace elements and scanning electron microscopy to explore the inner structure of the crystallites at the mesoscopic scale. Other methods such as stereomicroscopy have been used for the morpho-constitutional analysis of the calculi and an experimental model was developed for the study of the effect of medicinal plants in vitro.Although the number of urinary stones considered being low, the epidemiology of urolithiasis in this region of Algeria was sketched. Calcium oxalate stones become predominant due to a change in eating habits but with a persistence of infection-induced calculi persist, whatever the urinary tract or gut origin of the infection. The acquired data do not underline a catalytic role of trace elements detected within the stones but are in favor of a simple adsorption process. None of the tested extracts from the Algerian pharmacopoeia has had a significant effect to dissolve the urinary stones.

OBJETIVOS: O aumento da expectativa de vida tem gerado um envelhecimento populacional global, fazendo com que a proporção de indivíduos com mais de 60 anos de idade cresça mais rapidamente do que as demais faixas etárias. A incidência de litíase urinária em indivíduos idosos tem aumentado nos últimos anos, principalmente em nações industrializadas. Aspectos particulares do envelhecimento orgânico aumentam a morbidade associada à litíase urinária em idosos, tornando a prevenção e o tratamento clínico ainda mais relevantes nessa faixa etária. Nosso objetivo é analisar a avaliação metabólica de homens idosos portadores de cálculos renais. MATERIAIS E MÉTODOS: Realizamos um estudo clínico tipo caso-controle. Os critérios de inclusão foram: indivíduos do sexo masculino com mais de 60 anos de idade, com antecedente de cólica renal ou diagnóstico incidental de litíase urinária após os 60 anos (grupo caso); no grupo controle foram incluídos pacientes da mesma faixa etária sem antecedente de cólica renal ou diagnóstico incidental de litíase renal. Todos os participantes foram submetidos à anamnese e aqueles selecionados realizaram perfil metabólico para diagnóstico de litíase urinária: dosagem sérica de cálcio total, cálcio ionizado, ácido úrico, fósforo, glicemia, uréia, creatinina e paratormônio (PTH); coleta de urina para urocultura e pH urinário, e amostras de urina de 24 horas para quantificação do volume e dosagem de cálcio, citrato, creatinina, ácido úrico e sódio. Foram também submetidos à radiografia simples de abdome e ultrassonografia do aparelho urinário. Os indivíduos do grupo caso realizaram dois perfis metabólicos completos de urina de 24 horas, enquanto os do grupo controle somente um perfil. Os resultados foram submetidos à análise estatística. RESULTADOS: Cento e dez indivíduos foram convocados e, após aplicação dos critérios de inclusão, 70 foram selecionados. Cinquenta e um indivíduos concluíram a investigação clínica, sendo 25 no grupo caso e 26 no controle. Cinquenta e seis por cento dos pacientes do grupo caso apresentaram hipocitratúria comparados a 15,4% do grupo controle (p=0,002). A determinação de sódio em urina de 24 horas também apresentou diferença estatisticamente significativa entre casos e controles: 64% versus 30,8%, respectivamente (p=0,017). Estes resultados foram submetidos à análise de regressão logística univariada e múltipla, respectivamente, e mantiveram seus níveis de significância. CONCLUSÃO: A hipocitratúria e a hipernatriúria são os principais distúrbios metabólicos apresentados por indivíduos idosos do sexo masculino portadores de cálculo urinário / PURPOSES: Rise in life expectancy has caused a global populational ageing and people older than 60-years have increased more than any other age group. The incidence of urinary lithiasis in aging people has increased during the last years, mainly in developed nations. Some aspects concerning organic ageing increase morbidity related to urolithiasis in older individuals making prevention and medical management of urinary stones relevant in this age group. Our objective is to evaluate metabolic parameters in men older than 60 years with urinary stones. MATERIALS AND METHODS: A case-control study was performed. Inclusion criteria were: men older than 60- years old with renal pain episodes or incidental diagnosis of urinary lithiasis beginning after 60-years old (case arm). Control group was constituted by patients older than 60 years without renal colic past or diagnosis of urolithiasis. Patients were recruited from a database from the Urologic Clinic at University of São Paulo Medical School Hospital. Each individual was submitted to anamnesis and those selected underwent a metabolic evaluation for urinary stones: serum dosages of total and ionized calcium, uric acid, phosphorus, glucose, urea, creatinine and parathyroid hormone (PTH); urine culture and urinary pH. Twenty four hour urine samples were obtained for volume quantification and for calcium, citrate, creatinine, uric acid and sodium dosages. An abdominal x-ray and ultrasonography were performed in all patients. Case arm patients underwent two complete metabolic urinary investigations while control arm individuals to only one. All results were submitted to statistical analysis. RESULTS: One hundred and ten individuals were called up for initial evaluation and 70 were selected. Fifty-one individuals concluded the whole clinical investigation: 25 in the case arm and 26 in the control arm. Hypocitraturia was present in 56% of case arm patients and 15,4% of the control arm patients (p=0,002). Hypernatriuria in 24-hour urine samples was found in 64% of case arm patients and in 30,8% of control arm patients (p=0,017). These results were submitted to univariate and multiple logistic regressions and maintained their levels of significancy. CONCLUSION: Hypocitraturia and hypernatriuria are the main metabolic disorders among aging men with urolithiasis

A urolitíase é um problema recorrente na clínica veterinária considerada como causa de morbidade. As urolitíases são estreitamente associadas ao pH urinário e a nutrição exerce um papel fundamental no controle desta afecção, pois através da manipulação da dieta, pode-se modificar o pH urinário. A dieta possui cátions e ânions na sua composição mineral e a diferença entre íons é medida em miliequivalentes (mEq/kg) e denominado excesso de bases (EB) da dieta, calculado através da equação: (49,9 x Ca) + (82,3 x Mg) + (43,5 x Na) + (25,6 x K) – (64,6 x P) – (62,4 x S) – (28,2 x Cl), sendo a concentração dos elementos em g/kg de MS. A finalidade deste estudo, dividido em dois experimentos, foi avaliar o efeito da adição de fontes de enxofre (S) e cálcio nas dietas de felinos sobre o pH urinário e equilíbrio ácido-básico. A adição de fontes de enxofre objetivou demonstrar a eficácia na acidificação urinária. No primeiro experimento avaliaram-se três diferentes fontes de enxofre: sulfato de cálcio (CaSO4), DL-metionina (DLM) e Metionina hidróxi análoga (MHA) adicionados a uma dieta controle em dois níveis cada um. No tratamento controle não houve adição de acidificantes. No primeiro nível adicionou-se 1,28 g de S/kg e no segundo 2,56 g de S/kg, resultando em sete tratamentos. No segundo experimento duas fontes de cálcio foram avaliadas com o objetivo de pesquisar a eficácia destes sais na alcalinização da urina. No tratamento controle não houve adição de fontes de cálcio. Nos tratamentos 2 e 3 foram adicionados à dieta controle carbonato de cálcio e gluconato de cálcio, respectivamente, nas doses de +160 mEq/kg, resultando em três tratamentos. A urina produzida em cada período de 24 horas teve aferida seu volume, densidade e pH. No segundo experimento foi também medida a excreção urinária de cálcio no período de 72h. O equilíbrio ácido-básico foi avaliado pela hemogasometria de sangue venoso. A DLM no maior nível e o MHA diferiram da dieta controle em relação ao pH urinário (p<0,001) e seu poder acidificante foi maior que o do sulfato de cálcio (p<0,05). As duas fontes de cálcio alcalinizaram a urina, mas o carbonato de cálcio atingiu um pH urinário mais alto que o gluconato de cálcio. Concluiu-se que o efeito diferenciado das fontes de S e cálcio sobre o pH urinário é um indicador de que a participação do cálcio é dependente dos ânions a que está associado, o que leva ao questionamento sobre qual a melhor forma de avaliar sua participação no cálculo do EB. / Urolithiasis is a commom problem in the veterinary clinic considered as a cause of morbidity. The urolithiasis are closely associated with urinary pH and nutrition plays a key role in the control of this disease, because through dietary manipulation, it´s possible modify the urinary pH. The diet has cations and anions in their mineral composition and the difference between ions is measured in milliequivalents (mEq/kg) and called base excess (BE) of the diet, calculated by the equation: (49.9 x Ca) + (82, Mg x 3) + (43.5 x Na) + (25.6 x K) - (64.6 x P) - (62.4 x S) - (28.2 x Cl), being the concentration of elements in g/kg DM. The purpose of this study, divided in two experiments, was to evaluate the effect of addition of sources of sulfur (S) and calcium in the diets of cats on the urinary pH and acid-base balance. The addition of sulfur sources aimed to demonstrate the efficacy in urinary acidification. In the first experiment were evaluated three different sources of sulfur, calcium sulfate (CaSO4), DLMethionine (DLM) and Methionine hydroxy analogue (MHA) added to a control diet at two levels each. In the control treatment there was no addition of acidifying. At the first level was added 1.28 g S/kg and in the second 2.56 g S/kg, resulting in seven treatments. In the second experiment two calcium sources were evaluated in order to research the effectiveness of these salts in alkalinize urine. In the control treatment there was no addition of calcium sources. In treatments 2 and 3 were added to the control diet calcium carbonate and calcium gluconate, respectively, at doses of +160 mEq/kg, resulting in three treatments. The urine produced in each period of 24 hours had measured its volume, density and pH. The second experiment also measured the urinary excretion of calcium in the period of 72 hours. The acid-base balance was evaluated by blood gas analysis of venous blood. The DLM at the highest level and MHA differed of the control diet in relation to urinary pH (p<0.001) and their acidifying power was greater than the calcium sulfate (p<0.05). The two sources of calcium alkalinized the urine, but the calcium carbonate reached a urine pH higher than calcium gluconate. It was concluded that the effect of different sources of S and calcium on urinary pH is an indicator that the participation of calcium is dependent of the anions that is associated, which leads to questions about how is the best way to evaluate its participation in calculation of BE.

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