Computed tomographic assessment of retrograde urohydropropulsion in male dogs and prediction of stone composition using Hounsfield unit in dogs and cats

Abstract

Background Persistent uroliths after a cystotomy in dogs are a common cause of surgical failure. Objectives This study examined the following: the success rate of retrograde urohydropropulsion in male dogs using non-enhanced computed tomography (CT), whether the CT mean beam attenuation values in Hounsfield Units (mHU) measured in vivo could predict the urolithiasis composition and whether the selected reconstruction kernel may influence the measured mHU. Methods All dogs and cats that presented with lower urinary tract uroliths and had a non-enhanced CT preceding surgery were included. In male dogs, CT was performed after retrograde urohydropropulsion to detect the remaining urethral calculi. The percentage and location of persistent calculi were recorded. The images were reconstructed using three kernels, from smooth to ultrasharp, and the calculi mHU were measured. Results Sixty-five patients were included in the study. The success rate of retrograde urohydropropulsion in the 45 male dogs was 55.6% and 86.7% at the first and second attempts, respectively. The predominant components of the calculi were cystine (20), struvite (15), calcium oxalate (8), and urate (7). The convolution kernel influenced the mHU values (p < 0.05). The difference in mHU regarding the calculus composition was better assessed using the smoother kernel. A mHU greater than 1,000 HU was predictive of calcium oxalate calculi. Conclusions Non-enhanced CT is useful for controlling the success of retrograde urohydropropulsion. The mHU could allow a prediction of the calculus composition, particularly for calcium oxalate, which may help determine the therapeutic strategy.

A prospective evaluation of high- and low-power holmium laser settings for transurethral lithotripsy in the management of adults with urethral stone

“…Further investigation on the short-and long-term effects of holmium lasers on ureteral stones is lacking, nevertheless. Additionally, the composition of urolithiasis and whether the chosen reconstruction kernel may have an impact on the obtained mHU may be predicted using CT mean beam attenuation values in Houns eld Units (mHU) determined in vivo [23].…”