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The Minnesota Urolith Center form is an essential document for veterinarians who are submitting stones for quantitative urolith analysis. It requests detailed information, such as the submitting clinic and veterinarian, patient details including species, breed, and age, and specifics around the diet fed prior to urolith retrieval. The form also inquires about any previous treatments such as antibiotics, urine acidifiers, or alkalinizers, and whether the pet was on a prescription diet. For feline urethral plugs specifically, it provides guidance on submission for analysis. The form is a critical first step in diagnosing the composition of uroliths, which plays a significant role in determining the appropriate management and prevention strategies. Addressing the urgency of understanding urolithiasis, the form also outlines preventative measures to take until quantitative mineral analysis results are received. These include recommendations on post-operative radiographs, dietary considerations, and obtaining cystocentesis urine samples to monitor for and prevent secondary urinary tract infections. The form underscored the collaborative effort between veterinarians and the Minnesota Urolith Center, backed by the expertise of the University of Minnesota's College of Veterinary Medicine and support from Hill’s Pet Nutrition, Inc., to enhance the health and well-being of pets dealing with urolith issues.

Minnesota Urolith Center Example

LAB USE ONLY

DATE REC'D

# SUBMITTED

MINNESOTA UROLITH CENTER QUANTITATIVE UROLITH ANALYSIS FORM

PLEASE SUBMIT STONES DRY IN UNBREAKABLE CONTAINER (FOR PLUGS SEE BELOW)

**Please copy this form**

Date submitted

DOCTOR NAME:

CLINIC NAME:

ADDRESS:

PHONE NUMBER:

FAX NUMBER:

Owner's Name

Patient's Name/ID#

Species

Breed

Birth Date

If yes, date of detection:

Mineral composition?

Was the urine cultured before/during stone retrieval? . . . . . . . .

. . . . .Yes

No

Bacterial growth? . . . . . . . Yes

No

Isolates:

 

 

Were antibiotics given prior to stone retrieval? . . . . . . . . . . . .

YesNo

Type/dosage:

Were urine acidifiers or alkalinizers given prior to stone

retrieval?Yes No Type/dosage:

Gender: (circle one)

M

MC

 

F

FS

Unk

Source: (check all areas samples obtained from)

 

 

Upper Urinary Tract

 

Lower Urinary Tract

 

(

)

Kidneys

 

(

 

)

Bladder

 

 

 

 

 

 

 

 

 

 

 

(

)

Ureters

 

(

 

)

Urethra

 

 

 

 

 

 

(

 

)

Voided

 

Other

Date retrieved or voided

What brand of diet was fed prior to urolith retrieval/diagnosis?

How long was this diet fed?

Was a prescription diet fed? Yes No

If yes, which one?

 

(check one)

 

 

c/d(s)

dry

(

 

)

canned (

)

c/doxl

 

 

 

 

 

 

 

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

k/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

l/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

s/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

u/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

w/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

z/d

dry

(

 

)

canned (

)

 

 

 

 

 

 

 

 

Other

How long was this diet fed?

Previous Uroliths? . . . . . . . .Yes

No

Unk

Was allopurinol given prior to stone retrieval? . . . . . . . . . . . . .

 

Yes

 

No

Dosage and duration:

 

 

 

 

Previous illness or injury:

 

 

 

Dx:

 

;

Date

 

Dx:

 

;

Date

 

FOR FELINE URETHRAL PLUGS ONLY

Preferred method for plug submission: 1/2 dry, 1/2 in formalin

How was the plug preserved? (check)

 

 

 

1.

No preservative

(

)

 

 

 

 

 

 

2.

10% buffered formalin

(

)

3.

Other

 

 

 

 

If sample is very small, please submit dry.

MAIL TO:

MINNESOTA UROLITH CENTER

Dr. Carl Osborne

Dept. of Small Animal Clinical Sciences

College of Veterinary Medicine

Univ. of Minnesota, 1352 Boyd Avenue

St. Paul, MN 55108

612/625-4221 FAX 612/624-0751

Supported in part by an educational gift from Hill’s Pet Nutrition, Inc

MINNESOTA UROLITH CENTER

Hasan Albasan, DVM, MS

UNIVERSITY OF MINNESOTA

• Carl A. Osborne, DVM, PhD

Kathleen Carpenter, CVT

College of Veterinary Medicine

Laura Pederson, BS

Thomas F. Fletcher, DVM, PhD

1352 Boyd Avenue

David J. Polzin, DVM, PhD

Frédéric Jacob, DVM

St. Paul, MN 55108

Sheri Ross, DVM

Lori Koehler, CVT

Lab Phone (612) 625-4221

Laurie L. Swanson, CVT

Chalermpol Lekcharoensuk, DVM •

Fax (612) 624-0751

Lisa K. Ulrich, CVT

Jody P. Lulich, DVM, PhD

 

 

_______________________________________________________________________________

WHAT PREVENTATIVE MEASURES SHOULD I TAKE UNTIL I RECEIVE QUANTITATIVE MINERAL ANALYSIS RESULTS?

Urolith formation is a process that typically takes several weeks (eg. infection induced struvite), to months (eg. calcium oxalate)rather than days. The most common "cause" of rapid recurrence of uroliths is incomplete removal at the time of surgery.

Until quantitative mineral analysis on the urolith is completed, we recommend the following

steps.

-Perform post-operative radiographs of patients with multiple urocystoliths. Double contrast cystography may be necessary if the urocystoliths were not easily observed on pre- operative survey films.

-If small stones are detected on post-operative films, they may be able to be removed non- surgically either by catheter retrieval1, or voiding urohydropropulsion2 after healing takes place.

-Feed a diet unlikely to enhance urolith formation. We typically feed a diet that avoids mineral excess, and promotes a neutral urine pH. We often feed a diet designed for mild to moderate renal insufficiency. If possible, feed a canned diet to promote dilute urine. Once urolith results are received, refer to accompanying recommendation sheets.

-Obtain cystocentesis urine samples to monitor for, and prevent secondary urinary tract infections.

1Osborne CA, Lulich JP, Unger LK: Nonsurgical retrieval of uroliths for mineral analysis. In Current Veterinary Therapy XI. pp 886-889, 1992.

2Lulich JP, Osborne CA, Unger LK, et al: Nonsurgical removal of urocystoliths by voiding urohydropropulsion. In Journal of the American Veterinary Medical Association. Vol 203, pp. 660-663, 1993.

Osborne CA, et al.: Canine and Feline Urolithiases: Relationship of Etiopathogenesis to Treatment and Prevention. In Canine and Feline Nephrology and Urology, Osborne and Finco 1995, pp 798-888

Form Characteristics

Fact Detail
Form Use Quantitative Urolith Analysis
Submission Instructions Please submit stones dry in unbreakable container
Additional Notes for Feline Urethral Plugs Preferred submission: 1/2 dry, 1/2 in formalin
Address for Mail Submission Minnesota Urolith Center, University of Minnesota, 1352 Boyd Avenue, St. Paul, MN 55108
Contact Information Phone: 612/625-4221, Fax: 612/624-0751
Recommended Preventative Measures Pre-Analysis Perform post-operative radiographs, feed diets that do not promote urolith formation, and obtain cystocentesis urine samples to monitor for infections.

Steps to Writing Minnesota Urolith Center

Filling out the Minnesota Urolith Center form is a straightforward process, designed to collect essential information about the patient (a pet), their medical history regarding urolith (stone) formation, treatment details, and dietary habits. This information is crucial for the center to conduct a detailed quantitative urolith analysis, which helps in understanding the mineral composition of the stones. Such analysis can guide future prevention and treatment strategies for pets suffering from urolithiasis. Following the analysis, the submitting veterinarian receives recommendations on how to manage and prevent further occurrences, based on the composition of the analyzed uroliths. Here is how to fill out the form, step-by-step.

  1. Enter the Date Submitted at the top of the form to record when the stones and form are being sent.
  2. Fill in the Doctor's Name and Clinic Name under the respective fields to ensure the results are sent to the correct veterinarian and facility.
  3. Provide the Address, Phone Number, and Fax Number of the clinic for communication purposes.
  4. Enter the Owner's Name to link the patient with the owner for any follow-up required.
  5. Under Patient's Name/ID#, input the pet's name or identification number used by the clinic.
  6. Specify the Species, Breed, and Birth Date of the patient for demographic purposes.
  7. Circle the Gender of the patient (M for Male, MC for Male Castrated, F for Female, FS for Female Spayed, Unk if unknown).
  8. Mark all applicable sources Upper Urinary Tract and/or Lower Urinary Tract from where samples were obtained, including kidneys, bladder, ureters, urethra, or voided.
  9. Specify the Date retrieved/voided of the stones to document the timeline of the condition.
  10. Answer questions regarding pre-stone retrieval treatments such as urine culture, antibiotics, and type/dosage of any urine acidifiers or alkalinizers administered.
  11. Detail the diet fed prior to urolith retrieval/diagnosis, including the brand and how long it was fed, and if a prescription diet was used, specify which one.
  12. If the submission is FOR FELINE URETHRAL PLUGS ONLY, choose the preferred method for plug submission and indicate how the plug was preserved.
  13. At the bottom, provide information about any Previous Uroliths, if allopurinol was given prior to stone retrieval, and note any relevant previous illness or injury.
  14. Finally, review the form to ensure all information is correct and complete, then mail it to the Minnesota Urolith Center at the address provided at the bottom of the form.

Once the form and the urolith sample are received by the Minnesota Urolith Center, the submitted stones undergo a thorough analysis to identify their mineral composition. This information is pivotal in understanding the cause of urolith formation in the specific patient, enabling personalized treatment and preventive measures. Veterinary professionals will receive detailed results along with dietary and medication recommendations tailored to prevent urolith recurrence in the affected pet. Providing precise and comprehensive information on the form facilitates this process, ensuring that the analysis results are as insightful and applicable as possible.

Listed Questions and Answers

  1. What is the primary purpose of submitting stones to the Minnesota Urolith Center (MUC)?
    The primary purpose is to conduct a quantitative mineral analysis on uroliths (stones) to determine their composition. This analysis assists veterinarians in diagnosing the cause of urolithiasis in pets, advising on potential treatment options, and recommending dietary changes or medications to prevent future stone formation.

  2. How should stones be submitted to the MUC for analysis?
    Stones should be submitted dry in an unbreakable container. For urethral plugs, particularly in felines, it's recommended to send half dry and half preserved in formalin, if possible, to ensure the integrity of the sample for analysis.

  3. Can this form be duplicated?
    Yes, you can make copies of the Quantitative Urolith Analysis Form. Clinics are encouraged to copy the form for each case submission to the MUC.

  4. What information is required on the form?
    The form asks for detailed information, including the submission date, veterinarian's name, clinic name and contact details, as well as the patient's (pet's) name, ID number, species, breed, birth date, and gender. It also inquires about the urinary stone's retrieval details, any prior treatments (e.g., antibiotics, urine acidifiers/alkalinizers, allopurinol), the pet's diet, and any previous stone events.

  5. Is it necessary to culture the urine before or during stone retrieval?
    Indicating whether urine was cultured is essential for the form. Knowing if bacteria were present and the type allows for a more comprehensive understanding of the stone's etiology and may influence treatment recommendations.

  6. What should be done while waiting for the analysis results?
    While awaiting results, it is recommended to perform post-operative radiographs to ensure all stones were removed, adjust the pet's diet to one less likely to promote stone formation (often a canned diet for dilute urine), and monitor for urinary tract infections through cystocentesis urine samples to prevent complications.

  7. What happens if the stone is very small?
    If the sample size is very small, it should still be submitted dry to the MUC for analysis. Small stones can often be analyzed successfully to determine their composition.

  8. How is a urethral plug preserved for submission?
    For urethral plugs, it's recommended to send half of the plug dry and half preserved in 10% buffered formalin, if possible. However, if no preservative is available, submitting the plug dry is acceptable. Indicate the preservation method used when submitting the form.

  9. Where should the form and stone samples be mailed?
    Samples and completed forms should be mailed to the Minnesota Urolith Center at the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, located at 1352 Boyd Avenue, St. Paul, MN 55108. The provided contact numbers are for further assistance or questions.

  10. Is there any support available for submitting samples?
    The MUC is partially supported by an educational gift from Hill’s Pet Nutrition, Inc., indicating a collaborative effort in addressing pet urinary health. This collaboration reflects the center’s commitment to advancing veterinary medicine and pet care through research and education.

Common mistakes

  1. One common mistake is not submitting stones dry and in an unbreakable container as specified. The form states, "Please submit stones dry in unbreakable container," emphasizing the need for dry samples to ensure accurate analysis. If stones are submitted wet or in a breakable container, there may be a risk of contamination or damage to the sample, potentially leading to inaccurate results.

  2. Another frequent error is neglecting to circle the gender of the patient. The form requests the gender to be indicated by circling "M (Male), MC (Male Castrated), F (Female), FS (Female Spayed), Unk (Unknown)." Accurate gender identification is crucial for a comprehensive interpretation of the urolith analysis, considering certain urolith types are more prevalent in specific genders.

  3. Forgetting to check the appropriate boxes under the "Source" section where samples were obtained is also a mistake often made. The form distinctly asks to check all areas samples were obtained from, including options like "Upper Urinary Tract," "Lower Urinary Tract," and specific areas within these sections. Accurate source identification is essential for understanding the origin of the urolith and formulating a treatment and prevention plan.

  4. Lastly, a critical oversight is not specifying if a prescription diet was fed and, if so, which one. The form inquires, "Was a prescription diet fed? Yes No If yes, which one?" followed by a list of dietary options. A detailed dietary history is vital for identifying potential dietary influences on urolith formation and guiding dietary recommendations post-analysis.

Avoiding mistakes on the Minnesota Urolith Center form not only ensures the submission process is smooth but also guarantees that the analysis of the urolith can be as accurate and informative as possible, leading to better treatment outcomes.

Documents used along the form

When submitting the Minnesota Urolith Center Quantitative Urolith Analysis Form, it is crucial to ensure a comprehensive understanding of the patient's condition and history. This form is a pivotal step in diagnosing and forming a treatment plan for pets with uroliths (stones) in their urinary tract. Alongside this form, several other documents and forms often play a significant role in providing a complete picture and facilitating the best possible care and management strategies. These auxiliary documents are essential for veterinarians and pet owners aiming for a precise diagnosis and effective treatment.

  • Pet’s Medical History Form: This document details the pet's overall health history, including any previous illnesses, diagnoses, treatments, vaccinations, and any recurring health issues. It provides a context for the current urinary issues and can help identify patterns or pre-existing conditions that might contribute to stone formation.
  • Urine Analysis Report: A comprehensive analysis of the pet’s urine can reveal crucial information about the urinary tract's health, such as the presence of blood, pH levels, crystal formation, and bacterial infections. This report complements the stone analysis by providing insights into the factors that could contribute to stone formation or indicate concurrent urinary tract diseases.
  • Imaging Results: X-rays, ultrasounds, or other imaging results that show the presence, size, and location of uroliths within the urinary tract. Imaging provides visual evidence of the stones and can be critical in planning surgical or non-surgical removal, as well as in monitoring post-treatment recurrence.
  • Follow-up Care Plan: Post-analysis and treatment, a detailed care plan including dietary recommendations, medication, lifestyle adjustments, and follow-up testing schedules is crucial. This plan ensures ongoing management and prevention of future urolith formation, tailored to the specific mineral composition of the stones and the overall health of the pet.

Together, these documents create a comprehensive profile that aids in the accurate assessment and effective management of urolithiasis in pets. Each document contributes its unique set of data and insights, enabling veterinarians to tailor their approach to the needs of each patient. By understanding the importance and roles of these supplementary documents, pet owners and veterinary professionals can work collaboratively towards a common goal: the health and well-being of the pet.

Similar forms

The Minnesota Urolith Center form's primary function is similar to a Patient Intake Form found in human medical practices. Both collect crucial patient history, including any prior conditions or treatments, which is essential for providing targeted care. The specifics such as patient's name, birth date, and the medical concerns at hand mirror the structured data collection needed to tailor medical or clinical interventions appropriately.

With resemblances to a Veterinary Patient History Form, the Minnesota Urolith Center form specifically asks for details pertinent to the veterinary field such as breed and species, highlighting its tailored approach to animal healthcare. This specialized focus ensures that all necessary factors related to the patient's condition, like diet and previous illnesses or injuries, are considered for a comprehensive analysis.

Similar to a Laboratory Test Request Form, this document is essential for submitting samples for diagnostic testing. It captures detailed instructions regarding how samples should be prepared and preserved, ensuring that critical diagnostics are not compromised, thus maintaining the integrity of the test results.

The form shares traits with a Prescription Medication Form, particularly in sections where information about past or current medication related to the condition is collected. This includes details on antibiotics or other treatments administered prior to sample collection, which is crucial for understanding the context of the urolith analysis.

Resembling a Consent Form for Treatment or Procedures, this document implicitly requires the consent of the pet owner for the analysis of the submitted samples. By submitting the form and samples, the owner agrees to the diagnostic process, which is foundational for lawful and ethical medical practice.

Its similarities with a Dietary History Form are evident, especially where it inquires about the brand and type of diet fed to the patient. This section acknowledges the significant role that diet plays in the formation of uroliths, highlighting the importance of dietary history in both diagnosis and the formulation of a treatment plan.

Like a Radiography Request Form, the guidelines for post-operative care suggest the use of radiographs to ensure all uroliths were removed, underscoring the document's comprehensive approach to both diagnosis and follow-up care, ensuring a thorough examination and treatment process.

This form also parallels a Surgical History Form, particularly when it collects data about previous urolith occurrences and any related surgical interventions. This information is crucial for understanding the patient's medical history and potential predispositions, influencing both current and future treatment strategies.

Echoing the structure of a Medication Dosage Form, the sections asking for specifics about antibiotics, urine acidifiers, or alkalinizers previously given, including dosages, mirror the detailed tracking of medication that is vital for assessing treatment efficacy and patient response.

It operates akin to a Research Study Enrollment Form in a veterinary context, where submitting samples contributes to broader scientific understanding of uroliths. By analyzing diverse cases, the Minnesota Urolith Center enhances collective knowledge on treatment and prevention, much like participants in a study contribute to medical research.

Dos and Don'ts

Filling out the Minnesota Urolith Center form requires attention to detail and precision to ensure accurate analysis and effective treatment for your pet. To assist with this process, here are some do’s and don’ts to keep in mind:

  • Do submit stones dry in an unbreakable container to avoid contamination or damage during transport.
  • Do ensure to copy the form for your records before sending it to the Minnesota Urolith Center.
  • Do provide comprehensive information about the pet, including the species, breed, birth date, and gender, as these details can influence the analysis and recommendations.
  • Do accurately fill out the diet section, including brand, type (canned or dry), and duration the diet was fed before urolith retrieval/diagnosis, as diet plays a critical role in urolithiasis.
  • Do check the appropriate boxes regarding urine culture, antibiotic administration, and urine pH modifiers to give the laboratory a full treatment picture.
  • Don’t leave out information on previous uroliths or illnesses, as past health issues can be relevant to current conditions.
  • Don’t forget to specify the method of urolith retrieval, as this can affect the analysis and subsequent recommendations.
  • Don’t send the sample without checking the preferred method for plug submissions for feline urethral plugs (dry, half in formalin, etc.) to ensure the sample’s integrity upon arrival.
  • Don’t hesitate to contact the Minnesota Urolith Center if you have questions about the form or submission process. Their expertise is invaluable for preventing delays or misunderstandings.

By following these guidelines, you contribute significantly to the efficient and effective analysis of uroliths, ultimately benefiting the health and well-being of your pet.

Misconceptions

Understanding the Minnesota Urolith Center form is crucial for submitting urolith samples accurately. However, several misconceptions can lead to confusion or incorrect submissions. Here are four common misunderstandings:

  • Stones must be submitted in a specific type of preservative. Contrary to this belief, the form asks for stones to be submitted dry in an unbreakable container. For feline urethral plugs specifically, there is a recommended submission method of half dry, half in formalin, but this does not apply to all stone submissions.
  • The form is exclusively for veterinarians. While it's true that a veterinarian's information is required, the form also importantly gathers details about the owner and the patient. This emphasizes the comprehensive approach of the Center, considering both the medical and the owner's perspectives in their analysis.
  • Any diet information is irrelevant to the analysis. On the contrary, the form inquiries about the brand and type of diet the pet was fed before urolith retrieval/diagnosis, highlighting the importance of diet in urolith formation and the need for detailed dietary history for accurate analysis and recommendations.
  • Urolith analysis is the final step in treatment. While receiving the quantitative mineral analysis results from the Center is crucial, it's not the last step. The form outlines preventative measures to take until results are received. These measures emphasize ongoing management to prevent recurrence, demonstrating that analysis is part of a continuing care strategy, not an end point.

By understanding these aspects of the form, submissions can be completed more effectively, aiding in the accurate analysis and treatment of urolithiasis.

Key takeaways

Filling out and using the Minnesota Urolith Center Form requires attention to detail and adherence to specific instructions for the submission of urolith samples for analysis. When preparing to submit a sample, veterinarians should consider these four key takeaways:

  • Proper Sample Submission: It's critical to submit stones dry and in an unbreakable container to avoid any contamination or damage to the sample. Feline urethral plugs have specific submission instructions, requiring half of the sample to be submitted dry and the other half in formalin, when possible.
  • Information Accuracy: The form asks for comprehensive details about the animal, including the owner's name, the patient's name/ID, species, breed, gender, and medical history. Accurate and thorough recording of this information ensures a precise analysis. It is also essential to provide details on the diet fed prior to urolith retrieval and any treatments administered, such as antibiotics or urine acidifiers/alkalinizers, as these factors can influence urolith formation.
  • Ensuring Complete Removal: One of the primary causes of rapid recurrence of uroliths is incomplete removal at the time of surgery. Post-operative radiographs are recommended to confirm complete removal of urocystoliths. If small stones are detected, they may be removed non-surgically through methods like catheter retrieval or voiding urohydropropulsion after the patient has adequately healed.
  • Preventative Measures and Diet: Until the quantitative mineral analysis of the urolith is complete, a diet that does not promote urolith formation is advised. Such a diet typically avoids mineral excess and promotes a neutral urine pH, possibly designed for mild to moderate renal insufficiency. Additionally, promoting dilute urine through the feeding of a canned diet can be beneficial. Using cystocentesis to obtain urine samples can help monitor and prevent secondary urinary tract infections.

These measures not only assist in the accurate analysis of uroliths but also in the effective management and prevention of future urolith formation in pets. Following the detailed guidelines provided with the Minnesota Urolith Center Form is crucial for veterinarians seeking to mitigate urolith-related issues in animals under their care.

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