X Ray for Crystals??

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Venita

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Diabetic Cats in Need is sponsoring Shelly's newly adopted diabetic cat Bill.

Bill gets a dental procedure tomorrow and while he is under anesthesia, the vet wants to do X-Rays for bladder stones. This is because Shelley took in a urine sample this week and crystals were evident. However, the way Shelley obtained the urine was to syringe the urine out of the litter box.

I've never dealt with crystals or stones. I spoke to Bill's vet, and he says that the nature of the collection or handling of the urine would not change the fact of crystals.

Could this finding of crystals come from the way the urine was collected or handled?

Just wondering whether a cystocentesis and re-exam of the urine is the next logical step to rule out a possible contaminated sample. If crystals are there or not there regardless of collection method, I guess we do go straight to X-Rays to look for stones.

BTW, we do not presently have access to Bill's previous medical records to determine whether he has a history of crystals/stones.

PS--I have not heard anything from Jennifer or Shelley about Bill having any urinary tract problems or symptoms since he has been with Shelley (about two weeks).
 
I've asked Shelley about LB use and she says it's been normal. I also can't imagine he has any pain or discomfort with his low numbers.

I'll call my vet after I feed my cats and see what she says about crystals. I seem to remember her telling me that if a sample sits too long it forms crystals, but it was so long ago I'm just not sure anymore.
 
I could be wrong but I thought some crystals were normal. they do not show up in x-rays. stones will and depends on what kind on how they are handled. increase water intake (with wet food) will help them to keep moving along and not cause any kind of blockage
 
very quick search for Are crystals normal in cat urine

Crystalluria in animals with anatomically and functionally normal urinary tracts is usually harmless because the crystals are eliminated before they grow large enough to interfere with normal urinary function. Even so, they represent a risk factor for kidney stones.



Crystals that form in the urine following elimination or removal of urine from the patient often are of little clinical importance (i.e., crystals formed in the urine after leaving the body). Identification of crystals that have formed in vitro (in a lab environment) will not justify therapy. Situations that will require further follow-up are instances where some types of crystals are detected in patients without symptoms (asymptomatic); when large aggregates of crystals (e.g., calcium oxalate or magnesium ammonium phosphate) in apparently normal individuals are detected; or, when detection of any form of crystals in fresh urine collected from patients with confirmed kidney stones may have diagnostic, prognostic, or therapeutic importance.
 
If the urine is relatively old and and if some of it had evaporated (left in LB) then crystals are not that uncommon in that type of sample. Unless there are symptoms (for example, frequent or painful urination, bloody urine) I wold not be concern and would decline the x-rays. Bladder stones are related to crystals and may form if there are crystals. Stones are when the crystals grow and no longer can be passed. Bladder usually result in bloody and frequent urination. Frequently there is an indication of stones and maybe crystals by ultrasound. Many vets use ultrasound to get a cystocentesis sample and sometimes see those things. X-rays can usually confirm the presents of stones and frequently you can count the number.
 
Hi Venita

Replying here rather than PM, hope you don't mind:

Well if he were my cat, or your cat, and funds were not an issue, I'd say why not get an x-ray? Never hurts. Since the cat has no symptoms, though, and funds are especially precious, I would need for the vet to justify the need for an x-ray. Cats certainly have crystals without having stones, and often have stones without crystals. They can even have crystals of one type and stones of another :roll:

Some more compelling reasons for x-rays include symptoms, plus if a cat has very dilute urine and a ton of crystals ... that's weird because cats with dilute urine should be sweeping out crystals with their watery pee (don't you love my technical terms?) and crystals can form in concentrated urine when it's left around. Another reason would be a crystals of an unusual composition i.e. not struvite (aka triple phosphate) or calcium oxalate. Personally I'd repeat the urinalysis if I got such a weird result and take action only then.

Bottom line, unless this cat is feral and would need sedation to ever get another xray, and unless he is symptomatic, and unless there is some other factor causing the vet to be highly suspicious for stones, I'd leave it off. I'm curious why it was recommended in the first place, really.

HOpe this helps.
 
Hi Venita,

I cover this issue on my Urinary Tract Health page.

If a vet states that handling is not an issue with regard to crystal formation, then some serious continuing education is in order....

Also, keep in mind that not all stones are radiodense. In other words, not all stones will show up on xray. Most will...but some won't.
 
Thanks all for your advice. Turns out Shelley has worked with this vet and really trusts him. I think she'll be concerned if we don't get the X-Rays, so we will. Dr. Lisa, I sent your page to Shelley that she can learn, as I am doing reading it. Thanks!!
 
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