Peer-reviewed veterinary case report
Noninvasive ultrasound treatment to break urinary stones in pet cats
By Maxwell, Adam D et al.·Published in BMC veterinary research·2023·Department of Urology, United States·View original on PubMed →
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Original publication title: Development of a burst wave lithotripsy system for noninvasive fragmentation of ureteroliths in pet cats.
- Species:
- cat
Plain-English summary
A study tested a new non-invasive treatment for cats with urinary stones, which can cause serious issues. The burst wave lithotripsy system uses focused ultrasound to break down these stones without surgery. In tests, the device successfully fragmented a significant number of stones to less than 1 mm in size, which could help relieve blockages. This method showed promise with minimal injury to surrounding tissues, suggesting it could be a safer option for treating cats with ureteroliths in the future.
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Abstract
BACKGROUND: Upper urinary tract stones are increasingly prevalent in pet cats and are difficult to manage. Surgical procedures to address obstructing ureteroliths have short- and long-term complications, and medical therapies (e.g., fluid diuresis and smooth muscle relaxants) are infrequently effective. Burst wave lithotripsy is a non-invasive, ultrasound-guided, handheld focused ultrasound technology to disintegrate urinary stones, which is now undergoing human clinical trials in awake unanesthetized subjects. RESULTS: In this study, we designed and performed in vitro testing of a modified burst wave lithotripsy system to noninvasively fragment stones in cats. The design accounted for differences in anatomic scale, acoustic window, skin-to-stone depth, and stone size. Prototypes were fabricated and tested in a benchtop model using 35 natural calcium oxalate monohydrate stones from cats. In an initial experiment, burst wave lithotripsy was performed using peak ultrasound pressures of 7.3 (n = 10), 8.0 (n = 5), or 8.9 MPa (n = 10) for up to 30 min. Fourteen of 25 stones fragmented to < 1 mm within the 30 min. In a second experiment, burst wave lithotripsy was performed using a second transducer and peak ultrasound pressure of 8.0 MPa (n = 10) for up to 50 min. In the second experiment, 9 of 10 stones fragmented to < 1 mm within the 50 min. Across both experiments, an average of 73-97% of stone mass could be reduced to fragments < 1 mm. A third experiment found negligible injury with in vivo exposure of kidneys and ureters in a porcine animal model. CONCLUSIONS: These data support further evaluation of burst wave lithotripsy as a noninvasive intervention for obstructing ureteroliths in cats.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37660015/