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The Minnesota Urolith Center form is designed for the submission of uroliths for quantitative analysis. This form collects essential information about the patient, the uroliths, and any relevant medical history to assist in diagnosing and treating urinary stone disease. To ensure accurate analysis, it is crucial to fill out the form completely and submit it along with the urolith samples.

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Document Data

Fact Name Description
Form Purpose This form is used for submitting stones for quantitative urolith analysis at the Minnesota Urolith Center.
Submission Guidelines Stones must be submitted dry and in an unbreakable container.
Owner Information Includes fields for the owner's name, patient's name, species, breed, and birth date.
Urine Culture The form inquires whether the urine was cultured before or during stone retrieval.
Previous Uroliths Questions about the presence of previous uroliths and any treatment given prior to retrieval are included.
Dietary History Details regarding the diet fed prior to diagnosis, including any prescription diets, are requested.
Plug Submission For feline urethral plugs, the form specifies preferred methods for submission and preservation.
Contact Information Mailing address and contact details for the Minnesota Urolith Center are provided for submissions.
Preventative Measures The form includes recommendations for preventative measures until analysis results are received.

Additional PDF Forms

Documents used along the form

The Minnesota Urolith Center form is crucial for analyzing uroliths in pets. However, several other documents often accompany this form to ensure comprehensive evaluation and care. Below is a list of these documents, along with brief descriptions of their purposes.

  • Veterinary Referral Form: This document is used when a primary care veterinarian refers a patient to a specialist. It includes the patient's medical history, diagnostic findings, and specific reasons for the referral, allowing the specialist to understand the case better.
  • Urinalysis Report: A urinalysis report provides detailed information about the composition of the urine. It includes results on specific gravity, pH levels, and the presence of crystals or bacteria, which can help in diagnosing urinary tract issues.
  • Radiology Report: This report summarizes findings from any imaging studies performed, such as X-rays or ultrasounds. It helps identify the presence of stones or other abnormalities in the urinary tract.
  • California Homeschool Letter of Intent: This document serves as an official declaration submitted to local school districts to notify them of a family's decision to homeschool. For more information, visit https://homeschoolintent.com/editable-california-homeschool-letter-of-intent.
  • Client Consent Form: This form is essential for obtaining permission from the pet owner before performing any procedures or tests. It ensures that the owner is informed about the risks and benefits involved.
  • Post-Operative Care Instructions: After surgery, this document outlines the necessary steps for recovery. It includes guidelines on diet, activity restrictions, and signs of complications to watch for.

These forms and documents work together to provide a thorough understanding of a pet's urolithiasis condition, ensuring that veterinarians can deliver the best possible care. Proper documentation is essential for effective communication and treatment planning.

Essential Questions on Minnesota Urolith Center

What should I include when filling out the Minnesota Urolith Center form?

When completing the Minnesota Urolith Center form, ensure you provide all necessary details. This includes the date of submission, your name, clinic name, address, and contact information. You will also need to input the owner's name, the patient's name or ID, species, breed, and birth date. Additionally, indicate if the urine was cultured before or during stone retrieval, and if antibiotics or urine acidifiers were administered. Providing information about the diet fed prior to diagnosis is crucial, as is noting any previous uroliths and relevant medical history.

How should I submit stones for analysis?

Stones should be submitted dry and placed in an unbreakable container to prevent damage during transit. If you are submitting plugs, please follow the preferred method indicated on the form: half dry and half preserved in 10% buffered formalin. If the sample is particularly small, it is recommended to submit it dry. Ensure that the container is securely sealed to avoid leaks.

What steps should I take while waiting for the analysis results?

While awaiting the quantitative mineral analysis results, take proactive measures to prevent further urolith formation. Perform post-operative radiographs if multiple urocystoliths were present. If small stones are detected, consult your veterinarian about non-surgical retrieval options. Feed a diet that minimizes mineral excess and promotes a neutral urine pH. A canned diet may help produce dilute urine, which is beneficial. Additionally, obtain cystocentesis urine samples to monitor for potential urinary tract infections.

Who can I contact for assistance regarding the form or submission process?

If you have questions or need assistance with the Minnesota Urolith Center form or the submission process, you can contact the Minnesota Urolith Center directly at their lab phone number, 612-625-4221. Their fax number is also available at 612-624-0751. Don't hesitate to reach out for guidance; timely communication can ensure proper handling of your samples.

Common mistakes

Filling out the Minnesota Urolith Center form requires careful attention to detail. One common mistake is leaving out essential information. For instance, failing to provide the doctor's name or clinic name can delay the processing of your submission. Ensure that all fields are completed accurately.

Another frequent error is not indicating the species and breed of the patient. This information is crucial for proper analysis and treatment recommendations. Omitting this detail can lead to misunderstandings and potential misdiagnoses.

People often neglect to specify whether the urine was cultured before or during stone retrieval. This question is vital for understanding the potential causes of urolith formation. Marking Yes or No without providing additional context can result in incomplete assessments.

Many submitters fail to detail the diet fed to the patient prior to urolith retrieval. Not mentioning the brand or type of diet can hinder the analysis. It is essential to provide accurate information about any prescription diets as well, as this can significantly impact treatment options.

Another mistake is not indicating whether antibiotics were administered before stone retrieval. This detail is critical for determining the presence of bacterial infections. Be sure to include the type and dosage if antibiotics were given.

Lastly, some individuals overlook the section regarding previous uroliths. Failing to answer this question can lead to incomplete historical context for the patient's condition. Always provide a clear and thorough account of any past uroliths, including dates and relevant details.

Similar forms

The Minnesota Urolith Center form shares similarities with a veterinary medical history form. Both documents collect essential information about the pet, including the owner's details, the patient's name, and medical background. This information helps veterinarians understand the pet's health history and any previous conditions that may affect current treatment. The medical history form often asks about prior illnesses, medications, and dietary habits, similar to the inquiries found in the urolith analysis form.

Another comparable document is the veterinary referral form. This form is used when a veterinarian refers a patient to a specialist. Like the urolith analysis form, it gathers vital information about the pet's condition, previous treatments, and current symptoms. The referral form ensures that the specialist has all necessary background to provide effective care, much like the urolith form aims to provide insights into the pet's urolith formation and treatment history.

For those looking to ensure a smooth and legally sound transaction when selling a vehicle, it is crucial to complete the Missouri PDF Forms accurately, as this document provides a comprehensive record of the sale and essential details about the vehicle and the parties involved.

The prescription diet form is also similar. This document is used to specify dietary needs for pets with specific health issues. It collects details about the pet's current diet, duration of the diet, and any specific dietary restrictions. The urolith analysis form similarly asks about the pet's diet prior to stone retrieval, emphasizing the importance of nutrition in managing uroliths.

A surgical consent form is another document that bears resemblance. This form is used to obtain permission from pet owners before performing a procedure. It often includes information about the pet's health status and any risks involved. The urolith analysis form, while not a consent form, collects critical health data that can influence surgical decisions, highlighting the interconnectedness of these documents in veterinary care.

The laboratory submission form for diagnostic tests is also similar. Both forms request specific information about the patient and the samples being submitted. The lab submission form collects details about the type of test, sample handling, and patient history, similar to how the urolith analysis form requests information on stone retrieval and medical background to ensure accurate analysis.

A vaccination history form can be likened to the urolith analysis form as well. This document records the pet's vaccination status and any reactions to vaccines. It helps veterinarians assess the overall health and immunity of the pet, much like the urolith form gathers information to assess the risk factors for urolith formation.

The pet insurance claim form is another document that resembles the urolith analysis form. This form collects information about the pet's medical history, treatments received, and costs incurred. Both forms aim to provide comprehensive details that support the ongoing care of the pet, whether for insurance reimbursement or for understanding urolith issues.

The emergency contact form is also similar in nature. This document gathers information about whom to contact in case of an emergency, along with the pet's medical history. While the focus is different, both forms emphasize the importance of having accurate and comprehensive information readily available to ensure the best care for the pet.

Additionally, the health assessment form used during routine check-ups shares similarities. This form collects information about the pet's health status, diet, and lifestyle. The urolith analysis form also seeks to understand the pet's health and dietary habits, reflecting the importance of these factors in overall wellness and specific conditions like uroliths.

Finally, a follow-up care form can be considered similar. This document is used to track the recovery and ongoing care of a pet after treatment. It often requires information about the pet's condition and any changes in diet or medication. The urolith analysis form, while focused on initial analysis, also aims to guide future care based on the results, making it essential for ongoing management of 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

Key takeaways

When filling out the Minnesota Urolith Center form, consider the following key takeaways:

  • Submit dry stones: Ensure that the stones are dry and placed in an unbreakable container. This is crucial for accurate analysis.
  • Complete all fields: Fill in all required information, including doctor and clinic details, as well as owner and patient information. Incomplete forms may delay processing.
  • Document prior treatments: Clearly indicate any antibiotics or dietary changes that occurred before stone retrieval. This information is vital for understanding the urolith's formation.
  • Indicate method of plug submission: For feline urethral plugs, specify the preferred method of preservation, such as using formalin or no preservative at all.
  • Mail to the correct address: Send the completed form and samples to the designated address at the University of Minnesota. Double-check for accuracy to avoid misdelivery.
  • Follow preventative measures: Until analysis results are received, adhere to recommended steps to prevent further urolith formation, including dietary adjustments and monitoring for infections.