Wednesday, February 8, 2012

Importance of stone analysis - Calcium phosphate urinary stones at recurrence

In my review of this recurrent urolithiasis, for the benefit of dog owners, the vet did not perform a stone analysis in the first cystotomy done 12 months ago. This was probably due to the owner's instructions to reduce costs. In the recurrent case, operated by at Toa Payoh Vets by Dr Vanessa, I insisted on a stone analysis. The results were as follows as this ought to be done to know the type of stones present and hence a preventive program using prescription diet or other ways to manage and prevent recurrence.

12.1.12 At Vet 1
after midnight emergency


Shih Tzu, Male, 8 years old



BLOOD TEST
URINE TEST
X-RAY
WBC high 24.48 (5.5 -17)
Neutrophils 82%, L=3.6%, Mono = 12.9%
Absolute High for Neutrophils, Monocytes, Basophils, Platelets, BUN, ALKP.
Dysuria urine pH = 7.2, USG 1.015




3.1.12 at Toa Payoh Vets

SURGERY
URINE TEST
STONE ANALYSIS: Calcium Phosphate.


Urine pH 7.0, USG 1.012
Protein 2+, Blood 4+, WBC 468 RBC 25, Bacteria 3+, Crystals Nil.

Do proper planning before surgery to save on manpower time and resources and to reduce length of anaesthesia, ensuring better survival outcome for old dogs.
No crystals in the urine do not mean no urinary stones inside the bladder or kidneys
Negative for oxalate, urate, magnesium, cystine, ammonia, bicarbonate.
In conclusion, most Singaporean pet owners don't bother with prescription diets, monthly urine tests and 3-monthly X-ray to detect small urinary stones which can be flushed out using urohydropropulsion and thereby saving on surgery and higher costs. However, it is THE DUTY of the veterinary surgeon to record in the case sheet that such advices have had been offered to the owner to prevent misunderstanding when there is a recurrence.

Younger Singaporeans may be much more sophisticated and educated and may understand the need for such preventive tests. But many Singaporeans are time-pressed. Till the dog can't pee or pass blood and then they may consult the vet. I hope this review will provide some information to owners who wants more information on prevention as I do know of some owners who would just euthanase the dog when there is a recurrence.


Website updates and images:
http://www.sinpets.com/dogs/20120219recurrent-urolithiasis-urinary-stones-toa-payoh-vets_Singapore_ToaPayohVets.htm

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