Friday, July 12, 2013

Update:How to prevent bladder stones (struvites) in your dog

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   13 July, 2013
Focus: Small animals - dogs, cats, hamsters, turtles, guinea pigs & rabbits

 
The Death Sentence for Producing Urinary Stones - How to prevent recurrences
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written:  1 September, 2009
Updated:  13 July, 2013

 
Many times, it is a death sentence when the pet dog produces urinary stones again as the average Singaporean dog owner feels that the surgical treatment, hospitalisation, nursing care and medication from around S$900 at Toa Payoh Vets to over $2,500 elsewhere are "expensive". Unfortunately, urinary stones do recur in some dogs such as the Miniature Schnauzer.

Recurring urinary stones Miniature Schnauzer Toa Payoh VetsSome tips to prevent recurrences of struvite stones are:

1. BREED. Breeds like the Miniature Schnauzer are prone to producing urinary stones. Urinary examination at least 3-monthly will be ideal. If not, during the yearly vaccination, ask your vet to do a urinary analysis to check for urinary crystals.

2. DIET. No dry dog food definitely. No canned foods or treats. Special low stone prescription diet or home-cooked food.

3. URINE pH, S.G,  Red and White Blood Cells measured weekly using dipsticks in collaboration with your vet.

4. WATER INTAKE. Measure diligently and scientifically 24-hourly water drunk in collaboration with your vet. Some sedentary dogs need to be encouraged to drink by more exercise or supervision.

5. ACIDIFICATION OF THE URINE if the urine pH is 7.0 and higher in collaboration with your vet.

6. BLADDER PALPATION. If stones or a crackling gassy sound are felt, it is bad news. Consult your vet promptly.

7. Early detection of blood in the urine and treatment.  Small struvite urinary stones may be dissolved using the prescription struvite diet.  Some owners ignore the blood in the urine till the dog cannot pee.

The following shows two female dogs that had blood in the urine.
Recurring bladder stones female miniature schnauzer. Toa Payoh Vets  
Recurring bladder stones female cocker spaniel. Toa Payoh Vets
The Schnauzer, peeing out stones, was fed home-cooked food at the same time as another dog (Golden Retriever) was fed dry food by the maid 8 months ago after consulting me. The owner did not want surgery. She was given acidification tablets and C/D diet for 1 month and had no longer produced stones. She might have eaten some dry food given to the Golden Retriever and produced stones 8 months after my consultation.

The Cocker Spaniel had been fed dry dog food for 8 years. She drank little water. Vet 1 removed bladder stones and advised feeding a fish-based diet sold by him after surgery. However blood in the urine occurred and the young lady owner consulted me. I removed 31 bladder stones in Sep 2009.

UPDATE ON JUL 13, 2013
The Cocker Spaniel had no recurrences and died in December 2012 of old age. The owner saw me in July 2013 when she brought a stray kitten badly bitten on the neck by an adult stray cat in the garbage dump near her office. She told me that the Cocker Spaniel I operated had passed away of old age in December 2013.

I followed up with the life of her Cocker Spaniel. The case study is at:
http://2010vets.blogspot.sg/2013/07/review-of-much-loved-cocker-spaniels.html
  
The objective is to prevent struvite crystal formation by ensuring that the bladder is free from bacterial infections and that the urine pH is alkaline.

The dog owner has to be educated in prevention and to take good care post-surgery in collaboration with their vet keeping proper records of urine test.

Unfortunately, few Singapore dog owners bother about feeding a proper commercial diet or just home-cooked food as in the case of the Cocker Spaniel above.  In the Cocker Spaniel, I was surprised that the young lady owner took the trouble to cook home-cooked food of vegetables and chicken for her dog to prevent any recurrence.

A recurrence means a death sentence, especially during times of recession as the owners do not want to pay for medical treatment. The above-mentioned guidelines apply to the prevention of struvite (triple phosphate) urinary stones only.

P.S
Here's the brief medical history of the beloved Cocker Spaniel.
The Cocker Spaniel was born in Sep 1998. Spayed at an early age by Vet 1 who was the sole vet for the next 11 years, till the recurrence of bladder stones in 2009.  Bladder stones removed by Vet 1 a few months ago. Vet 1 sold a fish-based brand of food - recommended feeding it. Stones presented in the bladder again as evident by blood in the urine.
1. Aug 27, 2009.  11 years old. Bladder stone removal surgery. She brought the dog for treatment of blood in the urine. Her father had said: "Why spend on treatment when $500 can buy a new puppy?"
2. Jan 30 2010 at 12 years old. Breast tumour surgery. Breast tumours at left MG4 & 5 removed by me.
3. July 13, 2010. Lateral ear canal resection of the right ear. The right ear stank. The left ear was not smelly. The right ear was filled with pus and was inflamed and itchy.
No more visits from the owner for the next 3 years. The Cocker Spaniel was weaker and weaker in 2012 and was treated by another vet. She died in Dec 2012 according to the young lady. The dog would be 14 years old. The young lady works for a famous US company unlike the childcare centre when I met her.
"What do you feed after 2nd bladder stone surgery? Any recurrence?" I wanted to update myself as 3 years had passed by so fast. 
"Boiled vegetable and chicken meat as advised by you."
"Were you strictly disciplined on this feeding regime?" I asked. "Did you ask your mum to cook for the dog? You must have fed a lot of vegetables!"
"I cook myself," she said. "Boiled cabbage and carrots are sweet when boiled. She loved it."

"Is she very thin on this diet?" I asked.
"She is OK," she said. "Her weight was maintained at 12-14 kg."
"How you weigh her?"
"I use the human weighing scales." she said.
This diet did not result in bladder stone recurrence. "My dog died of old age at 14 years in December 2012," she said sadly as she recalled her management of the old companion. "She was getting weaker every day and was treated by at (a vet practice).
No breast tumour recurrence. The right ear was slightly smelly and needed cleaning. Overall, the dog owner was satisfied with the clinical outcome. The dog had lived a good life, much loved, to a ripe old age. She typifies the younger generation who cares very much for the older dog.

References:
Bladder Stone case studies

The Vet's Best Is Not Good Enough

Update will be on this webpage:
http://www.bekindtopets.com/animals/200905806Struvite
_Urinary_Stone_Recurrence_ToaPayohVets.htm
 
 
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All rights reserved. Revised: July 13, 2013
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