Thursday, July 4, 2013

1502. Trust & Audit Case & Clinical Research - Dissolving struvite stones - Golden Retriever, M, 4 years

This is a case study of using S/D diet to dissolve struvites in a Golden Retriever.  I will check on the size of the bladder stone as I have not seen the X-ray of Vet 1.

Vet 1 who x-rayed the dog and discovered a small bladder stone. The owner consulted Dr Daniel on  April 4, 2013 who advised a urine test to confirm struvites. Another urine test was performed one month later.

FIRST URINE TEST  April 5, 2013
pH  8  (5-8)
SG 1.030  (1.005-1.030)
Protein +
Urobilinogen +
Blood 3+
White blood cells 3
Red blood cells >2250
Epithelial cells 3
Bacteria Occasional
Crystals Triple phosphate +

pH  9  (5-8)
SG 1.019  (1.005-1.030)
Protein 2+
Urobilinogen  Normal
Blood Nil
White blood cells 10
Red blood cells 0
Epithelial cells 0
Bacteria 2+
Crystals Amorphous phosphate 2+

April 4, 2013  Canine C/D dry prescribed pending lst urine test.
April 20, 2013  S/D x 24 cans
April 27            S/D x 24 cans
May 11             S/D x 12 cans  (2nd urine test on May 13, 2013)
May 18             S/D x 12 cans"
Jun 27            S/D x 12 cans
Jul 4                S/D x 12 cans

A third urine test is being done today Jul 4, 2013.

It appears that the S/D is not working so far. S/D is recommended for 3 months but it is still early. I phoned the home and the husband answered. The wife came to buy the S/D and said it was already 3 months of trial but it wasn't.

"Did you feed any other food beside the canned S/D?" I asked.
"No," he said.
"Did you feed apples?"
"Yes," he said.
"Some chicken from the dining table?"

There was no blood in the urine as evident in the 2nd urine test.
I advised strictly no other food or dog treats or vitamins and only S/D from now on. Plain water. Will wait and see.

Much depends on the size of the bladder stone and it may take several weeks to dissolve it. Clients do forget that they can't feed other types of food while on the S/D diet as illustrated in this case.

Taking out the bladder stone by surgery is often the better way to resolve the problem of blood in the urine. I have a feeling that the bladder stone is large (>5 mm across) and have asked the husband to email to me the X-ray.

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