Wednesday, August 14, 2013

1078. The Ang Mo Kio Silkie Terrier ate lots of treats

I had known Cookie since he was a puppy in 2005. After the puppy vaccination, no more visits as this is a common practice. In Jul 3, 2013, blood in the urine.

July 3.  Haematuria. Urine test. pH 9.0, SG 1.034, Protein +, Blood 3+, Crystals triple phosphate +, amorphous phosphate 3+ . No bladder stone palpated.  I advised X-ray and S/D for 3 months. 
Blood test. SGOT/AST 114 (<81 78="" 9.3="" br="" creatinine="" urea="">
July 10. Cannot pee. Owner sent the dog for X-rays at another practice. No stones seen.


Aug 13. The owner brought in the urine for test. pH 8, SG 1.020, Blood Trace, Bacteria +, amorphous phosphate 2+, Triple phosphate occasional

After July 10, no problems of urination or visible blood in the urine and so the owners were satisfied. 


Dissolving of urinary crystals
My advice. S/D 3 months to dissolve the crystals. Urine test monthly.  Then C/D dry.

PROBLEM
Dog will not eat the S/D.
Owner advised to feed 10% S/D and then add to become 100%. However, the owner bought S/D x 7 cans on Jul 6, 12 cans on Jul 20 and now 12 cans on Aug 13.

No dog treats given. Fed Pedigree Canned + rice in the past month.

CONCLUSION
The cat had no episodes of urination difficulty since Jul 10 todate. However, the mixture of S/D diet and other food did not dissolve the crystals as the owner needs to convert to 100% of S/D. I text the owner who says he will do it.


Aug 15, 2013. The husband phoned to see me in 20 minutes. I advised medication and review of the X-rays taken by another vet again. Many cases need monitoring and review but vets will have no "work-life" balance if they really review ever case and write case report to understand the effects of home management on S/D diet. In this case, S/D diet would have worked to eliminate the amorphous phosphate crystals in the urine if the owner had diligently converted the dog to 100% of S/D. As he did not, he still benefited in that the dog no longer had urination problem. But the latest urine test or the only one showed that blood, bacteria and crystals are coming back in the alkaline urine again. Many owners don't understand the technical use of S/D diets in dissolving the crystals by acidification of ther urine. So they don't comply since the dog will not eat it. The trick is to give 5% increasingly and consistently.

Let's hope this dog will be OK with the new motivation and participation of the owners, a couple in their late 50S 

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