Thursday, May 31, 2018

3163. How to prevent recurrent urinary stones in an 8-year-old female, Japanese Spitz?

May 31, 2018

An internet query from a lady to Toa Payoh Vets. Vet 1 asked her to seek a vet as he or she does not do Voiding Urohydropropulsion which is a non-invasive treatment (ie. no surgery).




Treatment of uroliths in dogs are:

1. Medical dissolution for struvite stones
2. Cystotomy (surgical removal).
3. Lithotripsy for large stones of kidneys, liver or gall bladders.
4. Voiding urohydropropulsion.


An interesting case study of a possible case for medical dissolution and voiding urohydropropulsion is discussed below.








In this case, if the owner compliance is available, medical dissolution for 6 weeks and voiding urohydropulsion may be possible.

The dog had a cystotomy earlier. Now, she has recurrent urocystoliths. Early detection of small uroliths that can pass through the urethral lumen will avoid surgery as VU can be effective.
3-6 months after cystotomy - X rays are recommended.

The dog was fed Hills' C/D diet. But the dog got fed apples, strawberries, por or chicken meat, soup. So the urine was not acidified. The pH was around 7 - 8.


 


Chemical composition of the stone can only be confirmed by the laboratory, not based on physical appearance.
Stones may be compound mixture of struvites and calcium oxalates.


To prevent recurring struvite stones, feed an acidifying diet. No other food or treats. Ensure the dog drinks water and does not hold back urine for many hours.  Urine test for pH every 3 -6 months. X-rays yearly so that small stones can be flushed out using voiding urohydropropulsion.

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