Sunday, October 7, 2018

3310. Query from Thailand - 2nd opinion on prevention of Calcium oxalate stones in a Pom

o judy, me
Dear Judy (TOA PAYOH VETS)

Greeting from Bangkok. I am seeking the second opinion about stone in dog's bladders. My dog has CaOx stones in his bladders and already operated 2 times

I wonder whether Dr Sing Kong Yuen can give me the advise about how to prevent or reduce the recurrence of the stone. FYI, I already manage to give urinary dietary (Hills C/d)  and also drink lots of water (500ml). So i just want to explore more other ways to prevent it in detail

If Dr Sing Kong Yuen can give the advice about this, can I meet him on Sat Oct 13 around  3.00 pm?

Can I also know how much is the consulting fee?

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Below is the summary of my dog's profile
1. My dog’s profile
Age: almost 7 years
Breed: Pomeranian
Sex: Male
Weight: 6.8 kg
2. Stones in Urinary bladder’s Timeline
·         1st Operation: 15 June 2018
o   Stone analysis: Calcium Oxalate Stone
o   Bacteriology Test: test from urinary bladder’s wall, result NO GROWTH
·         After 1st Operations (15 June –Aug 22)
o   Dietary: Vet recommended to take Royal Canin S/O (Canned Food)
o   Water: 400-450 ml per day
o   **dog is fed small piece of apple (but not every day, each time not more than 1-2 small pieces)
·         22 Aug, 2018 (only 2 months after 1st operations)
o   Ultrasound and found 2-3 stones (size 0.4 cm)
o   **after found, STOP feed apple to dog
o   Strictly feed only urinary food, **but change to Hills C/D (Canned food)
·         20 Sep, Decided to have the 2nd operations to remove 2-3 stones form urinary bladder
o   Stone analysis: Calcium Oxalate Stone
o   Bacteriology Test: test from urinary bladder’s wall, result NO GROWTH


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Urine pH  7.0
USG  1.020 




15.6.2561
Urine pH  7.5
USG 1.020





25.6.2561
Urine pH  6.5
USG 1.025




23.8.2561
Urine pH  6.05
USG 1.015


 25.??.2561   Thai calender
Urine pH  6.5
USG 1.005




Blood test - no anaemia or leucocytosis

Stone analysis on 21.6.2018  Calcium oxalate


Ultrasound   22.8.2018          3 small cystic calculi in urinary bladder  2-3mm

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ADVICES

To prevent URINARY stones recurring:

 1.  the dog should be regularly monitored, using urine testing and either X-rays or ultrasound examination to look for new small stones. These small stones can be removed by voiding urohydropropulsion or treated with diet to dissolve them (e.g. struvites), without surgery.

 2. Most prescription diets are safe for long-term feeding but a few are low in certain nutrients like calcium. Regular blood test is necessary. 

3. For dogs predisposed to urate stone formation, e.g. Dalmatians with high uric acid, dogs with liver shunts,  a low purine prescription diet e.g. U/D must be fed.  








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