3317. Pom, M, 6 yrs with calcium oxalate stones on Jun and Sep 2018 removed in Thailand

October 13, 2018

Dear Dr Sing

Thank you very much for your kind.

The attached files are the result of 2 time operations (both are calcium oxalate)

1st operation 15 June and 2nd operation 20 Sep

Ultrasound is on Sep 19 (before the 2nd Operations)

Urinary Test & Bacteria Test result is on Sep21 (see attached files)

Latest blood test is on Sep 24 (see attached files)

Now I fed the dog only urinary food (Hills C/D)

Drink Water around 500-600 ml per day

His current weight is 6.5 kg (Pomeranian, Male)

I just dont want my dog to have the recurrent of the stones again so i try to study and seek the consultant for the prevention.

See you soon Dr.Sing!

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Significant findings

1. Calcium oxalate stones removed in Jun and Sep 2018 by cystotomy.

2. It is possible that stones less than 5 mm could have been removed without surgery (cystotomy), using voiding urohydropropulsion after ultrasound showed stones around 4mm across.

3. Urine pH stated to be around pH 7.

4. Prevention

4.1  Decrease urine concentration. Add water to kibbles or feed food with 75% water ie. canned food..

4.2  Avoid urine acidification. This means urine pH to be above 7.0.

4.3 Avoid diets with excessive protein content.

4.4 Consider Potassium Citrate or Other Alkalinizing Citrate Salts for Dogs and Cats with Persistently Acidic Urine. 
4.5 Consider Thiazide Diuretics for Frequently Recurrent Calcium Oxalate Uroliths

4.6. Check urine for hypercalciuria with either hypercalcemia (primary hyperparathryoidism) or normocalcemia.

4.7 Strive to achieve a urine specific gravity ≤1.020 in dogs

4.8 Diets and medications designed to promote urine acidification (pH less than 6.5) should be avoided.

4.9. X-rays 6 monthly and then yearly to detect small stones which do not need surgery. Use voiding urohydropropulsion.