Therapeutic considerations include reduction of stress through environmental changes, dietary adjustments eg, use of canned preparations , pheromones applied topically in the environment, and analgesics eg, butorphanol , 0. Absorptive hypercalciuria is characterized by increased urine calcium excretion, normal serum calcium concentration, and normal or low serum parathormone concentration. For small stones, voiding urohydropulsion may be effective. Give a Gift from Mother Nature! Urinary cystine output should be reduced. Cystine is a relatively insoluble amino acid; therefore, in high concentration it may precipitate and form stones. One way to help counteract this damage; however, is to consume foods that minimize the amount of time and energy your nervous system spends in catabolic mode, which tears down the body, and maximizes the amount of time and energy it spends in anabolic mode, which nourishes, heals, and regenerates the body.
You can add cranberries and blueberries to smoothies and other dessert dishes. In the book "Healthy Foods," authors Myrna and Mark Goldstein suggest limiting your daily intake of sugary foods to prevent the breeding of bacteria in your urinary tract system.
Instead of consuming sugar-packed foods like carbonated drinks, cakes and cookies, choose foods that contain reduced, low or no sugar, such as water, fruits and whole grains. Video of the Day. Ways to Prevent Urinary Tract Infections. Vitamins to Prevent UTI. Limit your intake of particularly sugary items, such as soft drinks, pancake syrup, frosting and candy. More often, choose naturally sweet, nutritious fare, such as baked sweet potatoes dusted with cinnamon, unsweetened applesauce or fruit smoothies.
Video of the Day. Can Certain Foods Dissolve Gallstones? Medications That Cause Gallstones. Can Certain Foods Remove Gallstones? Diet for Gallbladder Sludge. Gallbladder Disease and the Elimination Diet. What to Eat to Keep the Gallbladder Healthy. Foods to Relieve Gallbladder Attacks. Gallbladder Diet Plan for Pregnant Women. It may occur suddenly or may develop throughout days or weeks. Initially, the animal may frequently attempt to urinate and produce only a fine stream, a few drops, or nothing.
Animals may also exhibit extreme pain manifested by crying out when attempting to urinate. Urethral obstruction is an emergency condition, and treatment should begin immediately. If the bladder is intact, it is distended, hard, and painful; care should be used when palpating the bladder to avoid iatrogenic rupture.
If the bladder has ruptured, it cannot be palpated and urine can sometimes, but not always, be obtained from the abdominal cavity by paracentesis. Animals with spontaneous bladder rupture may appear temporarily improved because the pain associated with bladder distention has been relieved; however, peritonitis and absorption of uremic toxins and potassium occur rapidly and lead to depression, abdominal distention, cardiac arrhythmias, and death.
Hyperkalemia and metabolic acidosis are life-threatening complications of urethral obstruction. Initial emergency care involves immediate relief of obstruction by catheterization and fluid therapy with normal saline.
Occasionally, an obstruction at the external urethral orifice can be dislodged by gentle massage. Sometimes, when a portion of the urethra is dilated with fluid under pressure and then suddenly released, urethral calculi can be flushed out. The urolith nearly always can be flushed back into the bladder by using the largest catheter that can be easily passed to the calculus, occluding the distal end of the urethral lumen around the catheter, and infusing a sterile mixture of equal parts of isotonic saline solution and an aqueous lubricant.
If the urethrolith cannot be flushed back into the bladder, a urethrotomy should be performed to remove the obstructing stone s. Depending on the clinical circumstances, the urethrotomy site may be sutured or a permanent urethrostomy created. Calculi flushed back into the bladder should be removed by cystotomy to prevent recurrence, although in some cases they can be dissolved.
The stone should be sent for quantitative analysis, with the animal managed medically to prevent stone recurrence based on the results. The most common canine uroliths are magnesium ammonium phosphate, calcium oxalate, or urate; less common uroliths include cystine, silica, calcium phosphate, and xanthine. While general management includes surgical removal and medical management, the appropriate treatment protocol depends on the location of the urolith and its chemical composition, as well as on patient-specific factors.
Nephrolithiasis is generally not associated with an increase in the rate of progression of kidney injury; thus, it is recommended that animals with nephrolithiasis be managed without surgery in most cases.
The most common urinary stones in dogs are composed of struvite. Although they are frequent in cats, sterile struvite uroliths rarely form in dogs. They have been detected in a family of English Cocker Spaniels, suggesting a genetic predisposition.
Medical management involves dissolution and prevention of stone formation. For dissolution, urine should be extremely undersaturated for struvite; for prevention, the degree of struvite saturation should be sufficiently low to make crystallization unlikely. The choice between surgery, lithotripsy, and medical treatment may not be easy. If stone dissolution is prolonged or fails, it may be more costly than surgical treatment.
Surgical removal of uroliths is often incomplete, with small, hidden uroliths often inadvertently left in the urinary tract serving as a nidus for recurrence. Before beginning stone dissolution by medical therapy, a physical examination, CBC, serum chemistry profile, urinalysis, urine culture and sensitivity, abdominal radiographs to document stone size, and blood pressure measurement if possible should be performed. Contraindications to stone dissolution include heart failure, edema, ascites, pleural effusion, hypertension, hepatic failure, renal failure, and hypoalbuminemia.
However, chronic kidney disease is not always a contraindication for dissolution of struvite nephroliths. While the use of urinary acidification to reduce urine pH to Urease-producing urinary tract infections must be treated.
The choice of antibacterial should be based on sensitivity testing when possible. Most Staphylococcus and Proteus infections are sensitive to levels of amoxicillin or ampicillin achieved in the urine of healthy dogs. A urease inhibitor can be given but is not usually necessary. Concurrent treatment with a urease inhibitor such as acetohydroxamic acid enhances the rate of struvite stone dissolution, particularly when antibiotic resistance precludes effective antibacterial sterilization of the urine.
A reasonably safe dose of acetohydroxamic acid appears to be A reversible, mild hemolytic anemia has been seen in dogs given higher dosages. The stone dissolution protocol should be discontinued if severe adverse effects develop, although a mild degree of hypoalbuminemia is to be expected and can be tolerated.
With good compliance, the following results can be anticipated: When surgery is performed to remove multiple small struvite calculi, removing all stone material is often difficult. In such cases, a 4-wk dissolution protocol starting at the time of suture removal aids in preventing recurrence due to residual crystalline material.
Once the urinary tract is free of stones, prevention strategies are much more likely to be successful. The key to prevention of recurrence in animals with a struvite stone associated with infection is to achieve and maintain sterile urine. Routine testing of urine pH by the owner is important.
If fresh urine is alkaline, a urinalysis and culture should be done, with the dog treated appropriately if an infection is present. Once stone dissolution is completed, a prevention program can be considered. The aim is to prevent urinary tract infections with urease-producing microbes. The concentration of major struvite solutes in urine should also be reduced.
A commercially available diet may be fed to lower urinary phosphate and magnesium and to maintain an acidic urine. Urease-producing infections should be eliminated, after which owners should regularly check the pH of the first voided urine in the morning after an overnight fast; in most dogs on a normal diet, the urine will be acidic. Checking urine pH weekly is sufficient.
Calcium oxalate uroliths have been increasing in frequency in dogs. Most affected dogs are 2—10 yr old. Hypercalciuria leading to calcium oxalate stone formation can result from increased renal clearance of calcium due to excessive intestinal absorption of calcium absorptive hypercalciuria , impaired renal conservation of calcium renal leak hypercalciuria , or excessive skeletal mobilization of calcium resorptive hypercalciuria.
Absorptive hypercalciuria is characterized by increased urine calcium excretion, normal serum calcium concentration, and normal or low serum parathormone concentration.
Because absorptive hypercalciuria depends on dietary calcium, the amount of calcium excreted in the urine during fasting is normal or significantly reduced when compared with nonfasting levels.
Renal leak hypercalciuria has been recognized in dogs less frequently than absorptive hypercalciuria. In dogs, renal leak hypercalciuria is characterized by normal serum calcium concentration, increased urine calcium excretion, and increased serum parathormone concentration.
During fasting, these dogs do not show a decline in urinary calcium loss. The underlying cause of renal leak hypercalciuria in dogs is not known. Resorptive hypercalciuria is characterized by excessive filtration and excretion of calcium in urine as a result of hypercalcemia.
Hypercalcemic disorders have been associated only infrequently with calcium oxalate uroliths in dogs. Routine laboratory determinations should include serum calcium, phosphate, total CO 2 , and chloride to eliminate the possibility of hyperparathyroidism and renal tubular acidosis. Dissolution of calcium oxalate stones by medical means has not currently been established.
Treatment requires surgical removal or lithotripsy followed by preventive strategies. Recurrence is a major problem with calcium oxalate uroliths.