How much of the s/d diet to be given?

Other procedures to ensure compliance from the owner:
1. Antibiotics from 14-30 days and review using urine cultures
2. Monthly urine analysis (check for UTI) and blood tests (esp. serum urea nitrogen, magnesium, phosphorus and calcium and alkaline phosphatese)
3. Monthly x-rays of kidney (V/D view), bladder (lateral views).

Back to normal commercial food for the puppy as soon as X-rays show no stones. For adult dogs, give prescription food for one more month after negative X-ray results. No commercial dog treats or snacks during the period of treatment.  In practice, I advise initially 3 months of the S/D diet and get urine tests done monthly in most cases. The Singapore dog owner seldom complies with the above-mentioned procedures or with monthly urine tests! Till blood in the urine returns! 

RECURRENT UTI
Specialised tests like double-contrast cystography (to check out anatomic abnormalities of the bladder, obstruction of urine flow from kidneys), retrograde positive-contrast urethrocystography (to check out anatomical abnormalities of the urinary tract to the prostate gland area, bladder tumours) if there is recurrent uroliths or UTI (see case study of the old Corgi with recurrent UTI).

Recurrent UTI in an old Corgi - Part 1 http://www.sinpets.com/dogs/20111044blood-urine-recurs-over10times-old-corgi-female-toapayohvets.htm
Recurrent UTI in an old Corgi - Part 2 http://www.sinpets.com/F6/ 20111210recurrent-urinary-tract-infection-old-female-spayed-corgi-singapore-toapayohvets.htm
Voiding urohydropropulsion is used in cases where the uroliths are small. The owner must be informed that it takes 2-4 months or longer to get all struvite stones dissolved. The owner must be aware of the need for reviews and to note the costs involved in the dietary management to dissolve struvite urinary stones.    VETERINARY SURGERY --- VOIDING UROHYDROPROPULSION IN DOGS AND CATS What is urohydropropulsion? Basically it means pumping saline into the bladder (3ml/kg) and suck out the fluid together with the small uroliths (urinary stones) with a catheter. The stones in the bladder are too small and therefore no surgical removal is needed. ANAESTHESIA. May or may not be need.  Two methods described in Small Animal Clinical Nutrition 5th edition. POSITION 1. Hold the dog or cat upright so that the vertebral column is upright. The urine and stones will be at the bottom (neck) of the bladder. POSITION 2. Lateral recumbency. In both positions, catheterise, irrigate with saline (3ml/kg), massage or press bladder to shake up the stones, suck out the saline + stones with a syringe. X-rays to check if all are taken out but not all small ones can be seen. Dietary and medical treatment. More information is at: Small Animal Clinical Nutrition" by Hand et. al, 5th Edition. This webpage: http://www.sinpets.com/F5/20100697struvite-dietary-management-voiding-urohydropropulsion_ToaPayohVets.htm

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