9.3 kg, 39.3C
Dysuria >7 days. Haematuria. Eats dry food.
Now, anorexic.
Urethral obstruction. Catheter relieved
obstruction. Cystotomy the next day. Owner advised
prescription diet but was not interested. Would
feed home-cooked food. |
8.2 kg,
38.4C
Dysuria. Haematuria. Fed home-cooked food. Dr
Vanessa said that the catheter could not pass
through and the dog was biting. A prompt X-ray on
a Friday evening and immediate surgery. Dog went
home on Day 3. Dog not so aggressive now. Family
is
happy with good surgical outcome. |
URINE ANALYSIS
pH=7 (5-8), SG 1.030 (1.005 - 1.030).
Protein +, Blood 4+, WBC 504, RBC 1440, Bacteria
+, Crystals Nil
X-RAY. Small stones seen.
BLOOD TEST
Urea = 7 (4.2 - 6.3)
Creatinine = 61 (89-177)
WBC = 13.6 (6-17) with neutrophils 93%. Absolute
12.6, lymphocytes 6.5%. Absolute 0.88
No hypercalcaemia
SURGERY.
16.9.11 Cystotomy. Urinary stones removed by Vet 1
STONE ANALYSIS - multiple fragmented uroliths.
CANINE CALCIUM OXALATE
Calcium oxalate monohydrate 100% stone, 5% shell
Calcium oxalate dihydrate 95% shell
MANAGING
Calcium Oxalate Urolith prevention - do urinalysis
and X-rays.
If urine SG >1.020 give canned food or add water
to food
If urine pH <6.5, consider diets that produce less
acidic urine eg. u/d or use urinary alkalinizers
eg. K citrate If urine pH>6.5, USG <1.020, no
crystals, repeat urinalysis monthly, then every
3-6 months.
Repeat X-ray every 6-12 months to detect Urolith
recurrence early.
Repeat urine test and X-rays if signs -
haematuria, pollakiuria, dysuria recur.
For calcium oxalate prevention,
1. Diets promoting urine pH <6.59 were at highest
risk.
2. Avoid risk factors like hypercalciuria due to
hypercalcaemia, metabolic acidosis, high sodium
consumption and Vit D excess.
3. Feed canned foods and/or add more water to food
so that urine pH is consistently <6.5.
4. Consider hydrochlorothiazide (2mg/kg q 12 hr)
with highly recurrent urolithiasis in dogs
without hypercalcaemia.
5. Consider potassium citrate (75mg/kg q 12-24 hr)
if urine pH is consistently <6.5.
|
URINE ANALYSIS
pH=9 (5-8), SG 1.025 (1.005 - 1.030)
Protein 2+, Blood 4+, WBC 0, RBC >2250,
Bacteria
+, Crystals Triple phosphate +, Amorphous
phosphate 3+
(Struvites)
X-RAY. 15 stones seen. bladder and behind
os penis.
BLOOD TEST.
Owner declined test.
SURGERY.
3.2.12 Cystotomy. Urinary stones removed by Vet 1
STONE ANALYSIS - Sent stones to the lab
CONCLUSION
This is not a recurrent case of calcium oxalate
urinary stones as the 2nd episode showed struvite
stone formation.
If the owner had done urine tests monthly and
X-ray 3-monthly, the struvite stones will be
detected early and as small stones.
It is easier to remove without the need for
surgery. Either using urohydropropulsion and
sucking out the small stones or S/D diet to
dissolve them.
STRUVITE stones are clinically insignificant if
there is
no urinary tract infection as bacteria-forming
urease are required for struvite Urolith formation
in dogs.
In this case, the urine had bacteria and
had high alkaline pH (pH= 9.0)
favouring the urease-producing bacterial growth
and subsequently the production of struvites
(known as triple phosphates). |
TOA
PAYOH VETS
