Struvite urolithiasis in diabetic dog

Re: Struvite urolithiasis in diabetic dog

Anthony Dennison — Thu, 08 May 2014 12:55:12 GMT

One of my clients has a diabetic WHWT that had urinary problems, then became diabetic. She's still on the Royal Canin diabetic diet and it is working well for her

Re: Struvite urolithiasis in diabetic dog

Kate Richardson — Thu, 08 May 2014 12:06:15 GMT

Has she actually got uroliths or just crystals? Important to differentiate as if just crystals, highly likely secondary to a urinary tract infection.

[quote user="Adrienne McPartland"]Her curves have been dipping poorly lately with nadir values of 10-11 mmol/l.[/quote][quote user="Adrienne McPartland"]Her curves have been dipping poorly lately with nadir values of 10-11 mmol/l.[/quote]

Do you mean her glycaemic control has been poorer? Again, UTI would be most likely.

If definitely no uroliths, then I would treat her with a course of antibiotics (I would use amoxyclav) for 2 weeks then reassess the urine.

Re: Struvite urolithiasis in diabetic dog

Anthony Todd — Thu, 08 May 2014 09:29:36 GMT

[quote user="Birte Toft"]Methigel[/quote]

Yes, methionine, used it in cats when the pH stayed high on Rx diets, works well, don't know about dogs though.

Re: Struvite urolithiasis in diabetic dog

Birte Toft — Thu, 08 May 2014 08:50:38 GMT

I've found Methigel very effective in dissolving struvite stones when funds don't stretch to surgery or prescription diets. If the stones are very large it may take a while.

Re: Struvite urolithiasis in diabetic dog

Andrew Kent — Wed, 07 May 2014 19:52:44 GMT

A full sediment exam would be helpful if not done to look for other signs of infection, like WBC's as well.

Andy

Re: Struvite urolithiasis in diabetic dog

Adrienne McPartland — Wed, 07 May 2014 18:48:44 GMT

I'm not sure if they did gram stain, lab results just said negative culture. i'll give them a call tomorrow and find out. No rads have been taken as of yet, but will be in the next few days.

Re: Struvite urolithiasis in diabetic dog

Andrew Kent — Wed, 07 May 2014 18:45:29 GMT

I would say this is almost certainly a false negative culture - did the lab do a gram stain to look for bacteria. This dog has a major reason for UTI and struvite in dogs is associated with UTI in the vast vast majority of cases. So I would either look for infection again or treat the dog with prolonged antibiotics.

Are these just crystals or can you see stones? If crystals they will disappear with antibiotics. If stones of any size then surgery followed by antibiotics would be the answer. You don't need to change the diet.

Andy

Re: Struvite urolithiasis in diabetic dog

Yantha Smyth — Wed, 07 May 2014 15:35:47 GMT

Doh posting at same time! Could it be a false neg culture? Perhaps check a sediment and, or see if course of abs changes things?

Re: Struvite urolithiasis in diabetic dog

Yantha Smyth — Wed, 07 May 2014 15:33:48 GMT

+1 for UTI- predisposed as diabetic, and infxn with urease producing bacteria > pH increase > struvite

Re: Struvite urolithiasis in diabetic dog

Adrienne McPartland — Wed, 07 May 2014 15:33:32 GMT

Urine culture was negative, and obtained sample via cysto.

Re: Struvite urolithiasis in diabetic dog

Rob Davis — Wed, 07 May 2014 15:28:53 GMT

Have you ruled out a UTI? Common in diabetics and will often increase urine pH so predisposing to struvite formation.

Re: Struvite urolithiasis in diabetic dog

Anthony Todd — Wed, 07 May 2014 15:17:33 GMT

[quote user="Adrienne McPartland"]Looking for some opinion [/quote]

Should be able to acidify the urine and dissolve the crystals with ammonium chloride; methionine should do it as well. [works in cats at least]

Can't remember the doses but just increase dose until pH lowers, is I suppose, the best way.