Struvite crystalluria in a 5month old Cocker Spaniel

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Thu, 16 Apr 2015 23:45:47 GMT

I'd be pretty sure you'd see gross crystals if you had haematuria so I'd be very surprised if it was FUS and your idea of the kidneys sounds likely, might be a good idea to spin a sample though 'cos polystranguria favours FUS..... [er, bethedging I fear]

I was told that a bin liner outside the tray [ie the tray is in the bin liner], works well as a urine catcher but I've never tried it and there was some special kitty litter from which urine could be gained apparently.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Sammy82 — Thu, 16 Apr 2015 16:59:44 GMT

Don't want to go off topic here too much.It's a 7yr FN. No crystal seen in fresh sediment (don't have centrifuge, just let it settle for 10min), just loads of erys, mucus strands and and cellulaer cast which makes me think the source might actually be kidneys. Had polystranguria/peeing on sofa and (objective) polydipsia to start with, which has settled after 5 day course of Synulox + Metacam, still much smaller volume per wee as other cat but otherwise behaving normal. They have 2 large bowls of water available, but obviously not drinking enough. On Iams, but putting on meat and pouches now. I can see cystocentesis ect. coming, bloody hard work to get a decent free catch sample. In the process of moving, starting new job so a sick cat is all I need.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Thu, 16 Apr 2015 16:30:21 GMT

[quote user="Sammy82"]

Just checked my own cat's urine today (ongoing hematuria), SG was off the scale so quiet possibly 1.070. Glucose can give you false high SG (not in this case), not sure what else would do it.

[/quote]

Wow, didn't realise they can go so high, er, what's the haematuria, sounds like a potential FUS brewing... is he on dried food??

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Lucy Fleming — Thu, 16 Apr 2015 15:59:42 GMT

[quote user="Kate Richardson"]

Am speaking to RC later. Does anyone know of any specialist urologists? Any ideas welcome!!!

[/quote]

Just watched a webinar a few weeks ago (provided by Royal Canin) by Kit Sturgess regarding urolith management, perhaps RC can put you in touch with him?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Sammy82 — Thu, 16 Apr 2015 15:39:38 GMT

Just checked my own cat's urine today (ongoing hematuria), SG was off the scale so quiet possibly 1.070. Glucose can give you false high SG (not in this case), not sure what else would do it.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Thu, 16 Apr 2015 14:37:56 GMT

Just reread the thread. What or why did the SG drop to 1.028 [your post of Jan 28] but now its back up to 1050 ish with crystals?

Dog must be getting a load of Mg++ from somewhere.

I'm still backing the owners' water or diet management somewhere [NOT YOURS!!]

No chance of hospitalising the dog so everything is "observed" 'cos the history is weird and sus IMHO???

BTW I don't think I've ever seen urine from anything get up to 1.070??? No red star just tell me I'm wrong.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Kate Richardson — Thu, 16 Apr 2015 11:47:14 GMT

Yes acidifiers are next on the list to try if no response to 100% urinary diet. Just have to research best option with respect to his age. And yes compliance is excellent.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Wed, 15 Apr 2015 16:10:17 GMT

What about urinary acidifiers like methionine or NH4Cl although the latter is in the food anyway?

What about trying him on really low Mg food only? It stops struvite in cats completely, without acidifiers.

I can send you a list with concentrations if you want.

Can we eliminate owner non-compliance etc.?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Kate Richardson — Wed, 15 Apr 2015 15:43:54 GMT

Another 3 months down the line and still struggling with this case!

After looking at all options we elected to go onto a 50:50 mix of Hill s/d and Hills vet essentials, repeated monitoring of urine sediment exam and cultures, antibiotics stopped once culture was negative, and repeated scans to assess- dog got diarrhoea on s/d so changed to Royal Canin s/o urinary, which he has tolerated fine. But still no better. His bladdr looks like a snow globe! We have decided to increase to 100% urinary s/o diet and reassess in 4 weeks. His SG is still 1.048 and pH 8 despite the diet, wet food and added water!

Am speaking to RC later. Does anyone know of any specialist urologists? Any ideas welcome!!!

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Sat, 31 Jan 2015 14:55:25 GMT

[quote user="Kate Richardson"]regards to the dog's management which I found a little irritating.[/quote]

Sorry, no aspersions cast on you at all, but owners, as we all know, tend to be economical with the truth and it was to that "management" that I was referring.

I remember the thyrotoxic dog where other members of the household were also giving the dog the prescribed dose of thyroxin unbeknown to everyone....

The only thing that may have changed is surely the dog's water intake [plus the diet changes] and it wouldn't be the first time an owner has "suddenly remembered" that the daughter, or someone, takes the dog's water bowl up at night for instance. it's a common "cure" for incontinence.

[quote user="Kate Richardson"]Just be careful as table salt has MgCl2 in it to make the salt flow..... which adds to the struvite formed.[/quote]

It's caught me out in the past and it's just possible that others may make the same mistake, so a caveat does no harm and is not a criticism.

Will the SG ever change if water intake stays the same?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Kate Richardson — Sat, 31 Jan 2015 13:26:51 GMT

[quote user="Anthony Todd"] [quote user="Kate Richardson"]or adding salt to the diet[/quote]

Just be careful as table salt has MgCl2 in it to make the salt flow..... which adds to the struvite formed.

Has the dog's water intake been measured? I still wonder about the management of this dog.

[/quote]

You'll be pleased to know that I scanned the dog again this week and surprisingly there was minimal sediment in the bladder, urine SG was 1.028 and minimal struvite on sediment exam. Not sure why it has now decided to improve, but very happy it has. Dog is still on the Hills Vet essentials diet with the same management ie wet food and water added to dry although you did seem to imply that you thought either I or the owners were not being fully truthful with regards to the dog's management which I found a little irritating. And with regards to adding salt to the diet, just to refer to my actual post I did say [quote user="Kate Richardson"](neither of which I think can be justified at this stage)[/quote] Anyway both owners and I are very happy with the improvement and will continue to monitor. We had actually decided to use a dissolution diet if things weren't looking better having looked into all the pros and cons of the available options; however this doesn't seem to necessary now.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Mon, 26 Jan 2015 15:27:08 GMT

[quote user="Kate Richardson"]or adding salt to the diet[/quote]

Just be careful as table salt has MgCl2 in it to make the salt flow..... which adds to the struvite formed.

Has the dog's water intake been measured? I still wonder about the management of this dog.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Mon, 26 Jan 2015 15:23:34 GMT

[quote user="Andrew Kent"]But in a urinary stone case this is always too concentrated which is why dry urinary diets have never really made sense to me, they are essentially high salt diets in order to increase water intake and so reduce USG but this can be achieved much more easily using wet diets (whether urinary or other).[/quote]

So true, and I was well into FUS, in the cat anyway!! I was in at the start of the Go Cat furore.

Of course, with struvite there's always the route of reducing the [Mg++] which has been sort of sidestepped in the cat because, I suspect, it's not "economic" when compared to adding an acidifier!

I don't recall seeing many dogs with USG as high as 1.050 and my meter only goes up to 1.060 but it's not for urine.

[quote user="Andrew Kent"] but it can clearly happen as a result of other systemic diseases.[/quote]

But is this just because the other diseases cause dehydration, or are there specific conditions which concentrate urine?

In this dog I'm wondering whether there is any specific disease or, if water intake is increased, the struvite will dissolve and the problem will be solved.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Andrew Kent — Mon, 26 Jan 2015 14:14:56 GMT

[quote user="Anthony Todd"]So does 1.050 always indicate water restriction or can it occur because of a kidney anomaly which was my query.[/quote]

It doesn't necessarily mean either, many dogs (particularly on dry diets) may well have urine this concentrated normally. I can't think of any renal disease which should lead to inappropriately concentrated urine, but it can clearly happen as a result of other systemic diseases.

But in a urinary stone case this is always too concentrated which is why dry urinary diets have never really made sense to me, they are essentially high salt diets in order to increase water intake and so reduce USG but this can be achieved much more easily using wet diets (whether urinary or other).

Andy

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Kate Richardson — Mon, 26 Jan 2015 14:04:40 GMT

Hi Anthony,

In this case, all that could be reasonably done to dilute his urine has been done. When you think how concentrated urine can be (1.070 and greater) this may be relatively dilute for this dog, but short of giving diuretics or adding salt to the diet (neither of which I think can be justified at this stage) we cannot dilute it further. I have done a lot of research and am rescanning the dog tomorrow to see current state of play, but having weighed up risks and benefits, it is likely we are going to put this dog onto a dissolution diet and see how he responds. I haven't time to post further details just now, but will if I get a chance (2 year old bending my ear to do building now, oh no, she's emptying the kitchen drawer instead....)

:-)

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Mon, 26 Jan 2015 13:19:10 GMT

So does 1.050 always indicate water restriction or can it occur because of a kidney anomaly which was my query.

Trying to establish whether this is a management issue or an animal issue.

My suspicion is that water [as "liquid"] is being restricted leading to supersaturation or precipitation of struvite, which would be in solution , and therefore of no consequence, if urinary output and therefore SG was nearer "normal" or reasonable.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Andrew Kent — Mon, 26 Jan 2015 13:04:28 GMT

Hi Anthony,

A high USG can't always say you have perfect kidneys as you can have other renal disease (e.g. glomerular disease) without that necessarily altering the ability to concentrate. Equally, with a large reserve capacity, you can have quite extensive kidney damage without any change to USG.

But I think as a crude rule of thumb we can consider significant renal disease less likely if the animal is able to concentrate to that degree - certainly most animals with 'bog standard' chronic renal failure will not be able to concentrate to that level.

Andy

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Sun, 25 Jan 2015 23:40:59 GMT

Andrew, or others, is there any way any animal [ including human] can produce urine with a SG of 1.050 given unlimited water, even, say on a fluid overdose via a drip?

ie does this SG always indicate competent kidneys?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Andrew Kent — Sun, 25 Jan 2015 23:11:26 GMT

[quote user="Anthony Todd"]

What's happening? We can only learn by others experiences.

[/quote]

quite agree with this - any update Kate?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Fri, 23 Jan 2015 17:36:56 GMT

What's happening? We can only learn by others experiences.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Fri, 23 Jan 2015 15:08:27 GMT

What happened, how's the dog etc?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Virginia Campbell — Mon, 12 Jan 2015 21:12:42 GMT

Tips for improving water intake in cockers, based on personal experience:

Offer filthy puddles; the most disgusting, duck sh*t filled bit of the nearest lake; the inch of brown water lying on top of a stifle-deep patch of black, stinking mud; and the outflow from various run-off drainage pipes. All much more palatable than a bowl of fresh clean water in the kitchen, apparently.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Mon, 12 Jan 2015 20:48:12 GMT

[quote user="Kate Richardson"]So SG is too high, despite offering wet food and water added to dry.[/quote]

Just noticed this, do you mean >1.050??

Is there a condition where the kidneys can only hyperconcentrate urine.??

Sounds like there's something strange in the management ie water deprivation or some physiological defect surely??

I'd say any animal with that sort of urinary SG would precipitate struvite in virtually any concentration wouldn't it?

My earlier comment about strange management or diet seems likely.

Pup isn't one deprived of water at night to stop it peeing in the house by chance??

[sorry, I'm sure you've explored all these things but it is weird]

Might be another to keep in for a day or two, feed on slushy food and let the nurses give it water ad lib and treat it normally etc.?

Could be more revealing than a bladder biopsy TBH?

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Andrew Kent — Mon, 12 Jan 2015 19:20:57 GMT

[quote user="Anthony Todd"]I'm not to sure about the "supersaturation" label; they will precipitate out if the pH, concentration and temperature are right. anyway.[/quote]

Urine saturation is the driving force behind stone formation and therefore supersaturation is required for the precipitation of crystals. The point at which the urine is supersaturated and the point at which crystalisation occurs can be altered by certain variables (for example pH) but ultimately saturation is the key.

We can alter some of the variables but often the easiest thing to try to alter is the saturation. If we increase urine volume we can often avoid supersaturation - its the easiest thing for us to target.

Undersaturation can therefore favour the reverse - dissolving the crystals/stones where possible.

It is the same concept in both dogs and cats.

Don't get sidetracked by the bladder wall - that is merely a way to get a sample of something to culture for the purpose of excluding infection. A culture of one of the stones would also be a good idea if you can get your hands on one.

Re: Struvite crystalluria in a 5month old Cocker Spaniel

Anthony Todd — Mon, 12 Jan 2015 18:29:02 GMT

PSS before the many pedants point out "dilution" and "concentration" are totally related, er, sorry!