B. Despite high recurrence rate, the following steps can be taken to reduce the likelihood of having to perform repeated cystotomies
-
diet should have the following characteristics: protein-restricted; alkalinizing, low in oxalate; not calcium-restricted, sodium-restricted;
and canned if client can afford.
- one diet that meets these criteria is Hill's Prescription Diet u/d. This diet is protein-restricted, however the amount of protein in this diet is high enough that it can be used long-term
-
Hill's Prescription Diet u/d & Waltham S/O Lower Urinary Support are both high in fat contraindicated in patients with a history of pancreatitis or
hyperlipidemia
-
Hill's Prescription Diet w/d* can be used in patients where a high-fat diet is contraindicated
* this diet is an acidifying diet, and therefore should be used in combination with potassium citrate, which is primarily used for its alkalinizing properties.
3. Recheck Protocol
- Although calcium oxalate uroliths can not be dissolved medically, additional surgeries in dogs can be avoided by diligent
monitoring with the goal of detecting a recurrence when stones are small enough to remove by urinary catheter or by voiding
urohydropropulsion.
- The following frequency of rechecks is recommended:
› q 2 months for 1 year; if no recurrence, then
› q 4 months for an additional year; if no recurrence, then
› q 6 months thereafter.
- At each recheck, evaluate a lateral abdominal radiograph and a urinalysis.
- If at any time the dog has a recurrence, perform voiding urohydropropulsion and then go back to the beginning of the recheck
protocol
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