Page 882 - Small Animal Clinical Nutrition 5th Edition

Canine Struvite Urolithiasis 913

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Figure 1. Survey ventrodorsal abdominal radiograph illustrating a Figure 2. Intravenous urogram of the same dog described in Figure
large radiodense nephrolith (arrows) in the renal pelvis of the right 1 showing both ureters filled with contrast material and no evidence
kidney of a five-year-old neutered male rottweiler. of outflow obstruction.

Figure 3. Survey ventrodorsal radiograph obtained five weeks after Figure 4. Survey ventrodorsal abdominal radiograph obtained 18
initiation of therapy with a litholytic food and antibiotics. The weeks after initiation of therapy. There is no evidence of the
nephrolith (arrows) is about 75% of its original size. nephrolith in the right kidney.

for analysis. Consumption of food that usually results in acidic urine, administration of an antibiotic and formation of poorly con-
centrated urine may have reduced the likelihood of struvite crystalluria.
3. Dissolution of nephroliths presumed to be composed of infection-induced struvite can be accomplished using a combination of
a
a commercial veterinary therapeutic struvite litholytic food and antimicrobial therapy. In studies conducted at the University of
Minnesota, the mean time required for dissolution of infection-induced nephroliths was 26 weeks (range nine to 42 weeks).
Nephroliths and/or ureteroliths causing complete outflow obstruction and marked impairment of function in the associated kid-
ney should be managed by surgical intervention. Surgical removal of uroliths has the obvious advantage of rapid correction of the
mechanical components of the disease process; however, surgery cannot be relied upon to remove very small uroliths or to pre-
vent their recurrence. Likewise, nephrectomy is always associated with destruction of nephrons, the magnitude of which is influ-
enced by the number of renal end arteries that are transected.

Progress Notes
The owners requested dietary and medical treatment. A combination of a struvite litholytic food and a bactericidal antimicrobial
b
agent (amoxicillin and clavulanic acid ), chosen on the basis of antimicrobial susceptibility results, was used. The daily energy re-
quirement was estimated to be approximately 1,800 kcal (7.5 MJ) (1.4 x resting energy requirement) or 1.5 cans of Prescription