Nutritional Management of Urolithiasis Flashcards
(20 cards)
Goals of nutritional management of urolithiasis
↓ USG and dietary precursors
↑ stone inhibitors
Appropriate urine pH to enhance stability
USG goals for stone prevention
<1.020 (dogs) and 1.030 (cats)
Adding more moisture/ water to diet
High Na (↑ thirst)
Struvite in dogs
Rare without infection (no concern if no UTI)
Crystals form invitro, warm urine
Look for infection if crystals present
Struvite in cats
Majority sterile
Crystals in fresh urine a concern
Urinary obstruction in males
Should there be struvite dietary intervention in dogs and cats?
Pure stones dissolved with diet (then back to reg diet)
Dietary prevention rarely needed in dogs, recommended in cats
Dietary strategies for struvite
Reduce precursors: Mg, ammonia, phosphate
Reduce USG to <1.020 (dogs) and 1.030 (cats
<6.2 urine pH (dissolve in acidic, form in alkaline)
Struvite dissolution
Feed dissolution diet is 100% daily calories
Several weeks (2-5w for sterile stone)
Antimicrobials if UTI associated
Rads monthly
What does it mean if struvite stones aren’t smaller after 4-6w
Not 100% struvite (compound stone)
Inappropriate antimicrobial therapy
Poor owner compliance
Contraindications for dietary dissolution for struvites
Urinary obstruction
Mod to severe kidney dz
Growing, pregnant and lactating animals
Sodium intolerance
Severe CS
Negative cx in a dog (not struvite)
Expected poor client compliance
Struvite diet tips
Combo struvite- oxalate diets
Many high in Na
Don’t add treats (↓ efficacy)
Calcum oxalate
Recurrence is common
Crystals= risk for stone formation
NO DISSOLUTION
CaOx prevention
Reduce USG to <1.020 (dogs) and 1.030 (cats)
Adequate Ca, P, B6 and Mg
Avoid excess Ca
Potassium citrate = stone inhibitor
Most soluble pH >7, least <6
Oxalate sources in animals
Metabolism of tryptophan, glycine and vit. C (green leafy veggies)
What could CaOx/ struvite diets be a concern for
Comorbidities with heart dz, hypertension, kidney dz
Prevention diets for CaOx
CaOx/ struvite combo diets
Home-cooked low oxalate diet (+ K citrate)
Canned diet with low oxalate ingredients +/- moderate fat
Urate
Genetic: reduced uricase or transporter issues (dalmations)
Liver dz: hyperammonemia, hyperuricemia
uric acid in urine
Urate prevention for primary hyperuricosuria
Reduce dietary pruines (DNA)
Avoid organ meats, fish, shellfish and yeast
give plant proteins, egg, dairy= low purine
Reduce USG
↑ urine pH >7 (plant protein)
Urate dissolution
Reported using allopurinol if not associated with liver dz
blocks xanthine oxidase, but can lead to xanthine stones
Urate diet options in dogs
Therapeutic diets specifically for urate
Soy-based for allergies
Vegan/ vegetarian diets
Therapeutic diets
Urate prevention for secondary hyperuricosuria
Adress liver dz
Reduce dietary purines
Commercial liver diets (low purines and proteins)
