Rats Flashcards
(37 cards)
🐭 Clinical Question: Dentition and Physiological Characteristics of Rats
🧐 Which of the following statements about the dentition and physiology of rats (Rattus norvegicus) is TRUE?
A) Rats have elodont incisors that grow continuously throughout life, while their cheek teeth are anelodont and do not grow after eruption.
B) Rats have a gallbladder that stores bile before digestion.
C) Rats can vomit due to their well-developed gag reflex and absence of a limiting ridge.
A) ✅ Rats have elodont incisors that grow continuously throughout life, while their cheek teeth are anelodont and do not grow after eruption.
❓ Clinical Case Question (Multiple Choice)
A 250g pet rat requires intravenous catheter placement for fluid therapy. The veterinarian is considering two sedation protocols: Alfaxalone-Hydromorphone (AH) or Ketamine-Midazolam-Hydromorphone (KMH). Based on the study findings, which protocol is more suitable for achieving deep sedation at 20 minutes?
A) Either protocol is equally effective at 20 minutes since both contain hydromorphone.
B) Alfaxalone-Hydromorphone (AH), because it achieves peak sedation faster and maintains a longer duration.
C) Ketamine-Midazolam-Hydromorphone (KMH), because it provides deeper sedation at 20 minutes, improving success in IV catheter placement.
Ketamine-Midazolam-Hydromorphone (KMH), because it provides deeper sedation at 20 minutes, improving success in IV catheter placement
Here’s a more advanced clinical question related to the use of Alfaxalone in rats, with one correct and two incorrect answers, plus icons for better visualization:
🐭 Clinical Question: Alfaxalone Sedation in Rats
🔬 Which of the following statements regarding the pharmacodynamics and clinical application of intramuscular Alfaxalone in rats (Rattus norvegicus) is TRUE?
A) Alfaxalone provides effective sedation for thoracic radiographic positioning with rapid onset and recovery, though additional sedatives may be required for prolonged sedation.
B) Due to its high solubility and lack of accumulation in body fat, Alfaxalone has a prolonged recovery time and is not recommended for repeated administration.
C) Alfaxalone is contraindicated in clinically ill rats due to significant cardiovascular suppression and an increased risk of respiratory failure.
📑 Explanation:
✅ Correct Answer (A): The study demonstrated that Alfaxalone is effective for radiographic positioning in rats, with a rapid onset and recovery. However, for deeper or longer-lasting sedation, additional sedatives may be needed.
❌ Incorrect Answer (B): While Alfaxalone has high solubility, it does not accumulate in body fat and actually has a short recovery time, making it suitable for repeated administration if necessary.
❌ Incorrect Answer (C): The study found that Alfaxalone appeared safe in a small sample of clinically ill rats, though further research is required to confirm its safety in this population.
Clinical Case Question
❓ What is a potential side effect of long-acting buprenorphine formulations in rats?
A) Increased appetite and enhanced motor activity
B)Hyperthermia and decreased food intake
C) Hypothermia and increased fecal output
B) Hyperthermia and decreased food intake ✅ (Correct)
🐭 Clinical Case: Hematology Analysis in Laboratory Rats
🔬 A 6-month-old male Sprague–Dawley rat is part of a preclinical drug development study. The research team needs to perform a complete blood count (CBC) and compare results using different hematology analyzers. The study protocol includes side-by-side testing with the Sysmex XN-1000V and Siemens ADVIA 120, along with manual methods. Based on the most recent findings, which of the following statements is TRUE?
A) The Sysmex XN-1000V provides comparable results to the Siemens ADVIA 120 and manual methods, making it suitable for hematological evaluation in drug development studies for rats.
B) The Sysmex XN-1000V showed significant deviations from manual methods and was determined to be unreliable for preclinical studies.
C) The Sysmex XN-1000V requires extensive recalibration before each use to match the performance of the Siemens ADVIA 120.
✅ Correct Answer (A): The study concluded that the Sysmex XN-1000V produced results comparable to the Siemens ADVIA 120 and manual methods, supporting its use in preclinical drug studies for rats and mice.
🔬
A 9-month-old male Sprague-Dawley rat (Rattus norvegicus), weighing 480g, is presented for a minor surgical procedure requiring anesthesia. The rat is part of a toxicology study, and precise monitoring is essential to avoid adverse effects. During pre-anesthetic evaluation, the rat is noted to have mild respiratory distress, a slightly elevated respiratory rate (120 breaths/min), and mild weight loss over the past two weeks. The clinician must choose an appropriate anesthetic protocol considering the species’ unique metabolic and physiological challenges.
🧐 Question:**
Which of the following anesthetic management strategies is the BEST choice for ensuring safe sedation and recovery in this rat?
A) Intramuscular injection of a ketamine-xylazine combination for deep sedation, followed by maintenance with additional intraperitoneal ketamine doses as needed.
B) Induction with isoflurane via a mask, followed by maintenance with sevoflurane in oxygen, with active temperature monitoring and supportive oxygenation throughout the procedure.
C) No premedication is required due to the rat’s high metabolic rate; direct induction with intravenous propofol will ensure rapid sedation and a short recovery time.
✅ Correct Answer (B): Isoflurane or sevoflurane inhalant anesthesia is preferred for rats due to its rapid onset, easy titration, and reduced metabolic burden. Given the patient’s mild respiratory distress, inhalants allow better oxygen supplementation and precise depth control, minimizing hypoxia and respiratory depression. Active temperature regulation is essential due to the high surface-area-to-volume ratio in rats, which predisposes them to hypothermia.
🔬 Case Presentation:
A 7-month-old male pet rat, housed in a single-level wire cage, is brought to the veterinary clinic due to recurrent foot lesions and signs of anxiety-like behavior, including excessive chewing on cage bars and repetitive movements. The owner reports that the rat has been housed in this setup for the past 3 months, with wood shavings as bedding, a single food dish, and a water bottle. The veterinarian suspects that suboptimal housing conditions may be contributing to the rat’s health issues.
🧐 Question:
Which of the following statements provides the BEST recommendation for improving the rat’s welfare and health based on current housing guidelines?
A) The rat’s foot lesions are likely due to an underlying systemic infection rather than its housing conditions; medical treatment alone should be sufficient to resolve the issue.
B) The rat should be moved to a multi-level enclosure with soft bedding, multiple food and water sources, environmental enrichment (such as tunnels and nesting material), and a minimum cage size of 90–120 cm in width and height
C) To reduce stress and destructive behaviors, the owner should provide a larger food dish and limit handling to minimize further anxiety.
📑 Explanation:
✅ Correct Answer (B): The study emphasized that injury prevention, suitable cage materials, multi-level housing, and environmental complexity are critical for rat welfare. Wire flooring and inadequate space can cause pododermatitis (foot lesions), while lack of enrichment leads to stress-related behaviors. A cage with soft bedding, multiple food/water sources, and enrichment meets the recommended housing guidelines.
🔬 Case Presentation:
A 22-month-old female Long-Evans rat undergoing a tumor resection surgery is presented for pain management planning. The veterinarian must ensure effective analgesia while minimizing adverse effects given the rat’s advanced age, mild renal insufficiency, and history of gastrointestinal sensitivity. Postoperative pain is expected to be moderate to severe, and the rat must recover quickly to resume normal function.
🧐 Question:
Which of the following pain management protocols provides the BEST balance of efficacy and safety for this patient?
A) A single-agent opioid approach using fentanyl to achieve rapid and potent analgesia while avoiding NSAID-related renal and gastrointestinal complications.
B) A high-dose NSAID protocol with carprofen and ketoprofen to maximize anti-inflammatory effects, with opioids reserved for breakthrough pain.
C) A multimodal approach combining buprenorphine for systemic analgesia, meloxicam for anti-inflammatory effects, and lidocaine as a local anesthetic to reduce opioid requirements.
✅ Correct Answer (C):
Multimodal analgesia is the gold standard for rodent pain management. The combination of buprenorphine (opioid for systemic pain relief), meloxicam (NSAID for inflammation control), and lidocaine (local anesthetic for targeted analgesia) provides effective pain relief while minimizing side effects. Given this rat’s renal insufficiency, meloxicam is preferred over ketoprofen or carprofen due to its lower risk of renal toxicity when used carefully. Local anesthesia reduces systemic drug dependence, improving safety.
Question: 🐭 In assessing pain in laboratory rats using the Rat Grimace Scale (RGS), which of the following facial features is NOT a validated indicator of pain?
A) 👀 Orbital tightening
B) 👃 Nose and cheek flattening
C) 👅 Tongue protrusion
C) True - Tongue protrusion is not part of the Rat Grimace Scale. The RGS includes orbital tightening, nose/cheek flattening, ear position changes, and whisker position.
Explanation: The Rat Grimace Scale (RGS) is a validated tool for assessing pain in rats based on facial expressions. It includes four main components: orbital tightening, nose and cheek flattening, ear position changes, and whisker position. Tongue protrusion is not part of this scale, making it the correct answer as a feature that is NOT a validated indicator of pain in the RGS.
Clinical Case:
🐀 Dr. Whiskers, a veterinary researcher, is conducting a study on post-operative pain management in rats following abdominal surgery. The study involves 60 adult male Sprague-Dawley rats divided into three groups:
Group A: Receives standard analgesia (buprenorphine 0.05 mg/kg SC q12h)
Group B: Receives a novel long-acting opioid (LAO-X 0.1 mg/kg SC once)
Group C: Control group (receives saline injections)
📊 Pain assessments are conducted at 2, 4, 8, 12, 24, and 48 hours post-surgery using:
Rat Grimace Scale (RGS)
Von Frey filaments for mechanical allodynia
Thermal hyperalgesia test
Activity monitoring via implanted telemetry devices
🔬 Preliminary results at 12 hours post-surgery show:
Group A: Mean RGS score 0.8, 40% reduction in activity
Group B: Mean RGS score 0.3, 20% reduction in activity
Group C: Mean RGS score 1.5, 70% reduction in activity
😣 However, at 24 hours, Group B shows an unexpected spike in RGS scores (mean 1.2) and a 60% reduction in activity. Blood samples reveal that 30% of Group B rats have developed an acute kidney injury (AKI).
Question:
Given the complex interplay between pain, analgesia, and physiological stress in this study, which of the following conclusions is MOST supported by the data and our understanding of pain recognition in rats?
A) The spike in RGS scores and decreased activity in Group B at 24 hours definitively indicates that LAO-X is ineffective for long-term pain management.
B) The development of AKI in Group B suggests that pain assessment tools like RGS are unreliable in the presence of organ dysfunction, and only physiological measures should be used.
C) The increased RGS scores and decreased activity in Group B at 24 hours likely represent a complex interaction between wearing off of analgesic effects, development of AKI, and potentially increased pain sensitivity due to opioid-induced hyperalgesia.
Correct Answer: C
Explanation: This question requires a nuanced understanding of pain assessment in rats, pharmacology, and the potential complications of surgery and analgesia. The correct answer (C) acknowledges the complexity of the situation, recognizing that multiple factors could contribute to the observed changes in Group B at 24 hours.
The spike in RGS scores and decreased activity could be due to:
- The wearing off of the long-acting opioid
- Pain and physiological stress from the developing AKI
- Potential opioid-induced hyperalgesia, a phenomenon where opioid use can paradoxically increase pain sensitivity
Options A and D are incorrect because they draw overly simplistic conclusions from limited data. Option B is incorrect because while organ dysfunction can complicate pain assessment, it doesn’t invalidate behavioral pain scales entirely. The RGS and activity measures still provide valuable information when interpreted in context.
This question tests the ability to interpret complex clinical data, understand the limitations of pain assessment tools, and consider multiple interacting factors in a research setting.
Clinical Case:
Dr. Rodent, a veterinary anesthesiologist, is conducting a follow-up study on the interaction between cannabidiol (CBD), opioids, and inhalant anesthetics in rats. The study involves 80 adult male Wistar rats divided into four groups:
Group A: Sevoflurane + Saline (control)
Group B: Sevoflurane + Morphine (0.5 mg/kg IV)
Group C: Sevoflurane + CBD (5 mg/kg IV)
Group D: Sevoflurane + Morphine (0.5 mg/kg IV) + CBD (5 mg/kg IV)
The minimum alveolar concentration (MAC) of sevoflurane is determined using the tail-clamp technique. Additionally, the following parameters are monitored:
- Heart rate and blood pressure
- Respiratory rate and end-tidal CO2
- Body temperature
- Plasma concentrations of morphine and CBD
- Post-anesthetic recovery time
Preliminary results show:
- Group A: MAC = 2.4%
- Group B: MAC = 1.8% (25% reduction from control)
- Group C: MAC = 2.3% (4% reduction from control)
- Group D: MAC = 1.7% (29% reduction from control)
Unexpectedly, Group D shows significantly prolonged recovery times compared to all other groups, with 40% of rats exhibiting signs of respiratory depression during emergence.
Question:
Based on these findings and our understanding of the interactions between cannabinoids, opioids, and inhalant anesthetics, which of the following conclusions is MOST supported by the data?
A) The combination of CBD and morphine demonstrates a clear synergistic effect in reducing sevoflurane MAC, proving that CBD significantly enhances opioid-induced anesthetic sparing.
B) The lack of substantial MAC reduction in the CBD-only group (C) conclusively proves that cannabinoids have no role in modulating anesthetic requirements or pain perception in rats.
C) While CBD alone doesn’t significantly alter sevoflurane MAC, its combination with morphine may affect the pharmacokinetics or pharmacodynamics of opioids, potentially leading to increased side effects without substantial additional MAC reduction.
Correct Answer: C
Explanation: This question requires a nuanced understanding of anesthetic pharmacology and drug interactions. The correct answer (C) acknowledges the complexity of the situation and aligns with the study’s findings.
Key points supporting the correct answer:
- CBD alone (Group C) didn’t significantly reduce MAC, consistent with the original study.
- The combination of CBD and morphine (Group D) didn’t show a substantial additional MAC reduction compared to morphine alone (Group B).
- The prolonged recovery and respiratory depression in Group D suggest a potential interaction between CBD and morphine, possibly affecting opioid metabolism or enhancing side effects.
Option A is incorrect because the data doesn’t show a clear synergistic effect in MAC reduction.
Option B is incorrect because it overgeneralizes from the lack of MAC reduction to conclude that cannabinoids have no role in pain modulation, which isn’t supported by broader research.
This question tests the ability to interpret complex pharmacological data, understand the limitations of the study, and consider potential drug interactions beyond the primary measured outcome (MAC reduction).
In a study published in Veterinary Anaesthesia and Analgesia (2024), researchers investigated the feasibility of an ultrasound-guided sciatic nerve block in Wistar rat cadavers. Which of the following statements is true based on the study’s findings?
A) The study showed significant differences in nerve staining between the two volumes of bupivacaine dye used.
B) Sonoanatomy identified the sciatic nerve as a single ellipsoid image between the adductor and biceps femoris muscles.
C) The study supports the use of ultrasound-guided techniques for sciatic nerve injections in rats due to reliable anatomical landmarks.
C) The study supports the use of ultrasound-guided techniques for sciatic nerve injections in rats due to reliable anatomical landmarks.
⭐️ - True: The study concluded that the anatomical landmarks ensure the feasibility and reliability of using ultrasound-guided techniques for nerve block in rats.
A veterinarian is performing a sciatic nerve block in a research setting and must choose between a ‘blind’ anatomical approach and an ultrasound-guided technique for better accuracy. Based on current research findings:
Which method provides the highest likelihood of accurate nerve injection?
A) The ‘blind’ approach, as it is faster and equally effective
B) The ultrasound-guided approach, as it has a higher success rate
C) Neither method is effective for sciatic nerve blocks
B) The ultrasound-guided approach, as it has a higher success rate ✅
Clinical Case:
A 6-month-old male Wistar rat named Rex is presented at the veterinary clinic with symptoms of lethargy and a noticeable decrease in appetite. On examination, Rex is slightly overweight, shows signs of dental discomfort, and there is mild abdominal distension. His diet consists mainly of commercial rat pellets, supplemented with occasional treats high in sugar and fat. The owner reports that Rex doesn’t show much interest in his provided wooden chew toys, what is the most appropriate management strategy for Rex?
A) Increase sugar and fat content to boost Rex’s energy and weight.
B) Enhance fiber content in Rex’s diet and provide varied, hard-chewing materials.
C) Offer vitamin C supplements to improve Rex’s immune system.
B) Enhance fiber content in Rex’s diet and provide varied, hard-chewing materials.
⭐️ - True: Increasing fiber will support digestion and prevent obesity, while hard-chewing materials prevent dental malocclusion.
Clinical Case:
You are presented with a 1-year-old female rat named Luna. She has exhibited signs of weight loss, a sporadic head tilt, and decreased appetite over the past few weeks. Physical examination reveals nasal discharge and slight ataxia.
What is the most effective first step to address Luna’s diverse clinical signs?
A) Begin antibiotic therapy focusing on respiratory pathogens immediately, based on nasal discharge symptoms.
B) Use a multimodal diagnostic approach, including imaging, to differentiate between possible neurological and respiratory causes.
C) Offer supportive nutritional care while conducting PCR tests solely for respiratory pathogens.
B) Use a multimodal diagnostic approach, including imaging, to differentiate between possible neurological and respiratory causes.
⭐️ - True: A comprehensive diagnostic approach using imaging and other tests will help distinguish between differentials like ear infection or pituitary issues, enhancing treatment precision.
Clinical Case:
You’re consulted about a litter of 10-day-old rat pups. They have started to show signs of respiratory distress, including sneezing and mild nasal discharge. The pups are housed in a low-humidity environment, which the owner admits has not been monitored regularly. There is also a report of one pup showing tail constrictions. Based on the insights from “Pediatric Care in Rats,” what is the best initial step to address the health issues observed in these juvenile rats?
A) Address environmental conditions by increasing humidity and initiate supportive care for respiratory symptoms.
B) Initiate antifungal treatment to manage potential dermatophytosis given the prevalence of skin conditions in juvenile rats.
C) Administer a combination of antibiotics like doxycycline and enrofloxacin to address possible bacterial causes of respiratory distress immediately.
A) Address environmental conditions by increasing humidity and initiate supportive care for respiratory symptoms.
⭐️ - True: Increasing humidity can help prevent ringtail and improve respiratory conditions. Supportive care, potentially with nebulization, will assist in managing respiratory distress.
Clinical Case:
You are evaluating a 2-year-old male pet rat named Max, who has been experiencing persistent respiratory symptoms, including wheezing and labored breathing. Despite previous treatments with antibiotics and nebulization, there has been no significant improvement, what is the most appropriate next step in the management of Max’s condition?
A) Increase the dosage and duration of antibiotics to further address potential resistant respiratory infections.
B) Perform advanced imaging, such as thoracic radiographs, and cytology to evaluate for possible lymphoma.
C) Administer corticosteroids empirically to reduce inflammation and improve respiratory function.
Perform advanced imaging, such as thoracic radiographs, and cytology to evaluate for possible lymphoma.
⭐️ - True: Persistent symptoms despite antibiotic treatment warrant imaging and cytological evaluation to investigate underlying conditions like lymphoma, which can mimic respiratory issues.
Clinical Case:
A 14-month-old female domestic rat named Bella is brought to your clinic with swollen ears and difficulty maintaining her balance. Previous treatments for otitis externa have not resolved her symptoms,” what is the most critical next step to differentiate between common ear infections and potential underlying lymphoma?
A) Increase systemic antibiotic therapy to target persistent bacterial infections, based on microbiology findings.
B) Use imaging techniques like CT scans or radiographs to evaluate middle ear structures and potential extensions beyond infectious causes.
C) Focus on anti-inflammatory treatments to alleviate ear swelling and improve balance.
B) Use imaging techniques like CT scans or radiographs to evaluate middle ear structures and potential extensions beyond infectious causes.
⭐️ - True: Imaging helps differentiate between simple infection and more complex issues like lymphoma, showing bony changes or soft tissue mass involvement indicative of Mycosis Fungoides.
Clinical Case:
A 26-month-old female pet rat named Daisy is presented to your clinic with a rapidly enlarging, firm, and movable mass along the mammary chain near her abdomen. The owner reports occasional bleeding and foul odor from the site. Daisy’s history includes a high-fat diet and no prior spaying. Given the details from the article on mammary gland tumors in rats, what is the most comprehensive management plan for Daisy?
A) Proceed with surgical removal of the mass (mastectomy) and consider an ovariectomy if Daisy’s condition stabilizes post-surgery.
B) Commence with hormonal therapy using cabergoline to shrink potential pituitary tumors and monitor the mass response.
C) Initiate a course of tamoxifen to counter estrogen levels and reduce tumor size, followed by surgical assessment.
A) Proceed with surgical removal of the mass (mastectomy) and consider an ovariectomy if Daisy’s condition stabilizes post-surgery.
⭐️ - True: Mastectomy is the treatment of choice for mammary tumors, and ovariectomy can help prevent recurrence if the rat is stable enough for the procedure.
❓ Clinical Case Question (Multiple Choice)
A veterinarian is consulting an owner who wants to spay their 8-month-old female rat. The veterinarian explains that both Flank Approach (FA) and Ventral Midline Approach (VMA) are options, and the owner asks which method is safer based on scientific evidence. According to the study, what is the best response?
A) Both FA and VMA have advantages and potential complications, and the choice should be based on the surgeon’s expertise and case-specific factors.
B) The Flank Approach (FA) is the only recommended method, as it eliminates all post-surgical complications.
C) The Ventral Midline Approach (VMA) is significantly more dangerous and should be avoided.
A) Both FA and VMA have advantages and potential complications, and the choice should be based on the surgeon’s expertise and case-specific factors. ✅ (Correct: The study found no statistically significant difference in complication rates when considering patient factors and surgeon experience.)
❓ Clinical Case Question:
What is the main advantage of using carboplatin-impregnated calcium sulfate hemihydrate (CI-CSH) beads for local chemotherapy in rats?
A) Beads provide a controlled, localized drug release with minimal systemic toxicity
B) Beads completely dissolve within a few days, ensuring immediate drug delivery
C) Beads prevent the need for additional chemotherapy in all cases
A) Beads provide a controlled, localized drug release with minimal systemic toxicity ✅ (Correct Answer)
Clinical Case:
A 15-month-old female pet rat named Coco is brought to your clinic for evaluation. Coco has been showing signs of lethargy, decreased appetite, and mild abdominal distension. You suspect a reproductive issue may be involved and are considering surgical intervention,” what is the most appropriate course of action for Coco?
A) Delay surgical intervention and focus on symptomatic medical management to stabilize Coco’s condition first.
B) Proceed with elective ovariectomy (OE) or ovariohysterectomy (OHE) to address potential reproductive disease, considering elective surgeries have better outcomes.
C) Conduct a series of diagnostic imaging and blood tests before deciding on any surgical intervention to ensure comprehensive assessment.
B) Proceed with elective ovariectomy (OE) or ovariohysterectomy (OHE) to address potential reproductive disease, considering elective surgeries have better outcomes.
⭐️ - True: Elective OHE/OE is associated with more positive outcomes compared to emergency interventions and should be considered if Coco’s condition permits.
Clinical Case:
A 2-year-old male pet rat named Oliver is presented to your clinic with a history of intermittent head tilting, circling, and decreased coordination over the past few weeks. The owner is concerned these symptoms might indicate a serious neurological issue. Considering Oliver’s condition,” what would be an effective diagnostic approach to evaluate his neurological symptoms?
A) Initiate empirical treatment with antibiotics and anti-inflammatory medications to see if symptoms improve before any diagnostic imaging.
B) Schedule a CT or MRI immediately for a more detailed assessment, disregarding ultrasound as it lacks accuracy in small animal models.
C) Use transcranial ultrasound to assess for intracranial neoplasia, given its effectiveness and accessibility in diagnosing such conditions in rats.
C) Use transcranial ultrasound to assess for intracranial neoplasia, given its effectiveness and accessibility in diagnosing such conditions in rats.
⭐️ - True: Transcranial ultrasound is an effective, accessible, and less costly method for diagnosing intracranial neoplasia, appropriate for Oliver’s symptoms.
Clinical Case:
An 18-month-old female Sprague-Dawley rat named Lilly is presented to your clinic with symptoms of polyuria, polydipsia, weight loss, and occasional hematuria. She has a history of being fed a high-protein diet. What would be the most appropriate initial diagnostic and management approach for Lilly?
A) Initiate insulin therapy for suspected diabetes mellitus, considering the polyuria and weight loss symptoms.
B) Perform urinalysis and imaging studies to evaluate for urinary tract infections, stones, or other kidney abnormalities, and consider dietary modifications.
C) Begin empirical antibiotic therapy for urinary tract infection, without further diagnostics, due to the prevalence of infections causing similar symptoms.
B) Perform urinalysis and imaging studies to evaluate for urinary tract infections, stones, or other kidney abnormalities, and consider dietary modifications.
⭐️ - True: Urinalysis and imaging will help identify infections, stones, or structural kidney disease, while dietary changes can help manage potential nephrocalcinosis or stone formation.
