Efficacy of medical dissolution for suspected struvite cystoliths in dogs.

Abstract

BACKGROUND:

Medical dissolution of struvite uroliths in dogs is commonly recommended, but data on success rates and complications are limited.

OBJECTIVES:

To evaluate the efficacy of medical dissolution for suspected struvite cystoliths in dogs.

ANIMALS:

Fifty client-owned dogs fed a therapeutic dissolution diet, with or without administration of antimicrobials, for treatment of suspected struvite cystoliths.

METHODS:

Single institution, retrospective case series. Medical records were reviewed for dogs with at least 1 follow-up visit. Dissolution success, complications, and possible predictors of success were evaluated.

RESULTS:

Full dissolution of cystoliths was achieved in 58% (29/50) of dogs within a median of 35 days (range, 13-167). Of 21 dogs without success, 7 each had partial dissolution, no dissolution, or undetermined outcome. Uroliths containing >10% nonstruvite mineral were common in the nonsuccess group (11/16 analyzed). Maximum urolith diameter, number of uroliths, and baseline urine pH did not differ significantly between dogs with and without success. Dissolution was more likely in dogs receiving antimicrobial therapy (OR = 16.3, 95% confidence interval 1.9-787.4, P = .002). Adverse events occurred in 9 dogs (18%); urethral obstructions were the most common, but 3 of 4 dogs with this complication were obstructed on presentation, before trial initiation.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Results support a medical dissolution trial for dogs with suspected struvite cystoliths. If no reduction in urolith size or number occurs by 1 month, a nonstruvite composition is likely, and alternative interventions should be considered. Dogs presenting with urethral obstructions should not be considered candidates for medical dissolution.

• Authors: Allie M Wingert, Olivia A Murray, Jody P Lulich, Alexis M Hoelmer, Lindsay K Merkel, Eva Furrow
• Journal: Journal of veterinary internal medicine (J Vet Intern Med) Vol. 35 Issue 5 Pg. 2287-2295 (Sep 2021) ISSN: 1939-1676 [Electronic] United States
• PMID: 34469023 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.

Chemical References

• Magnesium Compounds
• Phosphates
• Struvite

Topics

• Animals
• Dog Diseases (drug therapy)
• Dogs
• Magnesium Compounds
• Phosphates
• Retrospective Studies
• Solubility
• Struvite
• Urinary Bladder Calculi (veterinary)