These Pesky Stones

So the human had a consultation with Rebecca Remillard Ph.D., DVM at Angell Medical Center. I’m glad he did: surgery is postponed. Here is the basic information: it’s useful for any of you out there you might be coping with bladder stones.

Way back when this all started, the vet tried to get a urine sample but wasn’t able to. Because I had all the signs of a UTI, I was put on an antibiotic. This was the first error. Had a urine sample been taken and cultured we might have already solved my problem. Dr. Remillard shared that if a culture of my urine grew staph, it would have been indicative of struvite stones. This could likely be solved through a nutritional intervention. An alternative culprit could be urate stones. These can be solve through nutritional interventions as well. Lastly, the initial diagnosis of calcium oxalate stones might still be correct. These cannot be solved through nutritional interventions.

Or, can calcium oxalate stones be remedied through diet?

In the May 2010 edition of the Whole Dog Journal featured an article on the diagnosis, treatment, and prevention of calcium oxalate kidney and bladder stones. It reviewed some anecdotal evidence that these types of stones can indeed be successfully treated by nutritional interventions. The diet focus on increasing water consumption, raising urinary pH a bit, feeding a diet low in oxalates, and various vitamin supplements.

Here are two highlights that were particularly interesting in the article:

• Standard treatment from many vets for stones of all sorts are prescription diets that among other things, restrict protein, calcium, and phosphorus. The article mentioned research published in 2002 by the American Journal of Veterinary Research. It showed that canned food diets low in protein, calcium and phosphorus and have the highest amount of carbohydrates were associated with an increased risk of calcium oxalate crystals. Whoops. No prescription diets for me!

• The American Journal of Clinical Nutrition and The Journal of the American College of Nutrition, among others, have published research four more than 40 years demonstrating that patients with long-standing, recurrent calcium oxalate kidney stones receiving supplements including magnesium oxide with or without vitamin B6 for five or more years demonstrate stone formation falling by more than 90 percent.

After consulting with my vet, we’ve decided on a different treatment plan that doesn’t involve surgery right now. I’m finishing up my course of treatment with Baytril. After that, we are going to carefully watch any symptoms that develop. The small risk is that I’ll get an obstruction which would be a medical emergency. Assuming that doesn’t happen, 14 days after I stop the antibiotic I’ll have a urinalysis to see where I am. Assuming that doesn’t show anything significant we’ll repeat the urinalysis again 30 days after I completed the course of antibiotics. If that shows signs of staph, I’ll have my diet altered to treat struvite crystals. If there is no staph, we’ll re-evaluate and go for plan B. Not sure what plan B is yet.

Okay, that’s not exactly true. The human took the cats to the Cat Doctor of Bedford and Nashua this past Friday. Dr. Carlson was informative as always. He suggested that I talk to my vet about having a cystoscopy. They would use a special instrument to peek inside my bladder, see what is there, and remove a stone for analysis. Something worth discussing!