Canine Struvite / Urate

Uroliths with considerable amounts of struvite and urate indicate that two diseases processes are occurring concurrently. In almost all dogs, struvite (magnesium ammonium phosphate hexahydrate) forms as a consequence of urinary tract infection. Preventing urinary tract infection is the primary method to minimize struvite urolith recurrence. Review our complete Canine Struvite Urolith Recommendations. Urate formation maybe associated with portovascular anomalies or less commonly genetic mutations in the urate transporter. Diets to minimize struvite are contraindicated because acidic urine increases the risk for urate precipitation.

• Urine cultures every 1 to 3 months and with urinary signs to prevent struvite. • Serum bile acids in hepatic shunt breeds (e.g. Yorkshire terrier, Min Schnauzer, Maltese, Pug, Shih Tzu). • Genetic tests for hyperuricosuria variant (vgl.ucdavis.edu) in suspected breeds (e.g. Bulldog, Black Russian terrier, Labrador, American Staffordshire terrier, Weimaraner, others) Most Dalmatians are positive for this mutation.

• Antibiotic strategies to prevent struvite: sporadic infections - administer culture susceptible antibiotics for 3-7 days; relapsing infections-see detailed struvite recommendations at z.umn.edu/mnurolithRX. • Allopurinol (5 to 7mg/kg q24hr or divided q 12hr) with genetic variants, not for dogs with liver shunts. • Potassium citrate if urine pH is consistently <6.5 (starting dose: 75mg/kg q12-24h)

• Low purine/protein foods that produce neutral to alkaline urine. • Dogs with genetic variants consider u/d, Derm Complete, HA hydrolyzed, others. • Dogs with liver disease consider Derm Complete, L/d, HA hydrolyzed, others. If needed, feed canned therapeutic foods or add water to achieve a urine specific gravity <1.020.

Urinalysis every 3 to 6 months to adjust pH to ≥ 7, and urine specific gravity to ≤ 1.020. Medical imaging every 6 to 12 months to detect recurrence. Recurrence is an indication for further evaluation and alternative treatment strategies.

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Canine Struvite / Urate