• Consider methionine or ammonium chloride to acidify persistently alkaline urine (pH≥6.5) to < 6.5.
Nutritional
• Lower phosphorus/magnesium foods that promote acidic (pH<6.5) urine (e.g. c/d multicare, others). If needed, feed canned therapeutic foods or add water to achieve a specific gravity <1.020 for dogs.
Monitoring
Medical imaging every 6 to 12 months to detect recurrence. Recurrence is an indication for further evaluation and alternative treatment strategies.