Efficacy of medical dissolution for suspected struvite cystoliths in dogs

Allie M. Wingert, Olivia A. Murray, Jody P. Lulich, Alexis M. Hoelmer, Lindsay K. Merkel, Eva Furrow

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)2287-2295
Number of pages9
JournalJournal of veterinary internal medicine
Volume35
Issue number5
DOIs
StatePublished - Sep 1 2021

Bibliographical note

Funding Information:
Partial funding for Eva Furrow provided by a National Institutes of Health ORIP K01 Mentored Research Scientist Development Award (K01-OD019912).

Publisher Copyright:
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.

Keywords

  • canine
  • magnesium ammonium phosphate
  • stones
  • urinary tract infection

PubMed: MeSH publication types

  • Journal Article

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