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Struvite

enero 12, 2021

 

Urolithiasis is defined as the formation of stones within the urinary tract.

The stones that are most frequently found in dogs and cats consist of struvite or calcium oxalate. In particular, in the case of struvite we will have the presence of ammonium and magnesium phosphate crystals deposited in the urine. Struvite stones cause a more or less intense inflammation of the urinary tract, with a possible difficulty in urination by our friend. It is often thought that this condition is unique to cats, but in reality it can also affect the dog.

Theexistence of several factors predisposing and triggering in this pathology. Among the most important we mention:

race (in fact, small dogs or toy breeds seem to be more involved, and in particular struvite stones are frequent in Miniature Schnauzer, Cocker Spaniel and Poodle);

sex, (in the case of dogs, females are more affected);

age (they are more common in the adult or elderly animal);

surgical sterilization, (spayed bitches tend to develop stones more frequently);

inadequate dietary regimen;

– presence or absence of cpre-existing pathological conditions at the level of the urinary tract;

urinary ph. The pH is a fundamental element to consider in the case of calculations, because depending on the type of calculation, the presence or absence of a bacterial infection and the type of diet used, it will have a different value. In the case of struvite stones it is usually in the presence of alkaline urine.

This pathology therefore has a multifactorial basis, and when it arises it has a deleterious and invalidating character for the life of our friend.

The symptoms encountered in the presence of stones depend on the type, quantity and quantity location where the calculations themselves are located. When the stones determine a slight and partial or total obstruction of the urinary outflow, the symptoms will be very evident and will tend to worsen rapidly. The owner will report:

presence of blood in the urine (hematuria);

frequent urination, with the appearance of attempts that are not always very productive (pollakiuria);

straining when urinating, difficult urination (dysuria);

painful urination (stranguria);

incomplete emptying of urine (urinary retention);

physiological needs carried out in inappropriate places (the cat associates the sensation of pain with urination, with the place where it is, thus always looking for new places);

frequent lapping of the genitals;

recurrent and relapsing cystitis.

These signs, present alone or in association with each other, are clinical signs associated with this pathology and easily observable by the owner, so it will be of fundamental importance to go to the doctor as soon as possible to avoid the most serious event represented by the rupture of the bladder. The monitoring during the walk, the control of the act of urination (as well as that of defecation) therefore allow to intervene in time in the case of this pathology. Our domestic attention can be an aspect of fundamental importance in order to succeed avoid the onset of clinical problems and more complex symptoms.

The stones are diagnosed by the doctor on the basis of anamnestic data provided by the owners of the animal and on clinical signs. We will proceed by integrating these initial assessments with blood analysis, urine analysis with microscopic examination of the sediment, in which crystals will eventually be detected in the sediment, antibiogram (which could also be recommended to highlight any underlying bacterial infection), radiographs, and finally the ultrasound. In particular, the ultrasound will be performed in order to verify the presence in the abdominal area of ​​neoplasms, polyps, and to try to better understand and identify the origin of the problem. As in any case, a precise and timely diagnosis will help to be quick and decisive, to try to put an end to our friend’s pain in the shortest possible time.

The first step that the doctor could take, in case of obstruction, would be to free our friend as quickly as possible by inserting a catheter. Clearly, the insertion of the catheter will be extremely difficult in cases of more intense obstructions.

The struvite uroliths they can be infection-induced or sterile. In case they have an infection at the base, a therapy based on the association of appropriate antimicrobials and a calculolytic diet will be sufficient. In the case of sterile uroliths, antibiotics will not be necessary, but it can be solved with the sole stone diet or using urinary acidifiers.

In fact, once the diagnosis of certainty has been reached, for the treatment of struvite uroliths it is possible to opt for a medical therapeutic choice or for a surgical resolution. The first will be done on the basis of important and delicate evaluations by the veterinarian. In fact, first of all we will try to obtain the dissolution of the stones through a calculolytic acidifying diet or using urinary acidifiers and will be feasible in the event that any bacterial infections are kept under control, if the stones are small, or if the calculation is totally of struvite.

The diet in this case will be acidifying and will induce the formation of urine with a more acidic pH. It will be a diet made using commercial products with a limited content of magnesium, proteins and phosphates, highly digestible and specific for struvite urinary problems. This diet will be useful not only to dissolve existing stones, but also to prevent their reappearance. Probiotics are also recommended to try to resolve intestinal dysmicrobisms that could be a contributing cause of the problem. It will be important in medical therapy to also use antibiotics chosen by choice on the basis of the results of the antibiogram and culture tests.

In the event that these conditions do not exist it will be necessary to resort to surgery. In fact, when these stones are not dissolved by medical therapy, it is necessary to proceed with the surgical removal of stones, associated with a strict diet to prevent these from reforming. In any case, it will be important to opt for the least invasive method that is best tolerated by our friend. It will also be important to consider that very often these pathologies, even after a complete resolution and healing of our friend, can have a relapsing appearance and trend. The control of our friend’s diet will represent the keystone for the prevention of the possible reappearance of the disease.

Depending on your specific condition, your doctor may also recommend a periodic and routine urine control, in order to constantly monitor the urinary health of our friend. In fact, in the specific case of the cat, one could use a non-absorbent sand that will allow us to take the urine produced by our friend, without causing stress or tension. In addition to the particular energy balance and specific nutritional indications, the wet diet will always be elective over the dry one to obtain a better dilution of the urine. Indeed provide a wet pet food allows you to increase the amount of water taken in by our friend during the day with the consequent increase in urinary volume and reduction in specific weight.

From what emerges therefore, i stones are indeed an insidious pathological occurrence, painful and which can lead to serious complications. It will therefore always be our responsibility to keep our friend under control to ensure optimal health.

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