diet for kidney stones in dogs

Kidney Stones in Dogs

Nephrolithiasis in Dogs

Nephrolithiasis is the medical term for the condition in which clusters of crystals or stones -- known as nephroliths or, more commonly, kidney stones -- develop in the kidneys or urinary tract. The kidney is composed of thousands of nephrons, each consisting of blood capillaries and a series of tubes through which filtered fluid flows as urine is produced. The tubes of the nephron drain into ducts through which urine flows; these ducts eventually enter the renal pelvis and a tube through which urine follows into the ureter. Kidney stones or kidney stone fragments can also pass through this system of tubes and into the ureter, causing serious complications.

Both dogs and cats are susceptible to kidney stones. However, some breeds of dog are more susceptible to certain types of kidney stones than others. For example, kidney stones containing calcium and oxalic acid (known as calcium oxalate nephroliths) are more likely to be found in Lhasa Apsos, Yorkshire Terriers, and Miniature Poodles. Kidney stones containing uric acid (known as urate nephroliths), on the other hand, typically affect Dalmatians, Yorkshire Terriers, and English Bulldogs.

Symptoms and Types

Many dogs with kidney stones have no apparent signs; that is, the nephroliths are often not detected until diagnostic testing is done for other medical problems. Some symptoms that may occur include blood in urine (hematuria), vomiting, recurrent urinary tract infections, painful difficult urination (dysuria), and frequent urination with small volume of production (polyuria). Other symptoms may appear but vary depending on the location and type of the stones.

Note that some nephroliths may be inactive; meaning, they are not infected, not progressively enlarging, and not causing obstruction or clinical signs. Inactive kidney stones may not require removal, but should be monitored periodically (via urine analysis for example) for any changes.

Causes

There are a number of causes and risk factors that may contribute to the development of nephrolithiasis and the development of uroliths, such as the oversaturation of stone-forming material's in the dog's urine. Other potential causes include increased levels of calcium in the urine and blood, diets that produce high (alkaline) urine pH, and recurrent urinary tract infections.

Diagnosis

You will need to give your veterinarian a thorough history of the dogs health, including the onset and nature of the symptoms. He or she will then perform a complete physical examination, ultrasound imaging, and urinalysis. However, in order to confirm the diagnosis, identify the mineral content of the stones, and develop a proper course of treatment, pieces of nephroliths must be retrieved for analysis. This is usually achieved by performing a procedure known as extracorporeal shock wave lithotripsy (ESWL), in which stones are broken up within the urinary tract using sound waves.

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Treatment

Many dogs diagnosed with inactive kidney stones can be treated at home with proper medication administered in order to dissolve the stones. An adjustment to the dog's diet is also necessary. These dietary changes will be dependent on the chemical makeup of the kidney stone.

In severe cases, the dog may require immediate removal of the kidney stone(s) and hospitalization. There are a number of options for kidney stone removal, including surgery or ESWL.

Living and Management

Because kidney stones tend to recur, routine monitoring is essential. Most veterinarians recommend abdominal X-rays and/or ultrasound examinations every three to six months post initial treatment. A periodic urine analysis is also frequently recommended.

Prevention

If your dog is predisposed to nephrolithiasis, special foods and dietary management can be effective at preventing stone formation.

Kidney Stones in Dogs: What You Need to Know

Kidney stones form in dogs for a few different reasons. The different causes ultimately predict which type of nephro (kidney) + lith (stone) is most likely to form. And the type of stone affects what treatments might help. Dogs with small kidney stones really may show no signs at all. Kidney stones may show up on x-rays of the belly that are being taken for unrelated reasons, as a so called incidental finding. For instance, they may be discovered when you think your pooch may have eaten something he shouldnt have, like one of your favorite earrings. (Your vet found a stone, all right, but not the missing diamond you were seeking.) Since kidney stones dont seem to cause dogs as much pain as they do for people, why worry about them at all?

Why are kidney stones in dogs important?A kidney stone that allows normal urine flow out may be one that your vet watches closely, but ultimately leaves untreated. However, if the stone gets very large, or if little pieces break off and lodge in the ureter (the long narrow tube that connects each kidney to the urinary bladder) it becomes a ureterolith, and is likely very painful. Kidney colic, signaled by abdominal pain, discomfort and even vomiting, may result; the kidney may also swell and become damaged. If this should happen simultaneously to each kidney, and the blockage persists, your dog will likely become critically ill from the disrupted flow of urine. For these reasons, if you think your pets abdomen is painful, or his urinations change in any way, please contact your vet right away. A urinary obstruction is a life threatening emergency that must be treated!

Signs of kidney stones in dogsThe signs and symptoms of kidney stones could include:

Causes and types of kidney stonesMetabolic kidney stones, those stones formed due to some blood or urinary imbalance, are a bit more common in dogs than are stones caused by infection¹. Female dogs outnumber males when it comes to stones², and there are certain dogs and certain dog breeds that seem to be stone formers. They may form stones multiple times, despite ordinary precautions being taken to prevent them. Calcium oxalate is one of the most common types of kidney stones, and is common in the bladder, too.

Stones that form in the bladder or kidney because of chronic bacterial infection are usually struvite. The stone components are magnesium, ammonium and phosphate.

Some dog breeds with an increased risk of kidney stones are listed here²:

Diagnosis of kidney stonesStruvite and oxalate stones usually show up readily on plain radiographs, but small stones may be hidden by whatever else is in your dogs belly. Certain stones dont consistently image well either, especially urate stones, which are common in Dalmatian dogs, so simple x-rays may not give enough information. Once its found, predicting the stone type is challenging, so your vet will need some diagnostic aids to help with that. She will want to do some tests to see what impact the stone(s) may be having on your dogs kidney health, and whether other conditions may be present that might increase the risk of stones. If a kidney stone is suspected, or already diagnosed, your vet will likely want to have a minimum data base to start from, consisting of these tests:

• Complete blood count (CBC) Low red blood cells (anemia) or high white blood cells are important findings
• Blood chemistry with electrolytes Testing for evidence of kidney disease and risk factors for stone formation
• Urinalysis The urine quality may predict kidney disease and help identify white blood cells and red blood cells that suggest bacterial infection, or crystals that may help predict stone type
• Urine culture with susceptibility Identifies bacterial infection and best antibiotic choice(s)
• Abdominal radiographs (x-rays) to examine the size and shape of the kidneys and look for urinary stones
• Systemic blood pressure To identify an important complication of kidney disease

Additional tests that may be suggested:

• Abdominal ultrasound This will help verify the location of any stones and the suspected degree of any obstruction
• Contrast radiography Dye studies may be needed to confirm blockage and help to show the contribution that each kidney makes to urine production

Treatment of kidney stonesEven if complications of kidney stones are not obvious, their presence may contribute to the progression of chronic kidney disease (CKD). Since oxalate stones do not dissolve, treatment can be challenging for your pet and for your veterinary team.

Some urinary stones, your veterinarian may want to treat conservatively, with a combination of antibiotics, diet, and plenty of water. Dissolving kidney stones completely, often takes months, but any early reduction in size is a good start.

Medical efforts to dissolve kidney stones are usually safer than surgery, but wont work for all stones. Skilled surgery is widely available, but does risk permanently damaging the affected kidney, even if the surgery goes smoothly. Veterinary urologists can offer special techniques to break stones into smaller pieces so they can just pass out in the urine. This alternative procedure to surgery could offer a safe cure for kidney stones³.

For bigger stones, specialists might break them up from the inside using endoscopes and special tools. Its always fair to ask your doctor if a recommended surgery is the only option, or if there might be a cutting edge technology to try, instead.Monitoring and Management of kidney stonesIf your vet suspects oxalate kidney stones, she may suggest using diet and some medications to reduce or slow stone growth, with a significant emphasis on increasing water intake. A general strategy involves reducing mineral concentration to discourage crystal and stone formation. Increasing water intake makes the urine more dilute and should reduce the amount of mineral available to form a stone. A variety of diets have been used successfully to prevent or manage urinary stones, but finding the best fit for your dog could take some trial and error. These strategies are worth the effort, for sure, to try to avoid the pain and problems that a growing kidney stone may cause. If an underlying cause for stones is suspected, then resolving that problem will be another important way to protect those kidneys from more stone damage.

Even if the stones dont seem to be active or causing infection or blockage, regular monitoring of lab tests for kidney function and urine quality will continue to be important for the rest of your dogs life. Your vet will want to make sure that the prevention strategy is working, to see that the stones are not growing or causing complications. That evaluation will likely need some form of imaging rechecks, with either radiographs (x-rays) or ultrasound. If the stones were removed or treated medically, monitoring for their recurrence will be key to keeping your dog healthy. You and your veterinarian can determine the monitoring schedule that best matches your dogs condition. A stone-free dog is a happier and healthier pet.

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

Resources:

1. Low WW, et al. Evaluation of trends in urolith composition and characteristics of dogs with urolithiasis: 25,499 cases (19852006). J Am Vet Med Assoc. 2010;236:193200.
2. Jessica E Markovich and Mary Anna Labato, Medical Management of Nephroliths and Ureteroliths in JD Bonagura and DC Twedt ed Kirks Current Veterinary Therapy XV, Saunders Elsevier, St. Louis, 2014 PP 892-896.
3. Berent, Chick Weisse Interventional Strategies for Urinary Disease in Kirks CVT XV JD Bonagura dn DC TwedtElsevier Saunders St Louis 2014 PP884-892

Why do dogs get bladder and kidney stones and how to treat them naturally

URINARY STONES CAUSE UNNECESSARY SUFFERING

Did you know that urinary,kidney and bladder stones are some of the most common problems found in dogs?

Tens of thousands of dogs suffer from urinary tract disease and stones. It often remains undetected until pain and discomfort show up. The conventional treatment consists of a special diet, fluid therapy, hospitalization, catheterization and in some cases surgery.

This article can be used as a resource if your dog has already been diagnosed with urinary stones or if you simply want to prevent this painful and annoying condition in the first place.

Why do stones form?

There is never one single reason why urinary crystals and stones form. Most people agree that genetics and diet play a role and genes are likely to manifest when they are switched on by environmental factors internal (hormones and regulators) or external (diet, water, stress and exercise to name a few).

High mineral content and mineral ratio disproportions such as calcium, magnesium and phosphorus are conventionally thought to be the most common reasons for urinary stone formation but, this is not exactly true. In fact, in some cases of crystal formation such as calcium oxalate, calcium and mineral deficiencies are the cause.

My goal today is not to repeat what you know already about urinary stones and crystals, but togive you a new perspective on why this problem troubles many dogs.

Bladder stone diversity

There are two common crystal and stone categories:

• Triple phosphate (struvite) is formed mainly in urine that is alkaline and dissolves in acidic urine.
• Calcium oxalate, with spiky hedgehog-like crystals and stones that are more likely to appear in acidic urine but can also be present in urine of any pH. I find these crystals much nastier because they are hard to dissolve when they form, and they usually need to be removed either surgically or crushed and blasted endoscopically. The sharp calcium oxalatespikes can cause excruciating pain and are much more difficult to treat than to prevent.

Some other less common types of crystals are cysteine, ammonium urate and silica crystals.

Beware of misdiagnosis

Adiagnosis of urinary stones and crystals is usually relatively simple, but I must caution you about one frequent error. If your dogs urine sample is concentrated and it sits in the collection jar under cool temperatures, crystals may form after the collection, the same way salty water forms crystals in the chemistry lab. This can result in a misdiagnosis.

If you suspect that this is the case, just collect another sample and have it examined right away at the in-house clinic lab. It is a good idea to give your dog some water before collection to make the urine more diluted and prevent post-collection crystal formation.

What to do if you find crystals: A Natural Approach

If your dog is suffering from crystals or has been diagnosed with stones in the bladder or kidneys, you have most likely been given special processed food, told to provide more water or have been given medicine to adjust your dogs urine pH.

Perhaps your dog is just recovering from kidney or bladder surgery and you are worried that the nasty stones will come back. Maybe you have already seen the same problem reoccur or you are worried about the undesirable effects of repeated surgery. Food that is heavily processed, sits on the shelves for months or years before it is sold and/or contains ingredients similar to the ones listed below is a concern:

• Brewers Rice
• Chicken By-Product Meal
• Pork Fat (preserved with mixed tocopherols and citric acid)
• Corn Gluten Meal
• Dried Egg Product
• Calcium Sulfate
• Lactic Acid
• Chicken Liver Flavor.

When I used special urinary stone diets in the 90s, I saw they prevented stones in some cases, but my patients didnt do well overall. They gained weight, were lethargic, appeared stiff, had digestive problems and aged faster. I started to ask, Who on earth would feed pork fat, cornmeal and egg product to their beloved dog? I suspected that stones were actually caused by the dog's processed food diet and didnt like the idea of feeding more processed food. At first, I wasnt sure what to do and then I searched for the answer in nature.

Over the years, I developed a natural, simple kidney and bladder stone treatment protocol that consisted of:

1. Cleansing the body.
2. Providing the right food and essential mineral and amino acid supplements, high-quality omega oilsand full-spectrum organic multivitamins.
3. Adding high-potency probiotics that are known to reduce crystal formation.
4. Rebalancing the patient's energy through a variety of holistic techniques such ashomeopathy, herbs, chiropractics, physiotherapy, osteopathy and massage to name a few.

I applied these principles to most patients with urinary tract stones and even though some had surgery before, I rarely see recurring stones after starting the above treatment plan.

Wondering why I supplement minerals in cases of urinary stones or crystals?

Conventional opinions suggest that urinary crystals are caused mainly by genetics as well as excess and imbalance of minerals in food. I now see processed food as the main cause. I have discovered that a complete, plant-based, natural diet can, in many cases, prevent crystals.

Science has made incredible progress in understanding metabolic cycles and processes, but the microcosm of the body is still not fully understood. It can be compared to someone trying to really grasp the nature of the universe. However, we know that the body works best with the fuel that it was built for. Lack of minerals, amino acids and other nutrients can throw many metabolic pathways off balance, which may cause crystals to form. It makes sense that minerals, amino acids and other nutrients are absolutely essential for your dog to have an efficient metabolism. This is the cornerstone of urinary crystal and stone prevention.

Dietary recommendations

If you are looking to reduce the chance of stones forming in your dogs kidneys or bladder, you need to follow the following steps:

1. Stop feeding your dog any processed food because it is, in my opinion, one of the main causes of urinary stones and crystals. It is not what nature intended for your dog. We do not put diesel fuel in your gasoline car either and the right fuel for your dog is essential for success.
2. Start feeding species-appropriate raw or cooked food, including raw bones and some vegetables to ensure that all nutrients are represented in the most natural and wholesome form.
3. Provide the body with all-natural, plant-based minerals and amino acids.
4. Add high-potencyprobiotics, like GutSense, that are known to reduce crystal formation.

The reason for the above recommendations is simple: processed and denatured food is a major cause of many health problems in animals and people and, in my experience, urinary stones in dogs fed natural, non-processed food is very rare.

How to test for missing minerals?

In most situations, a simple hair test will give you a good idea of what your dog is missing. It is easier than ever by running aHairQ test, a simple and reliable hair test that will give you a good overall idea of your dogs nutritional status.

General supplement recommendations

You may be still wondering why I recommend supplementing minerals to dogs that are on raw food.

Our soils and agricultural land have been overburdened with an increasing need for more food, which is transported over long distances. Minerals and nutrients are not being replenishedin the fields and this resultsin mineral and nutrient-depleted food chains, no matter how natural your dogs food is.

As animals and people age, mineral deficiency is a common, yet often undetected, cause of disease. The bodys metabolic cycles cannot run properly without the essential minerals, amino acids, omegaoils and wholesome vitamins it needs. Some may not be produced by the body but are essential for an efficient, smooth metabolism including that of the urinary system.

A few more points about diet and water

It is not the purpose of this article to get into thepreparation of a natural raw or cooked diet. However, I would like to mention a few important points.

• Dogs do better on meats of small and medium-sized animals. Bison, buffalo and beef have never been the main source of food for dogs. These meats have a higher content of inflammatory factors such as arachidonic acid which seem to increase the chances of bladder issues and stones.
• Raw bones are safe.Never feed cooked bones.

One of the common remedies for acidifying urine is

cranberry extract

, which can be also used in cases of struvite crystalluria. This supplement should be seen as an adjunctive treatment, not as a complete solution to the problem. It is also important to understand that there is a difference between dehydrated cranberries, cranberry powder and extract. I personally prefer organic cranberry extract with the following dosage:

As a preventative for recurrent UTIs / stones:

Weight	Daily dose
Up to 5 kg (up to 11 lbs)	100 mg
6 - 10 kg (12 - 22 lbs)	200 mg
11-15 kg (24 - 34 lbs)	300 mg
16 - 20 kg (35 - 45 lbs)	400 mg
21 - 25 kg (46 - 55 lbs)	500 mg
26 - 30 kg (56 - 66 lbs)	600 mg
31 - 35 kg (68 - 77 lbs)	700 mg
36 - 40 kg (78 - 88 lbs)	800 mg
41 - 45 kg (89 - 99lbs)	900 mg
Over 45 kg (over 100 lbs)	1000 mg

Double the dose during an acute illness or in case of urinary tract infections, crystals and stones.

Remember that an important part of addressing crystalluria (the presence of crystals in urine) is to ensure that your dog consumes an adequate amount of fresh,

ideally filtered, water

.

IMPORTANT NOTICE: Distilled water is NOT safe for consumption in dogs or people.

Words from one of our clients Brooke Mitchell (July 2013)

In the process of updating this blog, I have received this wonderful e-mail from one of my clients. Her dog, Rocky, suffered from serious crystal and urinary problems since 2011 and after bladder surgery, he had to be sedated and his bladder flushed every three months because stones continued to produce.

The following feedback truly makes my day because this is a glaring example that special processed food is horrible junk that dogs with urinary stones must avoid. Here is what Brooke wrote:

I am so elated to inform you that Rocky went for his 3.5-month checkup and he is completely stone-free!!!! Not only are there no stones present in his bladder, he also has no crystals present in his urine!! His vet said that he has never seen his bladder look so healthy on the x-ray! His vet is so enthralled with the results, he couldnt believe how far we have come in just 3.5 months! This is a huge accomplishment and I couldnt have done it without Dr. Dobias and your help as well Angela! I can't thank you enough for all the help. I never knew if Rocky could actually be healed, there were so many unsure opinions of everyone before you that I spoke with. You have opened my eyes to so much more than just Rocky's health. Thank you!

Now that we have the wonderful results, I would like to move forward with the GreenMinand also giving him bones. Please let me know what dose of GreenMin to give. And I will read the bone blog.

Forever grateful,

Brooke

Your dog is worth it

I know it sometimes takes guts to be different and go against what you have been told over and over. This would not be the first time in the medical history that we need to change the way we see problems. If the information here makes sense to you, try it. You have nothing to lose and lots to gain.