Transcript Calcium Oxalate Data - York College of Pennsylvania

A Retrospective Study of Canine Bladder Stone Recurrence
while using a Preventative Prescription Diet
Sarah Moser
Struvite Uroliths, petnutrigenomics.com
CaOx Stones, petnutrigenomics.com
Department of Biological Sciences, York College
METHODS
Struvite Crystals, axiomvetlab.com
RESULTS
Struvite Data
INTRODUCTION
s/d diet consumer
records & surgery
records (past 10 yrs.)
Canine Bladder Stones (Uroliths)
CaOx Crystals, axiomvetlab.com
Struvite Results
Using Hill's c/d diet
n = 35
10%
2 main types (Merck 2007)
• Struvite (MAP)
• Calcium Oxalate (CaOx)
n = 20
Dietary Prevention and Treatment
Struvite
• Dissolution diet (Hill’s s/d) (Hill’s 2005)
-Reduced phosphorus, magnesium,
and protein
-High moisture to promote diuresis
-Create acidic urine (Osborne 2004)
• Maintenance diet (Hill’s c/d) (Hill’s 2005)
-Low phosphorus and magnesium
-Acidic urine (pH 6.2-6.4)
Calcium Oxalate
• Maintenance diet (Hill’s u/d) (Hill’s 2005)
-Low oxalate, sodium, and protein
-Basic urine (pH 7.1-7.7)
HYPOTHESIS
The c/d and u/d prescription diets will
have a great effect on lowering the
recurrence of struvite and calcium oxalate
stones in canines at the Carlisle Small
Animal Clinic
57%
90%
c/d diet
no diet
Recurrence
No recurrence
Recurrence
Figure 1. The recurrence of struvite bladder
stones when using a prescription diet (Hill’s c/d
diet). A binomial test was used to find a p value
of 0.051.
recurrence
no
recurrence
recurrence
no
recurrence
No diet
27%
Calcium Oxalate Data
n = 15
surgery records
(past 10 yrs.)
n = 24
73%
Recurrence
No recurrence
Figure 2. The recurrence of struvite bladder
stones when returning back to the original diet.
u/d diet
no diet
Calcium Oxalate Results
Using Hill's u/d diet
recurrence
recurrence
no
recurrence
Checked for recurrence by:
n = 10
p = 0.017
80%
• Looking at surgical records for multiple
stone removals
• Search of entire patient history
•urinalysis, radiographs, urine C&S,
doctors’ notes
Recurrence
No recurrence
Figure 4. The recurrence of calcium oxalate
bladder stones when returning back to the
original diet.
CONCLUSIONS
2) Using a binomial probability test it was
determined that the struvite data were not
quite significant, but the calcium oxalate
data were
3) Statistics would improve with a larger
sample size
4) Next step is to look at the effectiveness
of other prescription diets (Purina,
Waltham, Royal Canin, etc.)
Literature Cited
20%
no
recurrence
n = 14
1) The Hill’s c/d and u/d prescription diets
reduced the recurrence of bladder stones
in canines
Bladder Stone Recurrence
Struvite
• 20-25% within 1 year (Merck 2007)
Calcium Oxalate
• 42% within 2 years (Minnesota 2002)
43%
p = 0.051
Stone Formation
Struvite (Magnesium Ammonium Phosphate)
• Urine oversaturated with minerals
• Usually infection-induced (UTI)
• Excess urea from protein and ureaseproducing bacteria cause alkaline urine
(Rinkardt 2004)
Calcium Oxalate
• Concentrated urine (acidic)
• Risk factors causing increased calcium
and oxalate excretion (Minnesota 2002)
No diet
No recurrence
Figure 3. The recurrence of calcium oxalate
bladder stones when using a prescription diet
(Hill’s u/d diet). A binomial test was used to find
a p value of 0.017.
Canine Calcium Oxalate Uroliths. College of Veterinary
Medicine at the University of Minnesota. 2002.
http://www.cvm.umn.edu//depts/minnesotaurolithcenter/recco
m endations/k9caox/home.html
Canine Uroliths. Merck Veterinary Manual. http://www.merckvet
manual.com/mvm/index.jsp?cfile=htm/be/130616.htm
Prescription Diet® for Dogs. Hill’s Pet Nutrition. 2005.
http://www.hillspet.com/zSkin_2/ products/pd_product_list.
jsp?FOLDER%3C%3Efolder_id=2534374302037389&bmUI
D=1168736008786
Osborne, Carl A., DVM. 2004. Improving management of
urolithiasis: canine struvite uroliths. DVM Newsmagazine.
Rinkardt, Nancy E. and Houston, Doreen M. 2004. Dissolution
of infection-induced struvite bladder stones by using a
noncalculolytic diet and antibiotic therapy. Canadian
Veterinary Journal. 45: 838-840.
Acknowledgements
Thanks to Dr. Bradley Rehnberg for mentoring this research project.