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Uroliths In A Dog

by Dreudog - December 7, 2018 View Case Report

Hi Steve and group,

This dog is an 11 yr old Lhasa apso. Prior to our time together, he has had 2 bladder surgeries for Calcium oxalate uroliths (bladder). He also has atopy, with increased pruritis spring and summer, some seborrhea, yeasty ears, moderate level of itch which was somewhat steroid- responsive. Also at least 2 bouts of IVDD (November). Bladder stones had recurred, prompting the owner's visit below. He was on Potassium Citrate at intake.

Exam # 1 was April 2018;
- ears hyperkeratotic, sl. yeasty
- pigement on ventrum , axilla, sl. seborrhea
- T: pink, dry
- P: ^ rate, toned, middle

I started him on San Ren Tang.

Recheck 1 month:
- PE about the same, Pulse still sl. rapid. Itch has ^ some w/ spring weather.

Changed to Si Miao San SID, but kept SRT for bladder.

Itch thru summer was not perfect, but better than usual per owner.

Recheck of bladder Xray 7/3 showed no change in uroliths. I started Crystal Stone Formula and quit SMS. Itch ^ off SMS, so we restarted and kept the CSF.

Allergies were decent thru summer, a couple rechecks ~ the same PE, but pigment improved some.

Another bladder Xray 11/16 ; uroliths still unchanged. (grrrr.....).

Since first seen in April, Leo has not had any dysuria, stranguria, blood. So THAT'S at least good, and perhaps SMS is keeping that inflammation at bay.

Still hoping to resolve these uroliths w/o surgery.

Thoughts?

Thanks,

Cathy

by naturevet

December 9, 2018

Hi Cathy,

Given the response to treatment, we know Damp is present. My favourite formula for eliminating the uroliths is Dang Gui Shao Yao San, and it is perhaps Damp draining enough to deal with the skin. Otherwise, next summer, just use SMS in tandem with it

I also tend to continue the potassium citrate, until we are stone and crystal-free at least

Note that resolution can take many months

I also let them know that resolution is likely impossible if the dog eats canned food or kibble. Not sure what the diet is here. Real food diets that are meat- and vegetable-based are what are called for I find. My theory is they cut down on proteinaceous nidus formation (from chronic renal tubular inflammation), ceasing crystal formation. Per this logic, there is no advantage to lowering protein, as the higher starch and fat levels that are used in its place promote more tubular inflammation

Hope that helps. We see success pretty routinely in these cases now, as long as the above measures are put in place. Please let us know how this case goes

Steve

Dang Gui Shao Yao San

by Dreudog

December 10, 2018

Thanks, Steve. Will try the DGSYS.
This owner has been reluctant to use a fresh diet, so the dog is on canned S/O. I'll push harder for a meat/veggie diet.

It's been my impression that raw is a bit more dampening than cooked? With these older dogs, I often start w/cooked diet, and then will sometimes switch to raw of they seem to have decent digestive power. Thoughts on that?

Cathy

by naturevet

December 10, 2018

Homemade diets will work as well as raw, provided they are not very starchy or fatty

S

by Dreudog

November 16, 2019

Hi Steve and group,

This is in regards to "Leo" Temple (posted perviously, just updated). He was on Si Miao san all summer, which seems to improve his allergic symptoms appreciably over years prior. In August, his pruritus ^, more seborrhea, scooting. I did not change his herb Rx and managed w/ antihistamines, bathing, etc. He is much improved now (w/ snow). Exam 8/13 - QAR, sweet, otitis w/ some thickening and discharge, mild generalized erythema, mild seborrhea . T: pink and moist. P: deeper, toned. He is due this month for a recheck bladder ultrasound, but as of May 2019, has uroliths were unchanged in size. Good news is that he has not been symptomatic since Nov. 2017, when this most recent set of uroliths were detected by his rDVM. (2 previous cystotomies for Calcium oxalate uroltihs). So the damp heat herbs seem to be keeping cystitis symptoms at bay.

He's made definite improvement w/ his allergies on San ren tang... DGSYS.... SMS. But I'm wondering if we can improve these bigger ragweed flareups next yr. He is on raw cooked diet. Assuming his uroliths are still present - thoughts? I would have waited until his next ultrasound, but his owner is pressing for some herbal answers!.

Thanks!

Cathy

by naturevet

November 16, 2019

Hi Cathy,

I guess one thought is to use Chu Shi Wei Ling Tang simultaneously with the SMS. It has anti-urolith action to some extent. I commonly use the two in SMS-responsive cases to get the case over the finish line. The deep pulse suggests you might need something more tonifying or dispersing than the current SMS

Just a thought

Let us know what happens with the ultrasound. You'll notice I've also linked your reply above in with the original thread for Leo

Steve

Chu Shi Wei Ling Tang

by Dreudog

November 18, 2019

Steve,

Happy to add in the CSWLT. Is there any chance that herb will help clear his late summer atopy also? I don't think of the formula for this season. I'm anxious to clear his uroliths, to try and avoid further surgery for this dog. But as his bladder symptoms have remained stable, the owner is more concerned for his atopy flare-ups each summer end.

I'll send an update when his ultrasound is repeated.

Thnx,

Cathy

by naturevet

November 18, 2019

Yes, for sure, that would be the intent. First and foremost it should help clear up his skin when used in tandem with the SMS

S

by DrLaura

October 18, 2023

Would anyone happen to know the dosing for Potassium Citrate? I have 2 Dalmatian dogs that are dealing with Ammonium Biurate stones and crytals +++ eating raw as well. Hoping to add some Potassium Citrate. Currently using DGSYS to try and help. Urine pH has increased from 6-7. Thank you! Laura

by naturevet

October 19, 2023

I've seen 75 mg/kg recommended, BID

S

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