Nutritional Assessment in a Dog with Urolithiasis

A nutritional assessment should be performed as part of every physical examination. In addition to obtaining a dietary history, the veterinary team should also evaluate the patient’s weight and weight trends, body condition, and muscle condition. The WSAVA Global Nutrition Toolkit (see Suggested Reading) includes useful handouts and charts to facilitate nutritional assessments.

A nutritional assessment should be performed as part of every physical examination. In addition to obtaining a dietary history, the veterinary team should also evaluate the patient’s weight and weight trends, body condition, and muscle condition. The WSAVA Global Nutrition Toolkit (see Suggested Reading) includes useful handouts and charts to facilitate nutritional assessments.

A nutritional assessment should be performed as part of every physical examination. In addition to obtaining a dietary history, the veterinary team should also evaluate the patient’s weight and weight trends, body condition, and muscle condition. The WSAVA Global Nutrition Toolkit (see Suggested Reading) includes useful handouts and charts to facilitate nutritional assessments.

A nutritional assessment should be performed as part of every physical examination. In addition to obtaining a dietary history, the veterinary team should also evaluate the patient’s weight and weight trends, body condition, and muscle condition. The WSAVA Global Nutrition Toolkit (see Suggested Reading) includes useful handouts and charts to facilitate nutritional assessments.

To avoid nutrient imbalance, treats and unbalanced foods should be limited to no more than 10% of daily caloric intake. This is particularly important to consider when attempting nutritional management of urolithiasis, as additional foods will decrease the efficacy of a therapeutic diet.

Clinicians should inquire about administration of dietary supplements while obtaining the dietary history. In patients being fed a complete and balanced diet, additional vitamin and mineral supplementation may be unnecessary and may lead to nutrient imbalance. In addition, supplements that contain stone precursors (eg, magnesium, phosphate, calcium, vitamin C) or that otherwise affect urine composition can interfere with a therapeutic diet’s efficacy when being used for management of urolithiasis.

To avoid nutrient imbalance, treats and unbalanced foods should be limited to no more than 10% of daily caloric intake. This is particularly important to consider when attempting nutritional management of urolithiasis, as additional foods will decrease the efficacy of a therapeutic diet.

Clinicians should inquire about administration of dietary supplements while obtaining the dietary history. In patients being fed a complete and balanced diet, additional vitamin and mineral supplementation may be unnecessary and may lead to nutrient imbalance. In addition, supplements that contain stone precursors (eg, magnesium, phosphate, calcium, vitamin C) or that otherwise affect urine composition can interfere with a therapeutic diet’s efficacy when being used for management of urolithiasis.

To avoid nutrient imbalance, treats and unbalanced foods should be limited to no more than 10% of daily caloric intake. This is particularly important to consider when attempting nutritional management of urolithiasis, as additional foods will decrease the efficacy of a therapeutic diet.

Clinicians should inquire about administration of dietary supplements while obtaining the dietary history. In patients being fed a complete and balanced diet, additional vitamin and mineral supplementation may be unnecessary and may lead to nutrient imbalance. In addition, supplements that contain stone precursors (eg, magnesium, phosphate, calcium, vitamin C) or that otherwise affect urine composition can interfere with a therapeutic diet’s efficacy when being used for management of urolithiasis.

To avoid nutrient imbalance, treats and unbalanced foods should be limited to no more than 10% of daily caloric intake. This is particularly important to consider when attempting nutritional management of urolithiasis, as additional foods will decrease the efficacy of a therapeutic diet.

Clinicians should inquire about administration of dietary supplements while obtaining the dietary history. In patients being fed a complete and balanced diet, additional vitamin and mineral supplementation may be unnecessary and may lead to nutrient imbalance. In addition, supplements that contain stone precursors (eg, magnesium, phosphate, calcium, vitamin C) or that otherwise affect urine composition can interfere with a therapeutic diet’s efficacy when being used for management of urolithiasis.

Amoxicillin is recommended as a first-line treatment option for simple UTIs. Cefovecin should be reserved for cases in which oral medication may not be an option. Doxycycline is not recommended due to high intestinal metabolism and excretion and, potentially, low urine levels. Enrofloxacin should be reserved for treating resistant UTIs or pyelonephritis.⁵ Once medical dissolution of infection-induced struvite urolithiasis is implemented, antibiotic therapy should be continued until successful dissolution is achieved. See Suggested Reading for a review of recommendations regarding antibiotic choices for UTIs.

Amoxicillin is recommended as a first-line treatment option for simple UTIs. Cefovecin should be reserved for cases in which oral medication may not be an option. Doxycycline is not recommended due to high intestinal metabolism and excretion and, potentially, low urine levels. Enrofloxacin should be reserved for treating resistant UTIs or pyelonephritis.⁵ Once medical dissolution of infection-induced struvite urolithiasis is implemented, antibiotic therapy should be continued until successful dissolution is achieved. See Suggested Reading for a review of recommendations regarding antibiotic choices for UTIs.

Amoxicillin is recommended as a first-line treatment option for simple UTIs. Cefovecin should be reserved for cases in which oral medication may not be an option. Doxycycline is not recommended due to high intestinal metabolism and excretion and, potentially, low urine levels. Enrofloxacin should be reserved for treating resistant UTIs or pyelonephritis.⁵ Once medical dissolution of infection-induced struvite urolithiasis is implemented, antibiotic therapy should be continued until successful dissolution is achieved. See Suggested Reading for a review of recommendations regarding antibiotic choices for UTIs.

Amoxicillin is recommended as a first-line treatment option for simple UTIs. Cefovecin should be reserved for cases in which oral medication may not be an option. Doxycycline is not recommended due to high intestinal metabolism and excretion and, potentially, low urine levels. Enrofloxacin should be reserved for treating resistant UTIs or pyelonephritis.⁵ Once medical dissolution of infection-induced struvite urolithiasis is implemented, antibiotic therapy should be continued until successful dissolution is achieved. See Suggested Reading for a review of recommendations regarding antibiotic choices for UTIs.

Nutritional modification can be used for medical dissolution of struvite, urate, and cystine uroliths. Prevention of struvite urolithiasis in dogs is generally focused on reducing risk factors for UTIs, except in rare cases of sterile struvite urolithiasis. Long-term dietary management is recommended to reduce risk for recurrence of other uroliths, including calcium oxalate, urate, cystine, and silica. 

If Stella’s urolithiasis and lower urinary tract signs had not improved with initial medical management, stone removal and analysis would have been indicated. Recommendations for long-term nutritional management would be indicated based on the results of stone analysis.

Nutritional modification can be used for medical dissolution of struvite, urate, and cystine uroliths. Prevention of struvite urolithiasis in dogs is generally focused on reducing risk factors for UTIs, except in rare cases of sterile struvite urolithiasis. Long-term dietary management is recommended to reduce risk for recurrence of other uroliths, including calcium oxalate, urate, cystine, and silica. 

If Stella’s urolithiasis and lower urinary tract signs had not improved with initial medical management, stone removal and analysis would have been indicated. Recommendations for long-term nutritional management would be indicated based on the results of stone analysis.

Nutritional modification can be used for medical dissolution of struvite, urate, and cystine uroliths. Prevention of struvite urolithiasis in dogs is generally focused on reducing risk factors for UTIs, except in rare cases of sterile struvite urolithiasis. Long-term dietary management is recommended to reduce risk for recurrence of other uroliths, including calcium oxalate, urate, cystine, and silica. 

If Stella’s urolithiasis and lower urinary tract signs had not improved with initial medical management, stone removal and analysis would have been indicated. Recommendations for long-term nutritional management would be indicated based on the results of stone analysis.

Nutritional modification can be used for medical dissolution of struvite, urate, and cystine uroliths. Prevention of struvite urolithiasis in dogs is generally focused on reducing risk factors for UTIs, except in rare cases of sterile struvite urolithiasis. Long-term dietary management is recommended to reduce risk for recurrence of other uroliths, including calcium oxalate, urate, cystine, and silica. 

If Stella’s urolithiasis and lower urinary tract signs had not improved with initial medical management, stone removal and analysis would have been indicated. Recommendations for long-term nutritional management would be indicated based on the results of stone analysis.

Diets formulated for dissolution of struvite urolithiasis in dogs have decreased concentrations of magnesium and phosphorus and have an acidic target urinary pH. There is some variation in protein concentration among products, but high protein concentrations should generally be avoided. Sodium content in dissolution diets can also vary depending on manufacturer and diet form (eg, canned vs dry).

Some leafy green vegetables (eg, spinach, Swiss chard) are high in oxalates and should be avoided in dogs with a history of calcium oxalate urolithiasis. In these dogs, avoidance of vitamin C supplementation is also recommended, as vitamin C is a metabolic precursor for oxalate.

Diets formulated for dissolution of struvite urolithiasis in dogs have decreased concentrations of magnesium and phosphorus and have an acidic target urinary pH. There is some variation in protein concentration among products, but high protein concentrations should generally be avoided. Sodium content in dissolution diets can also vary depending on manufacturer and diet form (eg, canned vs dry).

Some leafy green vegetables (eg, spinach, Swiss chard) are high in oxalates and should be avoided in dogs with a history of calcium oxalate urolithiasis. In these dogs, avoidance of vitamin C supplementation is also recommended, as vitamin C is a metabolic precursor for oxalate.

Diets formulated for dissolution of struvite urolithiasis in dogs have decreased concentrations of magnesium and phosphorus and have an acidic target urinary pH. There is some variation in protein concentration among products, but high protein concentrations should generally be avoided. Sodium content in dissolution diets can also vary depending on manufacturer and diet form (eg, canned vs dry).

Some leafy green vegetables (eg, spinach, Swiss chard) are high in oxalates and should be avoided in dogs with a history of calcium oxalate urolithiasis. In these dogs, avoidance of vitamin C supplementation is also recommended, as vitamin C is a metabolic precursor for oxalate.

Diets formulated for dissolution of struvite urolithiasis in dogs have decreased concentrations of magnesium and phosphorus and have an acidic target urinary pH. There is some variation in protein concentration among products, but high protein concentrations should generally be avoided. Sodium content in dissolution diets can also vary depending on manufacturer and diet form (eg, canned vs dry).

Some leafy green vegetables (eg, spinach, Swiss chard) are high in oxalates and should be avoided in dogs with a history of calcium oxalate urolithiasis. In these dogs, avoidance of vitamin C supplementation is also recommended, as vitamin C is a metabolic precursor for oxalate.