The following article is anecdotal in nature and not a definitive treatment. However, the information may be useful in discussing a bladder stone problem and its treatment with your vet.
From both personal experience and inquiries to the ANTA web site, I know that the occasional Norfolk develops bladder stones. Symptoms such as straining to urinate, multiple urination attempts, bloody urine, and/or recurrent bladder infection suggest the need for a trip to the vet.
There are two common types of canine bladder stones: Struvite and Calcium Oxalate. Struvites are the more common in females and oxalates are the more common in males. Struvites require an alkaline urine whereas oxalates need an acidic urine to form. Treatment for the two types differ and this discussion focuses on struvite stones. (For a more detailed discussion of stones, see http://www.marvistavet.com/html/bladder_stones.html).
About 10 years ago, we had a bitch, not quite 4 years old, have her first bladder stone occurrence. She was operated on to remove and analyze the stones and that was followed by special diet and antibiotics. Stones recurred about fifteen months later and they were again removed surgically with follow up diet and antibiotics. However, they recurred in a matter of weeks and we were reluctant to just operate (again) only to hope that the stones wouldn't come back. Finally, our vet suggested that we keep the dog on the antibiotic during the entire time it took for her to go through a case of the special (s/d) diet. (The antibiotic used was Baytril, which is a relatively expensive medicine.) Success!! She never had a recurrence in the remaining five years of her life.
Through that experience, I came to view the cause of the stones as something of a chicken or egg dilemma: did infection cause the stones or did stones cause infection? The important factor in getting rid of the stones seemed to be having stayed on the antibiotic until the stones were completely gone, as opposed to the typical 10-day course of medicine. Further, one vet observed that the tendency toward alkaline urine might be genetic but that diet affects the pH (acidity/alkalinity) of the urine. Additionally, we have relatively hard well water and there was the question as to whether the minerals in the water were a factor.
So with the above background, this past January we discovered bladder stones in an 8½-year-old bitch. Her urine tested very alkaline at a pH of 8½ and I was very concerned about the likelihood of recurring stones. Ultimately, we treated her for two months on s/d diet with Baytril antibiotic the entire time. But the stones remained. In March, we went back to her regular diet (a commercial reduced calorie chicken and rice formula) but began 125 mg Vitamin C every 8 hours to acidify the urine, changed the antibiotic to Amoxicillin twice a day, and provided only distilled water. And here is where a new approach came into the picture. Our vet had discussed the case with the Hill's Diet people and at their suggestion, she added Lithostat to the treatment.
Now Lithostat is a human medicine and apparently not very popular as none of the local pharmacies had it on hand. It comes only in 250 mg tablets whereas the desired dosage for our 13 lb dog was 100 mg twice a day and the minimum package size is 30 tablets. An internet search showed both Costco and Eckert to be sources and a phone call to Costco verified that they could work from a veterinary prescription. I was able to break the tabs into thirds of about 83 mg each (in consultation with my vet), so a half bottle provided pills for three weeks of treatment. When we re-X-rayed the dog, the stones were gone!
Since we changed several things at the same time in the treatment, it is not definite that the Lithostat was primarily responsible for clearing the stones. However, something worked and it was with great satisfaction that we both avoided surgery and found a relatively simple medical treatment that can be repeated should the stones recur. Certainly, should anyone else be faced with struvite stones in their Norfolk, it would be worth discussing the above treatment with your vet.
ANTIC, June, 2003
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