Feed Your Companion a Therapeutic Diet
Commercial therapeutic diets are the best option for reducing the development of most types of stones, says Heinze, who is board-certified in veterinary nutrition.
“Home-cooked diets are usually a second choice for dogs that can’t eat a commercial diet, rather than the first choice for stone prevention, because they can’t undergo the kinds of testing that commercial therapeutic diets do to ensure that the urine produced has the greatest chance of reducing stone risk,” she says.
Therapeutic diets work by providing less of the substances that form the stones, Su says. “Some of these diets are designed for prevention of stones, and some for dissolution of stones (and are therefore more depleted in stone formation ingredients), so make sure the pet is monitored by a veterinarian while on these diets.”
The type of diet your vet prescribes will depend on the stone. For example, “for dogs with urate and cysteine bladder stones, your vet will recommend specific lower protein therapeutic diets that promote alkaline pH and reduce intake of stone precursors,” says Larsen, who is board-certified in veterinary nutrition.
To prevent calcium oxalate stones, the prescribed diet will likely have moderate levels of protein, calcium, and phosphorous. “And it may have increased sodium chloride (to induce dilute urine) or higher fiber,” explains Dr. Joe Bartges, professor of medicine and nutrition at the College of Veterinary Medicine at the University of Georgia in Athens.
A cat or dog on a therapeutic diet shouldn’t be allowed to eat other foods without the permission of your vet. Dr. Susan Jeffrey, a veterinarian with Truesdell Animal Hospital in Madison, Wisconsin, had a client who had been mixing a therapeutic diet with an over-the-counter diet. “The cats stones returned and he needed another surgical procedure to remove them,” she recalls.
Although your vet has the final say about which foods are appropriate, there are some general guidelines. “Avoid rawhide, pig ears, bully sticks, and other collagen-rich treats,” Larsen says. “They are not only not high enough in moisture but also provide compounds converted to oxalate by the body,” which is an obvious no-no for pets with calcium oxalate stones. Su adds, “For patients with calcium oxalate stones, make sure to avoid excess calcium (avoid dairy products, extra supplementation), and high oxalate ingredients (like spinach).” Animals with urate and cysteine stones should avoid added protein (especially from seafood and organ meat for those with urate), Larsen says.
And continued, close monitoring for symptoms of stone recurrence is vital. Dietary manipulation does not work in all cases. “Recurrence of stones, especially calcium oxalates, can occur in some patients even if they are strictly fed the appropriate therapeutic diets,” Su says.
These stones form when two chemicals – calcium and oxalic acid – bind together in urine. Normally, calcium and oxalic acid mutually co-exist in your dog’s urine and don’t bind together. But under certain conditions, for example if the urine pH is too acidic, the two bind to form a compound called calcium oxalate. This compound can’t be dissolved or excreted, and so becomes lodged in the bladder. High levels of these chemicals in the urine also increase the likelihood of them binding together to form calcium oxalate stones.
Many people are afraid to add foods that contain calcium to their dog’s diet because of the name “calcium oxalate stones.” But restricting calcium to very low levels can cause oxalate in the diet to be absorbed at even greater amounts since calcium can bind to oxalate in the stomach and intestines before it moves to the kidneys. In addition, calcium is an essential mineral and lack of calcium will be damaging and may lead to more severe health problems including osteoporosis. Calcium restriction should be done very carefully. The goal is to feed the right amount of calcium. You can read more here.
If you’d like to try cooking for your dog, the best way to ensure that the diet is meeting all of your dogs nutritional needs is to get your recipe from a qualified nutritionist. Dietary manipulation to address a health problem should be done by someone who will work with your dog.
You can also prepare you dogs food at home using the same high quality ingredients that you eat. There are several health benefits of making your dogs food at home. By feeding your dog a home-prepared diet rather than a dry kibble diet, you can increase the amount of water they are drinking. And as mentioned above, increased water consumption makes urine more dilute and can help prevent stones forming.
Surgery doesn’t always remove every trace of the stones which is why following surgery, vets tend to ‘flush’ the bladder to remove any lingering traces of them. But unfortunately even with flushing, it can be impossible to remove everything, meaning some traces of the stones remain. This is why it’s very common for calcium oxalate stones to form again and again. There are however measures dog owners can take to decrease the likelihood of this happening (see below).
Is there any chance that bladder stones can be dissolved rather than resorting to surgery?
The opportunity to dissolve bladder stones in dogs, called dissolution, depends on the composition of the stones. Unfortunately, the most effective way to know the composition of a canine bladder stone is to remove one and have it analyzed. That said, it may be possible to draw some conclusions about the composition of a bladder stone based on crystals identified during the urinalysis. Also, it may be possible to retrieve a small bladder stone for analysis via a urethral catheter.
Your veterinarian will work closely with you to determine if attempting medical dissolution is a reasonable option for your dog. In most cases, surgical removal of bladder stones is the treatment of choice. Surgery provides the following benefits:
Homemade Dog Food for Struvite Bladder Stones
Many dogs love cooked squash –not only a good source of potassium -it’s also a great source of soluble fiber, which can help dogs feel more satisfied after eating and helps promote intestinal health.
Potassium plays an important role in maintaining osmotic balance, transmitting nerve impulses and facilitating muscle contractions. It’s an important electrolyte that is often lacking in raw diets because the best sources are veggies and fruits.
Which variety to choose depends on your nutrition goals. Read more Is Squash Safe For Dogs?
A generic diet may be based on dietary principles that work, but just how well they work can be based on unique metabolism, so we need to consider that as well. There are different types of bladder stones and many are combination stones.
The three most common are urate (Dalmatians are genetically disposed to forming these stones), calcium oxalate, and struvite. Urate crystals and stones can be a heads up about liver shunts, especially in puppies, so the Dalamation is not the only breed that can have these, but for different reasons. Urate crystals can be prevented by feeding the right diet. The problem here is that some people don’t want to hear what the right diet is because it’s vegetarian. Eggs, milk products and tofu can make up the protein part and the rest is pasta, potatoes or rice and certain vegetables that are low in purines. That’s the start. In some cases, chicken can be fed, but if you start with chicken and the dog has urate crystals, the chicken has to go and then you can recheck urine, see where you stand and take it from there. Chicken might be ok later, but there’s a weaning process to go through. I’ve been working with Dalmations for about 18 years and never had an issue with crystal formation once the right diet was being fed. The thing to remember is that “right diet” means it has to be right for that particular dog. Urate stones look like this:
Struvite stones are almost always due to a urinary tract infection and urine pH will be high. Struvite stones are the easiest to deal with from a dietary perspective. In a nutshell, we increase protein from eggs and meats and lower the carbohydrate content of the diet. There’s more to it, but that’s the start. A basic struvite stone looks like this:
Calcium oxalate crystals can be more challenging, but again, success comes from understanding how a certain dog reacts to proportions of certain foods rather than just the foods themselves. Basic calcium oxalate stones look like this:
Protein derived from meat, dairy and fish will decrease urine pH and most of these dogs have low urinary pH to begin with. That’s a common problem, so we need to feed less of the foods above, but “less” is relative because it depends how much of them the diet provided in the first place. To compensate for the lost calories after a reduction of dietary protein, we use carbohydrates (choose white rice, egg noodles, wild rice or rye bread) and as luck would have it, carbs help to increase urine pH. Bonus! Now, we add low oxalate vegetables and fruits which means we’re restricted to acorn squash, white cabbage, cauliflower, cucumber, green peas, iceberg lettuce, red pepper, turnip roots, zucchini, peeled apples, cantaloupe, cherries, honeydew, mangoes, nectarines and watermelon. Cook the vegetables and don’t feed organ meats.
UPDATE (2021) A common frustration for pet parents is finding treats that work well for calcium oxalate stone formers. Although feeding the foods listed above is helpful, calcium plays a critical role in helping to flush oxalate out of the body. Treats that can help in this way as well as provide support through important antioxidants and phytonutrients are unavailable. These formulated recipes fill that void.
One of the most critical thing you can do to prevent crystals and stones is to keep the dog really well hydrated. Make the food “soupy” by adding water to the food bowl. Preferably not plain tap or mineral water (filtered or distilled are much better) since we want to avoid excessive mineral intake – but we want to a feed a balanced diet, so this does’t translate to not adding the amounts of required minerals to food. Flushing out those crystals with water prevents them from aggregating into a stone in the first place.
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