Dog Community

Need to raise Ph

Posted : 8/23/2006 12:34:16 PM

My 1-1/2 year old cocker spaniel had a urinary tract infection in July. In fact, my new vet thinks my old vet misdiagnosed this and he may have had it for almost a year. Well, I had his urine cultured and the pH was 5.2 which is lower than it should be. My vet said a lower pH can contribute to stones forming that will need to be surgically removed. Is there anything I can give him to help raise the pH? Either food, supplements, etc.? I have him on a cranberry extract powder he gets every three days to prevent UTIs.

Margaret Tyler

Posted : 8/23/2006 1:05:26 PM

Oh that's a tuffy. Most dog foods try to lower the Ph in the urine. Innova Evo is one that doesn't lower the PH in the urine, but doesn't increase it either.

Avoid the ingredient DL Methiomine. DL Methiomine is a suppliment that alot of foods use to lower the PH in the urine. You want to raise the PH and decrease the acidity.

I'd double check the whole cranberry thing. I'm pretty sure that cranberry increases the acidity and decreases the PH in the urine - the oposite of what you want.

Also, canned food is recommended for any type of Urinary tract infection. The moisture flushes out the infection and the excess minerals that cause the infection.

Distilled water. Tap water both city and well contain minerals that cause UTI's.

Also make sure you are using a ceramic or metal food and water dishes. Plastic absorbs bacteria.

Good Luck!

Krista DeBellis

Posted : 8/23/2006 1:19:58 PM

Any ideas about which foods do not contain DL Methiomine? I looked up the one I use (Natural Balance) and it has it; so do many others. Seems to be a pretty common ingredient in all dog foods.

kennel_keeper

Posted : 8/23/2006 3:05:26 PM

First of all, I would have to ask about how the urine sample was collected. For urine samples to be accurate, they need to be tested as soon as they are collected. Any thing other than a fresh sample can give a lower pH urine results.

Calciuria is rare in young dogs, although is more prevalent in males.

Here's some information (it's long and I have to paste it due to website access) that may help.

Urolithiasis, Calcium Oxalate

- [linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#Basics]Basics[/link]
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Basics

DEFINITIONFormation of calcium oxalate uroliths within the urinary tract and associated clinical conditions
PATHOPHYSIOLOGYPresence of hypercalciuria, hyperoxaluria, hypocitraturia, and defective crystal growth inhibitors
HypercalciuriaIn dogs, normocalcemic hypercalciuria is thought to result from either intestinal hyperabsorption of calcium (so-called absorptive hypercalciuria) or reduced renal tubular reabsorption of calcium (so-called renal-leak hypercalciuria). Hypercalcemic hypercalciuria results from excessive glomerular filtration of mobilized calcium, which overwhelms normal renal tubular reabsorptive mechanisms (called resorptive hypercalciuria, since excessive bone resorption is associated with high serum calcium concentrations).
HyperoxaluriaIn humans, hyperoxaluria is associated with inherited abnormalities of excessive oxalate synthesis (i.e., primary hyperoxaluria), excess consumption of foods containing high quantities of oxalate or oxalate precursors, pyridoxine deficiency, and disorders associated with fat malabsorption.
HypocitraturiaUrine citrate inhibits calcium oxalate urolith formation. By complexing with calcium ions to form the relatively soluble salt calcium citrate, citrate reduces the quantity of calcium available to bind with oxalate. In normal dogs, acidosis is associated with low urinary citrate excretion, whereas alkalosis promotes urinary citrate excretion.
Defective Crystal Growth InhibitorsIn addition to urinary concentration of calculogenic minerals, large-molecular-weight proteins in urine, such as nephrocalcin have a profound ability to enhance solubility of calcium oxalate. Preliminary studies of urine obtained from dogs with calcium oxalate uroliths revealed that nephrocalcin had fewer carboxyglutamic acid residues than nephrocalcin isolated from normal dog urine.
SYSTEMS AFFECTEDRenal/urologic
GENETICSN/A
INCIDENCE/PREVALENCEIn dogs, calcium oxalate accounts for approximately 30–35% of the uroliths removed from the lower urinary tract and 40% of those removed from the upper urinary tract. In cats, calcium oxalate accounts for approximately 45–55% of the uroliths removed from the lower urinary tract and 50% of those retrieved from the upper urinary tract.
GEOGRAPHIC DISTRIBUTIONUbiquitous
SIGNALMENT
SpeciesDogs and cats
Breed Predilections

Dogs—in a large study, 44% of calcium oxalate uroliths came from three breeds: miniature schnauzer, Lhasa apso, and Yorkshire terrier.

Cats—the two pure breeds of cat with the greatest number were Himalayan (9%) and Persian (9%).
Mean Age and Range

All ages of dogs and cats are affected.

Dogs—55%, 5–12 years

Cats—53%, 4–9 years
Predominant SexMostly male dogs (73%) and male cats (55%)
SIGNS
General Comments

None in some animals

Depend on location, size, and number of uroliths

Animals with nephroliths are typically asymptomatic but may have persistent hematuria, ureteral obstruction, and subsequent hydronephrosis.
Historical FindingsTypical signs of urocystoliths or urethroliths include pollakiuria, dysuria, and hematuria.
Physical Examination Findings

Detection of urocystoliths by abdominal or rectal palpation; failure to palpate uroliths does not exclude them from consideration.

A thickened and contracted bladder wall palpable in some patients, especially in cats

Large urinary bladder if patient has complete urethral obstruction
CAUSESSee Pathophysiology
RISK FACTORS

Calcium supplements independent of meals

Excessive dietary protein, sodium, and vitamin D promote hypercalciuria.

Additional dietary oxalate (e.g., chocolate and peanuts) and ascorbic acid promote oxalate excretion.

Exogenous or endogenous exposure to a high concentration of glucocorticoids, diets that promote formation of acidic urine, and furosemide promote hypercalciuria.

Pyridoxine (vitamin B6)-deficient diets promote hyperoxaluria.

Consumption of dry diets is associated with a higher risk for calcium oxalate urolith formation than consumption of canned diets.
Diagnosis

[linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#TOP]

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DIFFERENTIAL DIAGNOSIS

Other common causes of hematuria, dysuria, and pollakiuria, with or without urethral obstruction, include urinary tract infection and lower urinary tract neoplasia.

Other common radiodense uroliths including those composed of magnesium ammonium phosphate, calcium phosphate, and silica (dogs)
CBC/BIOCHEMISTRY/URINALYSIS

Results usually unremarkable

Urinary sediment evaluation may reveal calcium oxalate crystals, but absence of crystalluria does not exclude uroliths as a possibility.

Hypercalcemia or azotemia (rare)
OTHER LABORATORY TESTSQuantitative mineral analysis of uroliths retrieved during voiding, by voiding urohydropropulsion, by aspiration into a urinary catheter, or by cystoscopy or cystotomy
IMAGINGCalcium oxalate uroliths are radiodense and may be detected by survey radiography; intravenous urography or ultrasonography may be required to verify ureteral obstruction.
DIAGNOSTIC PROCEDURESN/A
PATHOLOGIC FINDINGSN/A
Treatment

[linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#TOP]

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APPROPRIATE HEALTH CARE

Retrograde urohydropropulsion to flush urethral stones back into the urinary bladder or voiding urohydropropulsion to eliminate bladder and urethral stones can be performed on an outpatient basis. Voiding urohydropropulsion is contraindicated in patients with urethral obstruction.

Shock wave lithotripsy and surgery require short periods of hospitalization.
NURSING CAREN/A
ACTIVITYReduce during the period of tissue repair after surgery
DIET

No reports of dissolution of calcium oxalate uroliths with special diets

Hypercalcemia in cats without evidence of hyperparathyroidism or malignancy is sometimes minimized by use of Prescription Diet Feline w/d (Hill's).
CLIENT EDUCATION

Urolith removal does not alter the factors responsible for their formation; eliminating risk factors is necessary to minimize recurrence.

Approximately 60% of dogs with a normal serum calcium concentration reform uroliths within 3 years.

Patients with hypercalcemia typically reform uroliths at a faster rate.
SURGICAL CONSIDERATIONS

Medical dissolution of calcium oxalate uroliths remains a goal for the future.

Consider surgical removal of uroliths from patients with obstruction or dysuria if they cannot be removed by nonsurgical methods (e.g., voiding urohydropropulsion, catheter retrieval) or if clinical signs cannot be alleviated by flushing uroliths back into the urinary bladder.

In dogs (not cats), shock wave lithotripsy is an alternative to surgery for removal of nephroliths and ureteroliths.

Consider parathyroidectomy for patients with primary hyperparathyroidism and hypercalcemia.
Medications

[linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#TOP]

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DRUGS OF CHOICENo available drugs effectively dissolve calcium oxalate uroliths.
CONTRAINDICATIONSNone
PRECAUTIONSSteroids and furosemide promote calciuria.
POSSIBLE INTERACTIONSN/A
ALTERNATIVE DRUGSN/A
Follow-up

[linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#TOP]

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PATIENT MONITORING

Postsurgical radiographs are essential to verify complete urolith removal.

To prevent repeat surgery, do abdominal radiography every 3–5 months to detect urolith recurrence early. Small uroliths are easily removed by voiding urohydropropulsion or catheter retrieval.
PREVENTION/AVOIDANCE

If patient is hypercalcemic, correct underlying cause.

If patient is normocalcemic, consider diet with reduced oxalate, sodium, and protein that does not promote formation of acidic urine (Prescription Diet Canine u/d, Prescription Diet Feline c/d-oxl, Prescription Diet Feline k/d, or Prescription Diet Feline w/d, Hills Pet Products). Ideally, the diet should contain additional water (canned diets) and citrate, and have adequate phosphorus and magnesium. Avoid supplementation with vitamins C and D.

Reevaluate patient 2–4 weeks after initiation of diet therapy to verify appropriate urine dilution (specific gravity < 1.020 for dogs and < 1.035 for cats), appropriate urine pH (³6.5), and amelioration of crystalluria. Do not use inappropriately collected or stored urine samples (e.g., urine collected by owners, refrigerated, or contaminated with debris) to monitor therapeutic efficacy. To promote less-concentrated urine consider canned formulations of food or add water to all types of food. If urine is acidic, consider additional potassium citrate (75 mg/kg P0 q12h); adjust dosage to achieve a pH between 6.5 and 7.5. Vitamin B6 (2–4 mg/kg P0 q24–48h) may help minimize oxalate excretion, especially for animals fed homemade or pyridoxine-deficient diets.
POSSIBLE COMPLICATIONS

Urocystoliths can pass into and obstruct the urethra in male dogs and cats, especially if the patient is dysuric; managed by retrograde urohydropropulsion

Dogs that do not consume their daily requirement of the urolith prevention diet can develop various degrees of protein calorie malnutrition.

Diet-associated hyperlipidemia develops in some patients. Miniature schnauzers with hereditary hyperlipidemia and predisposition to pancreatitis can develop pancreatitis when consuming the prevention diet, in which case Prescription Diet Canine w/d (Hills) can be used as an alternative. This diet should be supplemented with potassium citrate as needed to maintain a urine pH between 6.5 and 7.5.
EXPECTED COURSE AND PROGNOSIS

Approximately 60% of dogs with normal serum calcium concentration reform uroliths in 3 years. Treatment to minimize recurrence is helpful. Patients with hypercalcemia typically reform uroliths at a faster rate.

Comparable data are not available for cats.
Miscellaneous

[linkhttp://www.vetmedcenter.com/vmc/vmc_5mvc_details.jsp?FOLDER%3C%3Efolder_id=1408474395181659&CONTENT%3C%3Ecnt_id=10134198673283626&bmUID=1156361838577#TOP]

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ASSOCIATED CONDITIONSAny condition predisposing to hypercalciuria (e.g., hyperadrenocorticism, acidemia, hypervitaminosis D, and hyperparathyroidism) or hyperoxaluria (e.g., vitamin B6 deficiency, hereditary hyperoxaluria, and ingestion of chocolate and peanuts)
AGE-RELATED FACTORSRare in young animals
ZOONOTIC POTENTIALNone
PREGNANCYDiets used to prevent calcium oxalate uroliths are not appropriate.
SYNONYMSOxalate urolithiasis
SEE ALSO[linkhttp://www.vetmedcenter.com/vmc/id=Crystalluria]Crystalluria[/link]
ABBREVIATIONSN/A