Reducing acidity of urine following kidney stone removal?

[Zedsded]

Just wondering if anyone has any experience of reducing your dogs acidity level in there urine? We are currently trying to bring Dudleys down to help try and avoid kidney stone recurrence but it’s tricky because of his food allergies.

He’s been tested regularly since his op and is clear of crystals and his urine is dilute which is good but we’re having trouble getting the PH right.

We’ve switched him to wet food as recommended and he’s having a dose of bicarbonate of soda as suggested by the vet but would love to hear if anyone has managed to change the PH with any other food items or additives?

Thanks for any suggestions, Simon.

 

[helsonwheels]

Any DARK green veggies and even alkaline water.

Try making treats with dark greens. Spinach, asparagus, green peppers, avocados, bananas, chia....

What does he eat as kibbles?

 

[Dollys Owner]

Usual way to reduce pH of urine to target 6.5-7 is through potassium citrate 75 mg/kg twice daily. eg. 30 kg dog, would be 2.25 g (about half teaspoon of powder ) twice daily. You would adjust amount of potassium citrate powder until you get to target. Avoid calcium supplements, food high in oxalate ( if it's oxalate stones ) and feed a reduced protein diet. Most important thing is for dog to drink a lot of water, thats why you're feeding wet dog food.

If your dog had oxalate stones, some high oxalate foods to avoid include:
beets,spinach,rhubarb, sweet potatoes, almonds and cashews.

 

[RiiSi]

We used bicarbonate of soda with my bully who had hyperuricosuria and so urate stones. He ate raw food with mostly tripe, chicken, turkey and leafy greens.

 

[Zedsded]

Any DARK green veggies and even alkaline water.

Try making treats with dark greens. Spinach, asparagus, green peppers, avocados, bananas, chia....

What does he eat as kibbles?

Hi Helson, thanks for the info Dudley doesnt get any kibble only tinned meat.

 

[Zedsded]

Usual way to reduce pH of urine to target 6.5-7 is through potassium citrate 75 mg/kg twice daily. eg. 30 kg dog, would be 2.25 g (about half teaspoon of powder ) twice daily. You would adjust amount of potassium citrate powder until you get to target. Avoid calcium supplements, food high in oxalate ( if it's oxalate stones ) and feed a reduced protein diet. Most important thing is for dog to drink a lot of water, thats why you're feeding wet dog food.

If your dog had oxalate stones, some high oxalate foods to avoid include:
beets,spinach,rhubarb, sweet potatoes, almonds and cashews.

Thanks for the info we will definitely try the Citrate powder you mention, Dudley had cystine stones removed.

 

[Zedsded]

We used bicarbonate of soda with my bully who had hyperuricosuria and so urate stones. He ate raw food with mostly tripe, chicken, turkey and leafy greens.

Thats what we’re currently trying but doesn’t seem to be making much difference maybe it just hasn’t been long enough yet?

 

[Dollys Owner]

Has Dudley been neutered?
If he has Type III Cystinuria he will be cured if he gets neutered - but I'm not sure how long you would maintain that target urine pH if he wasn't neutered up till now and that was the cause.

Didn't realize it was cystine stones, treatment is a bit different, I'll post from my vet manual, which is using medical treatment to dissolve the stones instead of surgery. I previously mentioned target urine pH 6.5-7, I think for cystine stones it's pH 7-7.5. The manual recommends potassium citrate over sodium bicarbonate :

Cystine uroliths: dissolution may require 1-6 months
Limit dietary cystine with a restricted protein diet low in methionine (e.g., Hill's u/d). See Nutrition/Diet, below.
If urine remains acidic, add potassium citrate (50-150 mg/kg PO q 12 h; dose adjusted to maintain urine pH of 7.0-7.5). Avoid sodium bicarbonate. Solubility of cystine in dogs is increased by administration of N-(2-mercaptopropionyl)-glycine (2-MPG)
A higher dose (15-20 mg/kg PO q 12 h) promotes urolith dissolution.
A lower dose (10-15 mg/kg PO q 12 h) is used to prevent recurrence.

NUTRITION/DIET
 
Cystine: Calculolytic diet with restricted protein and low in methionine (e.g., Hills Prescription Diet u/d) fed at least 1 month past dissolution.
If an ultra low-protein diet is not appropriate, consider a renal diet (e.g., Hill's k/d) with the addition of potassium citrate to keep the urine pH > 7.2.
Low purine diets (e.g., Royal Canine Urinary UC Low Purine, Hill's k/d) can be fed to reduce cystine recurrence.
Complications:
Cystinuric dogs (especially English bulldogs) fed ultra low-protein diets may be at risk of dilated cardiomyopathy.
Although uncommon, 2-MPG can lead to aggression, dermatopathy, myopathy, proteinuria, spherocytic anemia,thrombocytopenia, or increased hepatic enzymes.

COMMENTS
All of these uroliths are rare, and only the cystine urolith can be medically dissolved.

PREVENTION
Promote water consumption (e.g., canned food, wetted food, water fountains).
Cystine: restricted protein diet, urine alkalinization as necessary, ± long-term use of 2-MPG. Avoid breeding carrier dogs.

 

[RiiSi]

We had give it 3 times a day, not just once.

Thats what we’re currently trying but doesn’t seem to be making much difference maybe it just hasn’t been long enough yet?

 

[Dollys Owner]

Sodium bicarbonate is not recommended for cystine stones !!!! Potassium citrate is the preferred therapy as it does not result in an undesired increase in cystine excretion, which happens with sodium bicarbonate secondary to increased sodium intake.

 

[Zedsded]

Thanks for all the information Dollys Owner very informative and we are definitely going to give the potassium citrate a go but seems to be sold out everywhere at the moment.

The vet has mentioned that having Dudley neutered “could” help but said it wasn’t a certainty and have to say that would be a very last choice.

Duds has already been through CCL operation and Kidney stone operation in the last 8 months so really dont want to put him through another if we can control it another way

Prescription diet has also been mentioned but very tricky to find one that Duds can eat. He cant have, Beef, Lamb, Chicken or white fish!

 

[Zedsded]

We had give it 3 times a day, not just once.

Thanks for the info Siisi what kind of stones did your bully have ? Sounds like Dudleys may be different.

 

[Dollys Owner]

Thanks for all the information Dollys Owner very informative and we are definitely going to give the potassium citrate a go but seems to be sold out everywhere at the moment.

The vet has mentioned that having Dudley neutered “could” help but said it wasn’t a certainty and have to say that would be a very last choice.

Duds has already been through CCL operation and Kidney stone operation in the last 8 months so really dont want to put him through another if we can control it another way

Prescription diet has also been mentioned but very tricky to find one that Duds can eat. He cant have, Beef, Lamb, Chicken or white fish!

Castration leads to markedly decreased cystine excretion resulting in abolished risk for stone formation. I strongly recommend it as it will eliminate the problem. Castration is more minor of a procedure compared to spaying for females.

If you can in the meantime give a low protein diet and get the pH of the urine up you shouldn't need those special diets as they aren't very healthy anyways. There's also prescription medications such as the 2-MPG but they have some side effects.

 

[RiiSi]

It is very important to be sure. My boy had urates. If your boy has cystines normally castration prevents renewall.

Thanks for the info Siisi what kind of stones did your bully have ? Sounds like Dudleys may be different.

 

[Cbrugs]

Thanks for all the information Dollys Owner very informative and we are definitely going to give the potassium citrate a go but seems to be sold out everywhere at the moment.

The vet has mentioned that having Dudley neutered “could” help but said it wasn’t a certainty and have to say that would be a very last choice.

Duds has already been through CCL operation and Kidney stone operation in the last 8 months so really dont want to put him through another if we can control it another way

Prescription diet has also been mentioned but very tricky to find one that Duds can eat. He cant have, Beef, Lamb, Chicken or white fish!

Type III Cystinuria is testosterone driven which is why neutering takes care of the issue of stones. It usually affects adult, in tact males. Louie has cystinuria but he was neutered around 1 years old before any stones were formed.

I personally would stay away from any prescription diet. They are crap food.