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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24385
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My 7 year old Maltese had a cystotomy on 10/14...15 stones

Customer Question

My 7 year old Maltese had a cystotomy on 10/14...15 stones in bladder and some in urethra (not blocking urine flow at time of surgery). Stones were determined to be calcium oxalate. He is now having urine leakage issues....more at night but some leakage during the day. Is this common after surgey? Is it permanent? Is the special diet prescribed necessary?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

The inflammation associated with uroliths (stones) +/- bacterial urinary tract infection is a common cause of urinary incontinence which should abate as the inflammation abates. Control of any bacterial infection is essential, however. The special diet is an integral and necessary part of the chronic treatment for calcium oxalates. In addition, calicum supplements, acidifying diets, and foods high in oxalates such as green leafy vegetables must be avoided. Feeding a canned special diet or adding water to dry food when possible is also important.

We're particularly interested in producing a urine with a pH between 7.0 and 8.0 and a urine specific gravity less than 1.025. If the above measures aren't effective in doing that, we might add potassium citrate which should alkalinize the diet. If calcium oxalate crystalluria persists, diuretics such as hydrochlorothiazide might be prescribed or vitamin B6 can be added. Vitamin C and C supplementation, however, should be avoided.

Most important, adherence to dietary therapy must be strict. Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thank you for the quick reply. So, once the inflamation is gone...the incontinence should subside (what if there is scar tissue in the urethra?). How long are antibiotics usually prescribed for post-surgery? I was given no indication of any infection pre-surgery. Is there a natural, alternative diet that I can make for him vs. the prescribed expensive food?
Customer: replied 1 year ago.
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Expert:  Dr. Michael Salkin replied 1 year ago.

Scarring - particularly if it led to stricture - would be a negative prognostic finding. If no infection were found prior to surgery, perioperative antibiotics might be prescribed for a little as 5 days. Yes, here's an example of a home-cooked recipe designed for a patient such as Cello. The urinary pH must be monitored when this or any other special diet is fed...

chicken, breast, without skin, cooked, 2 ounces

rice, white, long-grain, cooked, 3 cups

canola oil, 5 tsp

salt substitute (potassium chloride), 1/2 tsp

bone meal powder, 2 tsp

salt, iodized (sodium chloride), 1/4 tsp

multivitamin & mineral tablet, kids complete, 1 each

zinc, 100 mg tablet, 1/2 tablet

The total kcal as prepeared = 920 kcal, the daily requirement of a 37lb adult neutered dog. Uneaten food can be refrigerated for 3 days or frozen indefinitely while checking for spoilage.

I regret that my state veterinary board of examiners doesn't allow me to communicate with customers by phone in this venue. Please stay in this conversation if you wish.