Yorkie with Struvites

Question
My yorkie just had surgery to remove 7 large struvite stones.  She is 5 lbs.  She has always had dry food, wet canned food and people food mixed together for meals.  The vet has prescribed straight Hills c/d.  Oh yes, and I have a maltese that eats at the same time she does.   Anyway, I know she will not eat straight dog food.  Can I give her the Hills and mix it with people food to get her to eat it?  She only eats meat & cheese - doesn't like eggs, and is a very picky eater.  I am looking for ways to get her to eat this - clearly she has to change her diet.  Suggestions on what to add to this dry food are much appreciated!!v6

Answer
Hello and I am so sorry that it took me soooo long to get back to you. I've just moved and I am swamped with things to do, obviously. I also have three little dogs that don't deserve to be neglected (never!) and well, I am just a little overwhelmed so forgive my lateness.

I found this on internet and am sending along for your perusal. Obviously by now you know tons about your pups stones etc. except for diet and I have a WONDERFUL REFERRAL FOR YOU with that and I PRAY you follow thru as you will never look back. So, read the following and then write to:
DoniaSea@aol.com. Identify yourself by using my name, SUSAN BEHLMAR, AND she will then know how you found her. She does not charge. She adores animals. She's brilliant with diets for dogs and well you will just have to find out for yourself. So many of my friends now write to her and no one has a single bad thing to say. She is marvelous. You will get dietary help. OK? She is the CEO of a supplement company out West and yes she is going to recommend supplements for your little one but you would have to get these anyway if you are going to cook for your dog (and I hope you will though RAW is the best they say--I lightly steam and do not feed raw)since even light steaming removes the necc. enzymes.

I could advice you here with my limited knowledge of stones but I would prefer that you contact Donia with all of your information and then, if you would, get back to me. Ok? My email is: DazzlinDaawg@aol.com. My dogs names are DixieCup, Buddy and Henry--the boys are rescues...from mean and cruel people not an organization.  Make sure you dog is drinking tons of water...as much as you can get into her.

You are not going to be to do anything quickly particularly if she won't eat dog food (smart dog LOL). Dog food is crap but sometimes necessary to get our little loves out of the woods. I am using a crap food right now with my YOrkie male who has serious IBD. i HOPE TO GOD IT'S NOT FOREVER.

Anyway, write to Donia and DO GET BACK TO ME. iN THE MEANTIME, here is something I found on the net and I hope you don't mind that I sent it. Bye now and again, I apologize for this delay in getting back to you. Susan

If your dog has struvite stones, he has a bladder infection. He doesn't need a special diet and he doesn't need his urinary pH adjusted. He needs his infection diagnosed and treated.

(To be perfectly accurate, there is a condition known as "sterile" or "metabolic" struvites that occurs very, very rarely in the dog. This condition isn't just a zebra, however; it's a unicorn. I'll say more about it later on.)

Why do dogs with urinary tract infections have struvite stones? Why do they so often have alkaline urine?

The urine becomes alkaline for the same reason the stones form: Because the urease-producing bacteria that usually cause canine UTIs produce magnesium, phosphate, and ammonium as waste products. The urine becomes super-saturated with these waste products. Add it all together, shake well, and you have struvite stones. It was once believed that the alkaline urine "caused" struvite stones, but that doesn't appear to be the case. Rather, it's now believed they are caused by the same thing, the bacterial waste products. In fact, sometimes struvite stones are called "triple phosphate" or "M.A.P" for "magnesium, ammonium, phosphate."

Should you acidify the urine of a dog with struvite stones to dissolve the crystals?

This is sort of like cutting the wire to the "check engine" light instead of fixing the engine. Diagnose and treat the bladder infection and the urinary pH will resolve naturally.

Won't acidifying the urine kill the bacteria?

That's a very common belief, expressed quite often on holistic email lists, but it's not true. While many bacteria don't like acid mediums, some do. More to the point, it's impossible to get bodily fluids and tissues acid enough to actually kill bacteria. There are bacteria that can live in vinegar (in fact, without some of them we wouldn't have vinegar). And as fast as you are acidifying the urine, the bacteria are in there alkalinizing it. The solution is to diagnose and treat the bladder infection. (Are you sensing a theme here?)

OK, how do you diagnose and treat a bladder infection?

To diagnose a bladder infection, you need to perform a test known as a urine culture. This should be done in combination with a sensitivity test to determine what antibiotics will be effective against the bacteria. It's helpful also to do a urinalysis, but you cannot diagnose a bladder infection, nor effectively treat it, with urinalysis alone.

A urine culture and sensitivity test will take about three days to run. If the dog has obvious symptoms, it's not unreasonable to begin antibiotic therapy before the results are known, as long as the urine sample is obtained before giving antibiotics. Antibiotics present in the urine will prevent bacteria from growing in the culture. Once the sensitivity results are in, if the chosen antibiotic was not appropriate, you can switch at that point.

Be absolutely sure to give your dog the entire prescribed course of antibiotics, as stopping the treatment too soon can create drug-resistant infections that are almost impossible to treat. If your dog has side effects from the antibiotics, even if the symptoms are gone, contact your vet instead of just stopping the drug.

But there were bacteria in the urinalysis, so why can't we just go ahead and treat without doing the culture and sensitivity?

A lot of vets do this, some because that's what they've always done and some because the clients won't pay for the extra testing. But this isn't a good idea for a number of reasons.

One, sometimes some other kind of debris is mistaken for bacteria. A properly obtained urine sample is less likely to have debris that is hard to differentiate.

Two, you can't tell what bacteria they are, so you have no real idea if you're choosing an effective antibiotic.

Three, if therapy fails, you won't really know what to do next. Was it the wrong antibiotic? Is this a new infection with a different organism? Is the problem something other than an infection?

Four, a culture done before, and again after, treatment gives you a yardstick to measure the success of your therapy.

My dog's urine culture was negative, but he has struvite stones. Does he have "sterile struvites"?

He might. He might also have an infection with a bacteria that doesn't grow in the culture that was used, or he might be infected with a bacteria that grows in tissue rather than urine. You can request a special, separate culture for mycoplasma/ureaplasma. If that, too, is negative, you can consider doing a biopsy of the bladder wall. However, at that point, many vets will instead put the dog on a trial of a drug effective against mycoplasma/ureaplasma, as a bladder wall biopsy is a very invasive test.

But yes, your dog might in fact have sterile struvites, in which case your vet's recommendation of a special diet and urinary acidification will be right on track. But those things are not appropriate for the vast, overwhelming majority of struvite stone cases, which are caused by infections that need to be diagnosed and treated.

My dog doesn't have struvite stones and he doesn't have a bladder infection, but he has struvite crystals. What should I do? Does he need a special diet?

If he has no symptoms and no stones and no infection, you don't need to do anything. Perfectly healthy dogs often have struvite crystals in their urine, and sometimes they will form due to the way the urine is handled. This finding is not significant.

Do I have to use antibiotics? Can't I treat the infection and stones with herbs and diet, even if acidifying the urine isn't enough?

There is no diet that will help treat a bladder infection, although of course proper nutrition will help a dog be more disease resistant in general. There are herbs that can help treat a bladder infection. Some of them are very potent, and are also powerful diuretics. Other, gentler herbs are also used in treating UTIs. Use them only as recommended by your qualified holistic vet, preceded and followed by a urine culture to make sure your treatment worked, just as you would do with antibiotic therapy. Don't cut corners and don't try to treat this on your own.

How can I dissolve the stones after I get the infection treated?

Most of the time, the stones will dissolve on their own once the infection is gone. If not, you can use urinary acidification or special diets temporarily to dissolve the stones. The commercial prescription diet S/D, formulated to dissolve struvites, is not intended for longterm feeding so should be discontinued when the stones are gone. Very rarely, surgery is necessary to remove the stones.

My dog gets infections over and over again. What causes that?

Your dog might not be getting infected over and over again; he might have one infection that is never fully eradicated. Doing a culture and sensitivity, then repeating the culture after treatment is finished, should clarify that situation.

However, some dogs have structural defects or other medical problems that cause them to suffer recurrent bladder infections. Other dogs have had surgical procedures such as a urethrostomy, which can make them more susceptible to bladder infections. Conditions such as Cushings also increase the incidence of bladder infections. Owners of dogs who suffer recurrent UTIs should ask their vet to refer them to an internal medicine specialist or veterinary college for an in-depth workup.