Treatment: Reimplantation surgery (extramural) or laser removal (intramural)
REFLEX DYSSYNERGIA
Active contraction of detrusor muscle without relaxation of internal or external urethral sphincter
Large male dogs
Diagnosis:
Normal initial voiding then narrowed urine stream, spurts of urine, dribbling as walks away, difficult to express bladder but easy catheterization (functional urethral obstruction)
Neurological exam
Treatment:
Intermittent catheterization to keep bladder small
Dissolved in 8-10 weeks but continue diet for at least 1 month after calculi not visible on rad (dog) or maintain on acidifying diet lifelong (cat, Hill’s c/d)
Not effective if UTI persists or if ureterolith/nephrolith
Contraindications:
Restricted protein: pregnant/lactating, growing, after surgery
High salt: CHF, hypertension, nephrotic syndrome
High fat: pancreatitis in Miniature Schnauzers
Prevention: water consumption to keep USG below <1.020 (dog) and <1.045 (cat)
Removal:
Cystotomy vs. voiding urohydropulsion (stones < urethra, females, NOT male cats)
Prevention
Increase water intake to keep USG below <1.020 (dog) and <1.045 (cat)
Struvite:
RC Urinary S/O or Hill’s c/d lifelong in cats (not in dogs because underlying cause is UTI)
Calcium Oxalate:
Canned food, RC Urinary S/O EXCEPT Schnauzers
If hyperlipidemic → RC Low Fat S/O Index (canned)
If not hyperlipidemic → RC Urinary S/O Moderate Calorie
Hill’s w/d
Potassium citrate 40-75mg/kg PO q12h
Hypercalcemic cats: high fiber diet, vitamin B6 2mg/kg PO q24h, hydrochlorothiazide 1-2mg/kg PO q12h
Human Food:
Acceptable:
Vegetables: cabbage, cauliflower, mushrooms, green peas, radishes, white potato