Calcium Oxalate Bladder Stones in Dogs; Prevent the Recurrence

calcium oxalate bladder stones in dogsSo your dog is urinating blood, whining and trying to pee on every bush in your front yard. Oh well, it’s probably a UTI or he is just having a bad day and you hope it all just goes away. Well, lots of times, if it is just a UTI, it will go away. However, many times these problems don’t go away because dogs with these symptoms commonly have bladder stones. This article discusses how to prevent the recurrence of calcium oxalate bladder stones in dogs.

Bladder stones in dogs are complicated as there are many different types that develop for many different reasons. For more questions and the latest research on the different types of stones and treatment, check out the Minnesota Urolith Center. This is the lab where I send stones for analysis.

So fast forward and say we have a diagnosis of stones and the stones have been surgically removed. Now, not all stones have to be removed surgically, but for the sake of this article, lets pretend they are. After removal, these stones should be sent to the Minnesota Urolith Center for identification. This is mandatory! If you don’t know the type of stone, then you don’t know how to prevent the recurrence. Fast forward again and lets pretend we have a diagnosis and identification of the type of stone and it is a Calcium Oxalate bladder stone.

Calcium oxalate bladder stones in dogs are unfortunately very common. We see them frequently in dogs of all ages, breeds and sizes; however, the typical patient is frequently a small breed dog (Shih Tzus, Toy Poodles, Schnauzers and Yorkies) somewhere around the age of five with a male-to-female ratio of 3:1.

Prevention of Recurrence/Lifestyle Changes

You will get hundreds of recommendations on how to prevent these stones from coming back. Unfortunately, some dogs no matter what you do have repeat episodes within three years. The following is what I recommend to my clients after surgical removal:

Monitoring

  1. Urinary ph with strip; should be around 6.5 to 7.5; purchase these at drugstore
  2. Blood Chemistry to monitor calcium once yearly by veterinarian
  3. X-ray of bladder once yearly to look for recurrence

Western Medicines

There are multiple Western Medicines that can be used and I will tell you only what I initially recommend .

  1. Potassium or Calcium Citrate- People debate over what is better and there is really no difference
  2. Vitamin B6 tablets
  3. PSGAG injection- If dogs concurrently have arthritis, I recommend this therapy. Why?  There is some belief that PSGAG prohibits minerals from sticking to the bladder wall.

Herbals

I also recommend one or the other.

  1. Crystal Stone Formula by Jing Tang Herbal
  2. Lysimachia-3         

Lifestyle Changes

I recommend all of these.

  1. Increase water consumption! This is vitally important. I don’t know the best way to increase water consumption but I can offer you some ideas such as always have clean, fresh distilled water available, setting out multiple water bowls and adding water flavoring agents. You will have to experiment with flavoring agents but some dogs like tuna, beef and or peppermint flavoring. Adding salt to the diet is controversial and I would not recommend.
  2. Multiple bathroom breaks!
  3. Dietary change! There are two ways to do this! You can either feed a prescription veterinary diet for CaOx uroliths, feed a specialty pet food, or feed a home-prepared diet. If you feed a homemade diet, I advise having a veterinarian develop the diet. Pulling a diet off the internet is not advisable! Keep dietary oxalates low! Most specialty pet foods are low in oxalates and a suitable diet for dogs with CaOx uroliths.
  4. Do not feed a kibble based dry food diet. My belief is that kibble based diets keep dogs slightly dehydrated (1-2%) and this leads to concentrated urine and thus concentrated urinary minerals. Feed canned food especially to a small dog.  If you must feed kibble, add water to the food and heat it before serving.
Dr. Marc Smith (98 Posts)

Dr. Marc Smith is a practicing veterinarian in Nashville, TN and Franklin, TN. His areas of specialty include: Traditional Western Medicine, Acupuncture, Herbal Medicine, Chiropractic and Prolotherapy. He is also co-creator of Pet-Tao Pet Foods, the only commercially available pet food combining Western nutritional science with Eastern Food Therapy. Chat with Dr. Marc Smith on | Google+ | LinkedIn | Facebook


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29 Comments

  1. My bichon frise just had her second struvite surgery in one year she was on hill’s s/d for 30 days when I took a sample of urine in she had oxalate crystles is there anything I can do besides give her 30 more days of hill’s s/d which she
    detests.

    • Hi Phyllis -- Thanks for writing! I am a little confused on the time frame of the surgeries and when you used the SD diet. Hills SD is a dissolution diet, only to be used for three months and only for dissolving struvite stones.
      After that time you switch to a different diet. I have seen this before and if you could tell me and be more specific on the time frames and such I may be able to answer your question more appropriately. Thanks, Marc Smith DVM

  2. Peisan says:

    My dog had surgery to remove 1 calcium oxalate stone in April 2013. Just last week, the xray showed that he has 3 stones (around 3 mm). He is now on u/d wet food and seems to be working well for him.

    The vet recommended surgery which i know is necessary but i wish we can avoid having it.

    Do you recommend that we take x ray once a month to check the ‘status’?

    Thank you.

    • I would say no to x-raying on a monthly basis. As a general rule, calcium oxalate stones do not dissolve with dietary therapy. Because they do not dissolve with diet change, the best option is to try and Eastern herbal medicine if you want to make any attempt to avoid surgery. Unfortunately, calcium oxalate can be a tough disease. You need to verify that the stones or crystals coming out of the urine now are, indeed, oxalate crystals. More times than not, the stone content can change to struvite depending on the dietary therapy chosen.

  3. Bill says:

    My bichon frise had calc ox stones removed in Jan 2013. She had been ob hills ud for the prior year because crystals were detected in her urine. After surgery the vet switched her to Royal Canin SO dry and crystals were again present. He recommended to switch to canned Royal Canin SO. Another test revealed less crystals and by fluke I found they also had the SO in a moderate calorie morsels in gravy. She loves it and its real wet. I have been giving that for about 7 months with a sprinkle of the dry SO and so far no recurrence. Now the past few days she was acting like she was having trouble jumping up on the couch as when she got the stones before so I quit adding any dry kibble. She is acting better. I just received my Lysimachia-3 and started giving her 1/2 of a 70g pill per day. Any further direction is appreciated.

    • Bill says:

      Okay,10.5 lb bichon “Jolene” has had an X-ray and urinalysis yesterday. She has what appears to be a tiny stone maybe two. Could they have been larger just prior to adding the Lysimachia-3? She is acting better jumping up okay and not lifting the right leg when she walks such as last week. So I have added the following to her feedings which is twice a day: 1/4 13oz can of Royal Canin SO/Morsels In Gravy, I drizzle a bit of olive oil, 180 mg of potassium citrate, 50mg vit B6, 700 mg Lysimachia-3, sprinkle of pro-biotic, sprinkle of benefiber, and really loosen the gravy with distilled water. Her BM after eating tonight was loose but not messy. Less olive oil perhaps. I have found that rinsing the food can with distilled water and putting it in her water dish she gulps it so the matter of her not drinking water is going to be okay now. Praying the stones will pass. Any comments ideas suggestions are very welcome.

  4. Christina says:

    My 1 year old Mini Schnauzer had a calcium Oxalate stone removed when he was only 9 months old. Six months after his surgery we checked his PH levels and he was still low; 6.5. He has been on Royal Canin SO since the surgery. He went in yesterday to get his yearly ultrasound to make sure he was clear of stones, and there say 3 more stones in his little bladder. His PH levels were great; 7.0, no blood in the urine, and no white blood cells either. I don’t understand how all of that can be perfect, yet he still has 3 stones inside of him? The Vet recommended the Distilled water, so I changed that as of yesterday. The ONLY thing I have ever given him treat wise after his surgery is a rawhide. He’s a 1 year old puppy, and I didn’t feel that the occasional rawhide would override the strict SO diet he’s on. He also is in doggy daycare where he may be getting an occasional treat here and there which I have warned the daycare NOT to do.
    At this point the Vet does not want to operate on his 3 stones because he says he’s already had one surgery, and to open him up again is very risky. Is this true? I’ve read of dogs have multiple surgeries to remove bladder stones. For now, I’m watching him like a hawk and if he shows any signs of distress, I will rush him in and make them do the surgery. Is there ANYTHING I can do to try to help these stones pass? He eats mainly the canned SO because he isn’t much of a water drinker (part of his problems). He’s only 1 year old as I said, I don’t want my baby to have to battle this all his life. I’ve been so strict with his diet, I was in a state of shock when they told me he had 3 more (the same size as the 1 he already had removed).

  5. Calcium Oxalate stones do not always read the book. I think your veterinarian gave you good advice not to pursue surgery right now. Although the stones will not dissolve, two surgeries before 2 years old is not real good either. Sorry you are battling this issue. The good news is that “yes” you can operate on the bladder several times without cause for concern. I would probably go back to the vet in a few months for recheck and maybe x-ray to make sure no new stone development. Also, you may want to try “Crystal Stone Formula,” an Eastern herbal medicine by Jing Tang herbal. You can read more about Crystal Stone Formula at http://franklintnvet.com/cystitis-and-stones-in-dogs-cats-and-horses/

    -Marc Smith, DVM

  6. Sheila says:

    Hello Dr. Smith,

    I found your site by searching on “Jing Tang concentrated crystal stone” and I am quite surprised and happy to read about your protocol and treating of crystals / stones for dogs. Great information!

    I believe the Jing Tang concentrated crystal stone capsules have helped our 12 year old shih-tzu, “Beau”. However, we are still in treatment with two local doctors, one western, one holistic, to ensure Beau’s health and wellness. I am curious, what you recommend when the lab test returned shows the stones to be “ammonium urate” stones? I’ve posted our story on the above link to my blog.

    We appreciate any additional advice you may offer here.

    • Hey Sheila,
      Thanks for your question! First, you must rule out liver disease. Urate stones are often associated with liver shunts. This may not be the case in your dog, but you need to know. After this, the following are my recommendations:
      1. Feed canned food or add water copiously to dry food.
      2. Feed low protein and less biologically available protein diet. Stay away from by-product meals and organ meats such as liver, kidney and spleen. Consider egg, dairy, whey proteins and even rice.
      3. Add salt to the diet to promote diureses. This is debatable but i recommend.
      4. Check ph and use modifiers if needed such as potassium citrate.
      5. Consider allopurinol depending on situation.
      5. Frozen bananas as treats or stay away from any treats.

  7. Debbie says:

    Hi Dr Smith,

    I just stumbled across your website and I am so happy to have found your article!

    My 11 year old, 80 pound male, black lab/border collie mix (Rocky) had 2 dozen CaOx stones surgically removed from his bladder last June. Only 3 of those stones were detected on x-ray. The rest were very small and the vet was surprised to find so many. The stones were sent to the lab after removal, so I’m sure they were CaOx. Rocky has also battled with UTI’s for the last several years and has hip dysplasia.

    Rocky’s been on dry Royal Canin Urinary SO since last June, and I switched to distilled water at the same time. I’ve also been giving him 200 mg of B6 daily. After reading your article, I’m going to mix more water in with the dry food and also purchase the wet, canned food too.

    I noticed a little blood in Rock’s urine 2 weeks ago. Brought a urine sample in to the vet and sure enough he had another UTI. He just finished the antibiotic prescription and I’ll be bringing him in for an xray in a few days, along with another urinalysis.

    I wanted to purchase the Crystal Stone Formula that you recommended, however the website will only allow a licensed vet to log in. Is there another website I can buy the formula from? Also, of the two (Lysimachia-3 and Crystal Stone formula) which do you prefer? Is one better than the other? Can you recommend a reputable place to buy Lysimachia-3?

    Have you heard of this product -- http://www.onlynaturalpet.com/products/Only-Natural-Pet-Chinese-Herbal-Blends-Bladder/999215.aspx

    Finally, I don’t want to put Rock through another surgery, so I am willing to try anything to keep him healthy!

  8. David says:

    Jan 2014 Bladder stones and diet change

    We had a lot of trouble with bladder stones ( Calcium Oxalate) with our Hannah (a Cairn terrier) including an instances of acute retention which could have killed her, but a change of diet to a bland and natural one seem to solve the problem on a life long basis. Most vets seem to favour a change of diet.

    For a description of Hannah’s problems and details of her case history please see --

    https://sites.google.com/site/caninebladderstones/

    If the link does not work then just copy and paste the address into the http:// address bar at the top of your screen.

  9. Giselle says:

    Hi Dr. Smith, im giselle from argentina and my 7 year old miniature shnauzer has been recently diagnose with oxalate stones. We made him an ultrasound and found 2 stones with moderate size. Since in my country we are not able to find Hills c/d diet or Royal canin urinary food, im making his food every day, but i would like to have a proper diet (actually im prepearing boiled chicken breast, with rice, boiled pumpkin and carrots). Im a litle bit concern that im might be missing nutrients in his food. Could you please help me with a homecook diet for my dog? Also as a biologist i would like to know more about giving him distilled water (isnt it bad to drink that kind of water can him loose minerals with it?), now with the wet diet he is not drinking much from the fountain so i might increase the amount of water in the food right?
    Thank so very much in advance!

    • Replace the chicken with turkey, preferably turkey breast. You need to supplement calcium. You can accomplish this by giving a whole egg daily with shell included or give a Tums tablet that can be bought at local pharmacy. Give distilled water as this limits the amount of unnecessary minerals often found in regular water that can contribute to stone formation.Also add some water to the food and make it like soup. If you want me to formulate a total diet, it will take some time and i would need other information about your pet’s ailment. thank you and i hope this helps!!

  10. Daphanie says:

    My dog Jasmin will be 10 yrs in Feb. Took her to the vet a week ago for incontinence, vet done a UA and found calcium crystals. I am so confused at this point because the focus has changed from why I went to the crystal’s in the urine. Are the crystal’s the cause on the incontinence? By changing her diet to the prescription food is that going to take care of the issue that?

  11. Jacqueline says:

    Hi Dr. Smith,

    I have a 6 year old Ocherese (maltese/peekapoo mix) who was diagnosed with a portosystemic shunt and has been developing calcium oxalate stones. He just had his second surgery to remove a stone yesterday and before that had surgery 2 1/2 years ago. He has been on Hill’s prescription k/d diet for several years now for the PSS. My vet is considering putting him on the Royal Canin SO diet for the stones but I am worried from everything I have read. I am considering doing a home diet and possibly adding the herbs you suggest, but want to make sure he is getting all the nutrients he needs. Any suggestions??? He only weighs 6 lbs 8 ounces.

    Thanks,

    Jacqueline

    • I think you need to decide what problem is most important. Are the issues with PSS more of a concern or are the issues with urinary stones more of a problem. It will be tough to treat both issues at the same time in the best fashion. How do you know there is a PSS? Have there ever been any clinical signs associated with the shunt. If “yes,” then i would stay away from a home cooked diet. If “no”, then I might consider. MY choice might be to acidify the urine with diet or with supplements, monitor the urine for infection, and see how that works for both issues.

  12. Julie says:

    Hi Dr. Smith
    I have a 10 year old terrier about 14 pounds. He has had two surgeries most recently in December 2012 for calcium oxalate stones. The vet has recommended Hills UD about a year now. Ever since he has been on this food, he has really bad skin issues..itchy scaly. The vet has prescribed prednisone, which if I don’t give him daily, he is miserable. I hate giving him this medication. I truly believe it is the food. The vet insist that it is not..I trust my vet, I have been using them for 20 years, but I was wanting to know if a homemade diet would make a difference. I want to try but I want to be sure that I am giving him the correct amounts of what he needs. I have done some research on homemade diets. I want to be sure this would be the right thing to do. Any help would be greatly appreicated :)

    • Hard to say for sure! Prednisone may increase Calcium in the urine leading to increased formation of Calcium uroliths. You may have to decide which problem, the itching or stones, is most important and treat accordingly. Home cooked diets can and do help many ailments; however, they are time consuming to prepare and somewhat more expensive. An easier option may be the Pet-Tao harmony diet, antihistamines and a real low, every other day dose of prednisone. If you want or prefer a homemade diet, I would recommend you get your veterinarian or a qualified person to advise you and formulate the diet.

  13. Julie says:

    Thank you for your prompt response! I will definitely take all this into consideration as I try and decide what to do.

  14. Gina says:

    Hi Dr. Smith! My cocker spaniel was just diagnosed with having CaOx crystals in his urine. Our vet put him on the urinary prescription diet and of course because my dog is the pickiest eater on the planet, he hates the food and won’t eat it. I’ve decided to make homemade dog food for him, if that will keep him healthy I don’t mind, but I’m not sure what “recipe(s)” to use, what proportions, added supplements, ect… I have lists of foods low and high in CaOx, so I have a general idea of what to include, but do I feed him a raw diet? My vet didn’t have any nutritional advice for me. I basically would like some recipes or meal plans to follow. Do you know where I may find them specific for CaOx?? Thank you! :)

    • Thank you for contacting me!! Sorry about your issue and I will see if i can help. How old is your dog and how much does he/she weigh?
      Specifically, I would recommend a diet low in oxalates. You can search the internet and find foods low in Oxalate content. Concerning supplements, I would use what I recommend on my blog post. Also, depending on your dog’s age, you may want to add a vitamin. If you dog is over three, you can add whole egg shells every other day and this can take the place of a vitamin.
      Concerning recipes, I do not have a place to send you directly that is credible. I wish i did. I would do a search and use low oxalate foods. Mix foods in a 60-20-20 ratio meaning 60% protein 20% carbs and 20% fat. As far as volume to feed, I would need to know the weight of your dog sex, age breed, and whether or not spayed/neutered. I hope this helps. If you want me to put together a specific diet, I would be happy to do that. It just takes some time and research and I will have to charge you for that. I do frequently put together home cooked diets for people. Another option if you decide not to home cook but want a good food is pettao.com.

      • Gina says:

        Thanks for your response!! I appreciate it :) I have searched for foods low in oxalates, I just didn’t know what proportions to feed him so this info will help! He is only a 2 year old cocker spaniel, poor little guy! I’ll check out supplements you suggest. Thank you so much for your help!

  15. Noelle says:

    Hi Dr. Smith,
    I am at a loss as to what to feed my dog! I have 7 year old neutered Basenji-mix (40 lbs). He has a variety of health issues including Addison’s Disease (managed with monthly DOCP injections and daily prednisone), food sensitivities, and recently had surgery to remove CaOx stones from his bladder. His vet put him on prescription food, but he does not like it. He was previously on Taste of the Wild, loved it, and was doing quite well on it. I am so disappointed in the prescription food ingredients and now am at a loss as to what to do. I would like him to be on a food with a quality protein and no corn. I have been researching the ingredients in OTC food and am hoping to find one that will be suitable for all of his issues. I was surprised to see that some ingredients listed on the prescription foods were on a list of high-oxalate foods! I could really use some advice. Does a diet change really make a difference if my dog is likely to develop stones again because of the prednisone? Thanks so much for your time, I know there is an answer out there somewhere!

    • I would follow all the advice on my blog post concerning the medications/supplements to use when a dog has been diagnosed with calcium oxalate stones. Also, since you are using prednisone, i think you should diligently follow my recommendations.concerning food, I would try one of the Pet-tao diets and use an herbal medicine called Bladder Damp heat. If you have other questions, please ask!!

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