SUMMARY:
ROYAL
CANIN Veterinary DietTM/MC canine URINARY
SOTM/MC (canned) and URINARY SO 13TM/MC
(dry) are complete and balanced diets for adult dogs formulated to aid
in the management of canine lower urinary tract disease. These diets have
been designed to ensure the production of urine that is undersaturated
with respect to struvite and which have a level of calcium oxalate saturation
at which spontaneous homogeneous crystallization will not occur.
INDICATIONS:
|
CONTRAINDICATIONS: |
| -- |
Dogs with or at risk of
developing canine lower urinary tract disease |
-- |
Growing
puppies |
| -- |
Dissolution of struvite uroliths |
-- |
Pregnant or lactating bitches |
-- |
Struvite urolithiasis prevention |
-- |
Dogs with pancreatitis or hypertriglyceridemia |
-- |
Calcium oxalate prevention |
-- |
Concurrent use of urinary acidifiers
|
-- |
Brushite prevention |
|
|
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RATIONALE:
Most veterinary diets for managing lower urinary tract disease in dogs
are designed exclusively for managing canine struvite urolithiasis. Canine
struvite uroliths are most commonly associated with microbial urease activity
due to a concomitant urinary tract infection. Urolith formation relies
on a favorable urinary pH (i.e., pH > 6.6). The current recommendation
for managing canine struvite urolithiasis, therefore, involves eradicating
the underlying urinary tract infection through the use of antibiotics
while concurrently feeding a diet designed to maintain slightly acidic
urine.
The management of calcium oxalate urolithiasis
is far more challenging. In humans, calcium oxalate uroliths can form
in urine across the full range of normal pH values (i.e., pH 4.8 to 7.4).
Urine pH manipulation cannot be used to reliably manage calcium oxalate
urolithiasis, nor is the restriction of dietary calcium and oxalate effective
in preventing oxalate urolith formation. The desire to develop diets which
effectively manage both struvite and calcium oxalate urolithiasis in pets
led Waltham to explore more complex research
methods for predicting urolithiasis risk.
The predominant urolith in humans is calcium oxalate.
More than 30 years ago, human urologists began looking at ways of predicting
the risk of calcium oxalate urolith formation in human patients. The result
was the development of a research methodology known as Relative SuperSaturation
(RSS). This methodology involves the analysis of 12 constituents of a
collected urine sample and determination of urine pH. These data are analyzed
using a computer program which calculates the concentrations of the large
number of possible interactive complexes between all ions present in this
urine. Finally, the program calculates the activity product of the urine
sample for a given urolith and divides this number by the known constant
thermodynamic solubility product for that urolith to determine RSS. If
the sample’s activity product for a given urolith type is less than
the constant, the RSS < 1.0 and the urine is "undersaturated"
for that urolith.
Although more complicated than the historical approach
of simply assessing urine pH, RSS is a much more powerful tool which is
now considered the gold standard for urine assessment in humans. Its value
derives from the fact that a single value incorporates all parameters
which influence the likelihood of a urolith forming: urine pH, urine dilution,
all relevant urine constituents, and the possible interactions between
them. RSS is a single value which can be used to describe the efficacy
of a given diet in managing urolithiasis in pets.
Using
RSS to assess the risk of struvite urolith formation in dogs:
| If a diet has
an RSS for struvite of: |
The urine produced by dogs
fed that diet is said to be: |
And the
risk for struvite urolith formation is: |
Less than 1.0 |
Undersaturated |
- New struvite uroliths will not form
- Existing struvite uroliths will dissolve
|
Between 1.0 and 2.5 |
Metastable |
- New struvite uroliths will not form
- Any existing struvite uroliths will not dissolve and may grow
|
Over 2.5 |
Oversaturated |
- New struvite uroliths may form
- Any existing struvite uroliths will grow
|
Using
RSS to assess the risk of calcium oxalate urolith formation in dogs:
| If
a diet has an RSS for calcium oxalate of: |
The
urine produced by dogs fed that diet is said to be: |
And
the risk for calcium oxalate urolith formation is: |
Less than 1 |
Undersaturated |
- New calcium oxalate uroliths will not
form
- Existing calcium oxalate uroliths will
not grow
|
Between 1 and 12 |
Metastable |
- New calcium oxalate uroliths will not
form
- Any existing calcium oxalate uroliths
may grow
|
Over 12 |
Oversaturated |
- New calcium oxalate uroliths may form
- Any existing calcium oxalate uroliths
will grow
|
The table below provides some important
RSS values for struvite and calcium oxalate:
| To
achieve the following: |
Choose
a diet which has an: |
To
avoid the risk of the alternative urolith, this diet should also
have an: |
| Dissolve pure struvite
uroliths |
RSS for struvite < 1.0 |
RSS for calcium oxalate < 12 |
| Minimize the risk of struvite
uroliths |
RSS for struvite< 2.5 |
RSS for calcium oxalate
< 12 |
Dissolve calcium oxalate uroliths |
It is not physiologically possible to dissolve calcium oxalate uroliths.
They must be removed surgically. |
| Minimize the risk of calcium
oxalate uroliths |
RSS for calcium oxalate
< 12 |
RSS for struvite < 2.5 |
Urinary Relative SuperSaturation (RSS)
values for struvite and calcium oxalate in dogs fed URINARY SOTM/MC
(canned) and URINARY SO 13TM/MC (dry):
| |
ROYAL CANIN Veterinary DietTM
canine URINARY SOTM/MC |
ROYAL CANIN Veterinary DietTM
canine URINARY SO 13TM/MC |
| |
Canned |
Dry |
| RSS for struvite |
0.134 +/- 0.011 |
Ask your sales representative* |
| RSS for calcium oxalate |
2.37 +/- 1.95 |
Ask your sales representative* |
| |
|
*Not available at time of print. |
URINARY SOTM/MC (canned) and
URINARY SO 13TM/MC (dry) are the only
diets clinically proven to aid in the management of both struvite and
calcium oxalate urolithiasis in dogs.
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Special
Tips:
| 1. |
URINARY SOTM/MC (canned)
and URINARY SO 13TM/MC
(dry) are designed to increase water intake in the dog increasing
the volume and frequency of urination. It is important to counsel
owners to expect changes in drinking and urination behavior and to
make sure they understand that these changes are desirable and beneficial
for their dog. |
| 2. |
Fresh water should be readily available and owners should be prepared
to offer their dog more frequent opportunities to urinate. |
| 3. |
While female dogs typically empty their bladders completely when
they urinate, male dogs often urinate small amounts at a time keeping
a reservoir available for marking territory. This means that urine
can stay in the bladder longer increasing the opportunity for uroliths
to form. It may help with male dogs to take them for a walk before
going to work or bed allowing them to completely void their bladders.
|
| 4. |
URINARY SOTM/MC (canned) and URINARY
SO 13TM/MC (dry) are designed to
undersaturate the urine for struvite, thereby promoting the dissolution
of existing pure struvite uroliths (in conjunction with the administration
of antibiotic therapy where appropriate). |
| 5. |
URINARY SOTM/MC (canned) and URINARY
SO 13TM/MC (dry) will reduce urinary
calcium oxalate RSS values to help reduce the risk of recurrence of
calcium oxalate uroliths after existing uroliths have been completely
surgically removed. |
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REFERENCES:
Stevenson
AE, Hynds WK, Markwell PJ. The relative effects of supplemental dietary
calcium and oxalate on urine composition and calcium oxalate relative
supersaturation in healthy adult dogs. Res Vet Sci 2003;75:33-41.
Biourge V, Iben
C, Wagner E, et al. Does increasing dietary NaCl affect blood pressure
in adult healthy dogs. Proceedings 12th ECVIM-CA/ESVIM congress, Munich
September 2002, p 153.
Robertson WG, Jones
JS, Heaton MA et al. Predicting the crystallization potential of urine
from cats and dogs with respect to calcium oxalate and magnesium ammonium
phosphate (struvite). J Nutr 2002;132:1637S-41S.
Robertson WG, Jones
J, Heaton MA, et al. Predicting the calcium oxalate and magnesium ammonium
phosphate crystallization potential of dog and cat urine. Waltham International
Symposium - Pet Nutrition coming of Age - Canada. 24. (2001).
Schwendenwein I,
Iben C, Wagner E, et al. Effect of increasing dietary NaCl on fractional
electrolyte clearance. Proceedings of 5th ESCVN Conference. Sursee, Switzerland.
2001, p 93.
Smith BHE, Hynds
W, Markwell PJ. Ex vivo canine struvite stone dissolution. J Vet Intern
Med 2001;15(3):301.
Stevenson AE, Hynds
W, Markwell PJ. Effect of dietary sodium on urine composition of healthy
miniature schnauzers J Vet Inter Med 2001;15(3):300.
Stevenson AE, Markwell
PJ. Comparison of urine composition of healthy Labrador retrievers and
miniature schnauzers. Am J Vet Res 2001:62:1782-6.
Markwell PJ, Stevenson
AE. Nutritional management of canine urolithiasis WALTHAM Focus. 2000;10:10-13.
Stevenson AE, Markwell
PJ, Kasidas GP. Preliminary data from quantitative analysis of canine
urolithiasis in Great Britain. IXth International Symposium on Urolithiasis,
2000
Stevenson AE, Wrigglesworth
DJ, Markwell PJ. Dietary sodium chloride, urinary calcium and urinary
oxalate in healthy adult dogs .IXth international Symposium on Urolithiasis,
2000, 794-796.
Stevenson AE, Blackburn
JM, Markwell PJ. Dietary Management of Calcium Oxalate Urolithiasis in
Dogs. J Vet Intern Med 2000;14:383.
Stevenson AE, Markwell,
PJ, Kasidas GP. Quantitative analysis of canine uroliths within Europe
in 1999. J Vet Intern Med 2000;14:383.
Stevenson AE, Wrigglesworth
DJ, Smith BH, et al. Effects of dietary potassium citrate supplementation
on urine pH and urinary relative supersaturation of calcium oxalate and
struvite in healthy dogs. Am J Vet Res 2000;61:430-5.
Stevenson AE, Smith
BH, Markwell PJ. A system to monitor urinary tract health in dogs. J Nutr
1998;128:2753S-57S.
Stevenson AE, Smith
BHE, Markwell PJ. A system to monitor urinary tract heath in dogs. J.
Nutr 1997;128(12S): 2761S-2762S
Smith BHE, Buffington
CA, Markwell PJ. Comparative species urine pH data. J Vet Intern Med 1996;10:189.
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