Study to evaluate urinary calcium oxalate supersaturation in dogs with calcium oxalate stones

Evaluation of urine calcium to urine creatinine ratios and urinary calcium oxalate relative supersaturation in dogs with calcium oxalate uroliths and 1 month after beginning a calcium oxalate preventative diet

Christianna Ziccardi, DVM (UGA Internal Medicine Resident)
Joe Bartges, DVM, PhD, DACVIM, DACVN (UGA Internal Medicine faculty)
Bianca Lourenço, DVM, PhD, DACVIM-SAIM (UGA Internal Medicine faculty)

If interested please contact our Clinical Trials Coordinator Lisa Reno via email ([email protected]) or phone at 706-296-7818.

Study description:
Calcium oxalate (CaOx) stones account for approximately 45% of urocystoliths (bladder stones) in dogs. CaOx urocystoliths are not amenable to medical dissolution; therefore, if their presence is associated with clinical signs, they must be physically removed through surgery or interventional procedures. Although calcium oxalate preventative diets are available, they are not uniformly successful in reducing the reoccurrence of CaOx urocystoliths. There are currently no easily performed tests to monitor recurrence.

This study will evaluate two urine biomarkers used to assess the risk of CaOx formation (urinary relative supersaturation and urine calcium to urine creatinine ratio) at the time of CaOx stone removal and 4-6 weeks after consuming a CaOx stone preventative diet.

Inclusion criteria:

  • Dogs of any age, breed, sex, or body weight
  • Dogs with active calcium oxalate urocystolithiasis
  • Urocystolith (stone) removal by surgery, percutaneous cystolithotomy, cystoscopy and retrieval, cystoscopy and laser lithotripsy, voiding urohydropropulsion, or a combination of the above

Exclusion criteria:

  • Any clinically significant abnormalities on a biochemistry profile
  • Urocystoliths composed of minerals other than only calcium oxalate
  • Dogs with suspected or proven hyperadrenocorticism, hypercalcemia, renal disease, bacterial urinary tract infection, nephroureterolithiasis; or those receiving calcium, vitamin D, or vitamin C supplements, glucocorticoids, or diuretics

Prior to acceptance into the study, dogs must have a baseline physical exam, lab work (complete blood count, serum biochemical analysis, urinalysis), and abdominal imaging. Diagnostics must be suggestive of CaOx urocystolithiasis. In addition, dogs must undergo urocystolith removal with confirmed CaOx composition. Prior to urocystolith removal, a baseline first morning voided, catheter, or cystocentesis urine sample will be collected and submitted for study biomarker analysis. Dogs will be subsequently transitioned to a CaOx preventative diet. After 4-6 weeks on this diet, dogs will return for a recheck visit which will include another first morning urine sample for biomarker analysis, physical examination, serum biochemistry panel, blood ionized calcium concentration, urinalysis, and focused urogenital ultrasound.

The study will cover the cost of urine biomarker analysis, and recheck examination which will include visit fee, physical exam, serum biochemistry panel, blood ionized calcium concentration, urinalysis, and a urogenital ultrasound. Owners are responsible for costs associated with the initial examination and labwork, stone removal procedure, and food.

Duration of study:
This study is currently OPEN.

Potential benefits to veterinary medicine:
Results from this study may provide information regarding how dietary preventative therapy can impact urine chemistries and subsequent calcium oxalate stone formation and may provide an easy, inexpensive urine test for monitoring CaOx urocystolith preventative measures.

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