Evidence cluster — dietary management of struvite uroliths in dogs (peer-reviewed, Europe PMC + PubMed)

Representative peer-reviewed studies (verbatim abstracts)

The following studies were retrieved from Europe PMC / PubMed and are reproduced verbatim. Interpretive synthesis is left to the API user.

PMID:41742526 — Outcomes of medical dissolution for suspected struvite uroliths in dogs using a therapeutic multipurpose urinary diet and antimicrobial therapy.

Source: J Vet Intern Med 2026
J Vet Intern Med. 2026 Jan 21;40(1):aalaf061. doi: 10.1093/jvimsj/aalaf061.

Outcomes of medical dissolution for suspected struvite uroliths in dogs using a therapeutic multipurpose urinary diet and antimicrobial therapy.

Toillion AR(1), Gilyot S(1), Lulich JP(2), Furrow E(2).

Author information: (1)Hill's Pet Nutrition, Inc., Topeka, KS 66601, United States. (2)Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, St. Paul, MN 55108, United States.

BACKGROUND: The consensus recommendation is to medically dissolve suspected struvite uroliths in dogs. However, more data is needed on outcomes for protocols using therapeutic multipurpose urinary foods formulated for both struvite urolith dissolution and calcium oxalate urolith prevention. HYPOTHESIS/OBJECTIVES: To describe outcomes for medical dissolution of suspected struvite uroliths in dogs using a therapeutic multipurpose urinary food and concurrent or recent antimicrobial therapy. ANIMALS: Thirteen client-owned dogs with suspected struvite uroliths. METHODS: Single-institution, retrospective case series (observational) of dogs fed a therapeutic multipurpose urinary food for dissolution of suspected struvite uroliths. Dogs had to be treated with antimicrobials concurrently or have an absence of bacteriuria on urine microbial culture after recently completed antimicrobial therapy. Follow-up abdominal imaging was required. Patient and urolith characteristics, dissolution outcomes, and complications were summarized. RESULTS: Complete urolith dissolution occurred in 9 (8 with cystoliths and 1 with nephroliths) of 13 dogs included in the study. Mean time until documentation of complete dissolution was 71 ± 52 days. Eight of the dogs with complete dissolution had bacteriuria less than 60 days prior to urolith diagnosis. Mean duration of antimicrobial therapy for dogs with successful dissolution was 66 ± 49 days. All dogs without complete dissolution had uroliths with non-struvite shells (composed of 80%-100% calcium). No dog developed a urethral obstruction during the dissolution trial. CONCLUSIONS AND CLINICAL IMPORTANCE: Struvite uroliths can be effectively dissolved in dogs with a therapeutic multipurpose urinary food and antimicrobial therapy. A non-struvite urolith layer is a common cause of unsuccessful dissolution.

DOI: 10.1093/jvimsj/aalaf061 PMCID: PMC12881935 PMID: 41742526

Conflict of interest statement: Alyssa R. Toillion is employed by Hill’s Pet Nutrition, Inc. Selena Gilyot is a former employee of Hill’s Pet Nutrition, Inc.

Abstract (verbatim excerpt):

JOURNAL:J Vet Intern Med 2026

J Vet Intern Med. 2026 Jan 21;40(1):aalaf061. doi: 10.1093/jvimsj/aalaf061.

Outcomes of medical dissolution for suspected struvite uroliths in dogs using a therapeu

PMID:41001835 — In Vivo Radiographic Characteristics Associated With the Mineral Composition of Calcium Oxalate, Struvite, and Cystine Lower Urinary Tract Uroliths in Dogs.

Source: J Vet Intern Med 2025
J Vet Intern Med. 2025 Nov-Dec;39(6):e70252. doi: 10.1111/jvim.70252.

In Vivo Radiographic Characteristics Associated With the Mineral Composition of Calcium Oxalate, Struvite, and Cystine Lower Urinary Tract Uroliths in Dogs.

Pulido Vega D(1), Motteau-Lévêque M(2), Maurey C(3), Mortier J(1).

Author information: (1)Service of Diagnostic Imaging, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France. (2)École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France. (3)Service of Internal Medicine, École Nationale Vétérinaire d'Alfort, INRAE, ANSES, UMR Virology, Laboratoire de Santé Animale, Maisons-Alfort, France.

BACKGROUND: Identifying urolith mineral composition (UMC) is crucial for treatment and prevention; however, current data rely on macroscopic or ex vivo studies. OBJECTIVES: To describe in vivo radiographic characteristics of canine lower urinary tract (LUT) uroliths and identify discriminating radiographic features among UMC types. ANIMALS: Two hundred and two dogs with LUT uroliths composed of ≥ 70% calcium oxalate (n = 109), struvite (n = 58), or cystine (n = 35). METHODS: Retrospective cross-sectional study. Radiographs were evaluated for urolith size, shape, surface, borders, internal architecture, and quantitative radiopacity, and also assessed using a ratio of urolith-to-L5 vertebra pixel values (UOR). The diagnostic performance of urolith size and UOR was assessed with receiver operating characteristics (ROC) curves, calculating the area under the ROC curve (AUC). RESULTS: Calcium oxalate uroliths were often highly radiopaque, associated with concurrent nephroliths, had unique shapes such as bosselated or spiculated, and less commonly ovoid. Struvite uroliths were larger (median: 15 mm; IQR: 8.1-25.8 mm) with a cut-off of ≥ 11 mm (AUC = 0.82, p < 0.001; specificity: 91%, sensitivity: 67%) and were associated with pyramidal shapes or solitary cystoliths. Cystine uroliths had lower radiopacity (median UOR: 0.71; IQR: 0.63-0.80), with a cut-off of UOR ≤ 0.83 (AUC = 0.81, p < 0.001; specificity: 67%, sensitivity: 84%). CONCLUSIONS AND CLINICAL IMPORTANCE: In vivo radiographic characteristics such as size, shape, and radiopacity can help differentiate LUT mineral compositions, enabling non-invasive diagnosis and guiding treatment.

DOI: 10.1111/jvim.70252 PMCID: PMC12464727 PMID: 41001835 [Indexed for MEDLINE]

Conflict of interest statement: Authors declare no off‐label use of antimicrobials. The authors declare no conflicts of interest.

Abstract (verbatim excerpt):

JOURNAL:J Vet Intern Med 2025

J Vet Intern Med. 2025 Nov-Dec;39(6):e70252. doi: 10.1111/jvim.70252.

In Vivo Radiographic Characteristics Associated With the Mineral Composition of Calcium Oxalat

PMID:40293168 — Association of Diet and Calcium Tartrate Tetrahydrate Uroliths in Dogs.

Source: J Vet Intern Med 2025
J Vet Intern Med. 2025 May-Jun;39(3):e70093. doi: 10.1111/jvim.70093.

Association of Diet and Calcium Tartrate Tetrahydrate Uroliths in Dogs.

Lulich J(1), Koehler L(1), Ulrich L(1), Furrow E(1).

Author information: (1)Department of Veterinary Clinical Sciences, University of Minnesota, College of Veterinary Medicine, Falcon Heights, Minnesota, USA.

BACKGROUND: Calcium tartrate tetrahydrate (CTT) uroliths are recently identified in dogs. OBJECTIVES: To report on the types and prevalence of diets, supplements, and medications containing salts of tartaric acid consumed by dogs with CTT urolithiasis. ANIMALS: Sixty-three client-owned dogs identified with CTT uroliths from a single urolith analysis laboratory. METHODS: Retrospective case series evaluating dogs with CTT uroliths and their prevalence of consuming diets, supplements, and medications containing salts of tartaric acid before diagnosis of urolithiasis. RESULTS: Dogs with CTT uroliths were predominantly male (53/63, 84%) small purebreds (48/63, 76%). Thirty-three of 63 cases provided additional information by completing our survey. In 25 of 33 (76%) cases, a source of tartaric acid was identified in diets, supplements, or medications. In 24 of these 25 cases (96%), the source of tartaric acid was choline bitartrate. CONCLUSIONS: When investigating a cause for CTT uroliths in dogs, consider diets and supplements containing choline bitartrate as a potential source of urolith components.

DOI: 10.1111/jvim.70093 PMCID: PMC12035869 PMID: 40293168 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no conflicts of interest.

Abstract (verbatim excerpt):

JOURNAL:J Vet Intern Med 2025

J Vet Intern Med. 2025 May-Jun;39(3):e70093. doi: 10.1111/jvim.70093.

Association of Diet and Calcium Tartrate Tetrahydrate Uroliths in Dogs.

Lulich J(1), Koehler L

PMID:39368059 — Medical dissolution of presumptive upper urinary tract struvite uroliths in 6 dogs (2012-2018).

Source: J Vet Intern Med 2024
J Vet Intern Med. 2024 Nov-Dec;38(6):3095-3104. doi: 10.1111/jvim.17204. Epub

2024 Oct 5.

Medical dissolution of presumptive upper urinary tract struvite uroliths in 6 dogs (2012-2018).

Manoharan SA(1), Berent AC(1), Weisse CW(1), Purdon K(1), Bagley D(2).

Author information: (1)Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York, USA. (2)Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

BACKGROUND: Minimally invasive approaches are the standard for treatment of upper urinary tract uroliths in humans. OBJECTIVE: To describe the medical dissolution of upper urinary tract uroliths in a series of dogs and report clinical outcomes. ANIMALS: 6 female dogs (9 kidneys). METHODS: Retrospective case series. A review of medical records in dogs that underwent medical dissolution of upper urinary tract uroliths utilizing diet, administration of antibiotics, and double-pigtail ureteral stent(s) placement, when indicated, was performed. Medical management was generally continued for 4 weeks beyond urolith dissolution. Information on biochemical, microbiological, imaging, and clinical outcomes before and after dissolution were recorded. RESULTS: Six dogs (9 kidneys) were included with bilateral (3) or unilateral (3) nephrolithiasis, ureterolithiasis, or a combination. A ureteral stent(s) was placed endoscopically in 5/6 dogs (6/9 kidneys) for obstructive ureterolithiasis (n = 5) or a nonobstructive massive nephrolith (n = 1). All dogs had a positive urine culture of Staphylococcus pseudintermedius with a median urine pH of 7.25 (range, 6.5-8) and 4/5 had pyonephrosis. All dogs had initial evidence of urolith dissolution at a median of 1.1 months (range, 0.42-5.9), with complete dissolution of ureteroliths at a median of 3.9 months (range, 1.5-7.6), nephroliths at 5.3 months (range, 1.5-7.6), and lower urinary tract uroliths at 0.87 months (range, 0.42-5.9). Stents were removed in 3/6 once dissolution was documented. The median follow-up time was 519 days (range, 177-2492 days). CONCLUSION AND CLINICAL IMPORTANCE: Medical dissolution and decompression of upper urinary tract struvite uroliths should be considered a minimally invasive treatment for dogs before more invasive options.

DOI: 10.1111/jvim.17204 PMCID: PMC11586565 PMID: 39368059 [Indexed for MEDLINE]

Conflict of interest statement: Authors declare no conflict of interest.

Abstract (verbatim excerpt):

JOURNAL:J Vet Intern Med 2024

J Vet Intern Med. 2024 Nov-Dec;38(6):3095-3104. doi: 10.1111/jvim.17204. Epub

2024 Oct 5.

Medical dissolution of presumptive upper urinary tract struvite uroliths i

PMID:41630760 — Comprehensive diagnostic evaluation of urolithiasis and cystitis in K9 dogs in Iraq: Clinical, laboratory, and imaging correlates.

Source: Open Vet J 2025
Open Vet J. 2025 Nov;15(11):5926-5935. doi: 10.5455/OVJ.2025.v15.i11.47. Epub

2025 Nov 30.

Comprehensive diagnostic evaluation of urolithiasis and cystitis in K9 dogs in Iraq: Clinical, laboratory, and imaging correlates.

Aldujaily AH(1), Abeed SA(2), Ameer NAHA(3).

Author information: (1)Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Kufa, Kufa, Iraq. (2)Department of Animal Production, Al-Furat Al-Awsat Technical University, Kufa Technical Institute, Kufa, Iraq. (3)Department of Pharmacy, Al-Furat Al-Awsat Technical University, Kufa Technical Institute, Kufa, Iraq.

BACKGROUND: Urolithiasis and cystitis are major contributors to urinary tract morbidity in dogs, particularly in working K9 units. Due to overlapping symptoms, proper differentiation is crucial. AIM: This study aimed to assess the clinical, hematological, biochemical, microbiological, and ultrasonographic parameters of urolithiasis and cystitis in Iraqi police dogs. METHODS: A total of 45 K9 dogs aged 3-10 years, including 10 healthy controls, 5 with urolithiasis, and 11 with cystitis (acute/chronic), were assessed at Al-Najaf's K9 unit, Iraq. Hematological, biochemical, urinalysis, microbiological testing, and abdominal ultrasonography were performed for clinical evaluation. Statistical analysis included analysis of variance and LSD test (p < 0.05). RESULTS: Dogs with urolithiasis exhibited abdominal pain, dysuria, hematuria, and urinary retention. Hematologically, they showed reduced RBC counts and hemoglobin levels alongside increased WBCs, neutrophils, and platelets. Biochemical analysis revealed elevated levels of total protein. Urinalysis revealed proteinuria, hematuria, and calcium oxalate/struvite calculi. Ultrasound confirmed hyperechoic bladder stones with acoustic shadowing. Patients with cystitis presented with dysuria, pollakiuria, stranguria, and periuria. Abdominal palpation revealed distended bladders, especially in the female patients. A significant increase in body temperature (p < 0.05) was noted. Hematological findings included elevated TLC, neutrophils, monocytes, band neutrophils, platelets, and ESR. Biochemical analysis showed increased urea, creatinine, and total protein levels. Urinalysis revealed acidic urine pH (6.2 ± 0.05). Microbiological culture (n = 26) isolated Escherichia coli (57.69%), Staphylococcus spp. (34.61%), Pseudomonas aeruginosa (15.38%), and other less common pathogens. Ultrasonography revealed bladder wall thickening, corrugation, and hyperechoic luminal content. CONCLUSION: Multimodal diagnostic protocols enable precise differentiation between dogs with urinary tract diseases. The results recommend routine checkups in K9 units for health maintenance and early diagnosis.

DOI: 10.5455/OVJ.2025.v15.i11.47 PMCID: PMC12861450 PMID: 41630760 [Indexed for MEDLINE]

Conflict of interest statement: All authors declare that there is no conflict of interest.

Abstract (verbatim excerpt):

JOURNAL:Open Vet J 2025

Open Vet J. 2025 Nov;15(11):5926-5935. doi: 10.5455/OVJ.2025.v15.i11.47. Epub

2025 Nov 30.

Comprehensive diagnostic evaluation of urolithiasis and cystitis in K9 dogs in

PMID:40104003 — Retrospective study of 353 confirmed cases of urolithiasis in dogs and cats treated at veterinary clinics in the northern region of Pará, Brazil.

Source: Braz J Vet Med 2025
Braz J Vet Med. 2025 Mar 13;47:e005624. doi: 10.29374/2527-2179.bjvm005624.

eCollection 2025.

Retrospective study of 353 confirmed cases of urolithiasis in dogs and cats treated at veterinary clinics in the northern region of Pará, Brazil.

da Silva WC(1)(2), Rocha BCA(2), Castro SV(3), Belo TS(2), Sousa CEL(2), Serruya FJD(1), Camargo-Júnior RNC(3).

Author information: (1)Departamento de Medicina Veterinária, Centro Universitária da Amazônia (UNAMA), Santarém, PA, Brazil. (2)Departamento de Medicina Veterinária, Instituto Federal de Educação, Ciência e Tecnologia do Pará, Santarém, PA, Brazil. (3)Centro Universitário Católico do Tocantins, Palmas, TO, Brazil.

Urolithiasis is the third most prevalent disease of the urinary tract of dogs and cats, and is characterized by presence of crystals and / or formation of stones. The present study objective was to report the confirmation rate of suspected cases of urolithiasis in dogs and cats treated at veterinary clinics in the city of Santarém, Pará. A retrospective cohort study was carried out from the database of medical records from six veterinary clinics from the years 2012 to 2023. Dogs and cats were evaluated for clinical suspicion, species, age, breed, feeding type, diagnosis, location of the urolith and type of urolith. As the data did not present a normal distribution, they were submitted to the Chi-square test and Fisher's exact test. The analyses were performed using Statistical Analysis Software (SAS), considering a 5% significance level. Of the 532 files analyzed of suspected cases, 353 were confirmed. The percentage of cases in cats (72.23%) was higher than in dogs (55.37%). The age range between 2 and 5 years was the period when it had more confirmed cases and most of the uroliths were found in the urinary vesicle, both in dogs and cats. It was concluded that there was a high index of confirmed cases of urolithiasis in dogs and cats, being superior in this last species. In addition, in both species are more affected animals between 2 and 5 years of age, being more common the location of uroliths in the bladder.

Publisher: Urolitíase é a terceira doença mais prevalente do trato urinário de cães e gatos, e é caracterizada pela presença de cristais e/ou formação de cálculos. O objetivo do presente estudo foi relatar a taxa de confirmação de casos suspeitos de urolitíase em cães e gatos atendidos em clínicas veterinárias da cidade de Santarém, Pará. Foi realizado um estudo de coorte retrospectivo a partir do banco de dados de prontuários de seis clínicas veterinárias dos anos de 2012 a 2023. Cães e gatos foram avaliados quanto à suspeita clínica, espécie, idade, raça, tipo de alimentação, diagnóstico, localização e tipo do urólito. Como os dados não apresentaram distribuição normal, foram submetidos ao teste Qui-quadrado e teste exato de Fisher. As análises foram realizadas por meio do Statistical Analysis Software (SAS), considerando um nível de significância de 5%. Dos 532 prontuários analisados de casos suspeitos, 353 foram confirmados. O percentual de casos em gatos (72,23%) foi maior que em cães (55,37%). A faixa etária entre 2 e 5 anos foi o período em que houve mais casos confirmados e a maioria dos urólitos foi encontrada na vesícula urinária, tanto em cães quanto em gatos. Concluiu-se que houve alto índice de casos confirmados de urolitíase em cães e gatos, sendo maior nesta última espécie. Além disso, em ambas as espécies são mais acometidos animais entre 2 e 5 anos de idade, sendo mais comum a localização dos urólitos na bexiga.

DOI: 10.29374/2527-2179.bjvm005624 PMCID: PMC11912946 PMID: 40104003

Conflict of interest statement: Conflict of interests: No conflict of interest.

Abstract (verbatim excerpt):

JOURNAL:Braz J Vet Med 2025

Braz J Vet Med. 2025 Mar 13;47:e005624. doi: 10.29374/2527-2179.bjvm005624.