Struvite Crystals

[Kolya]

Hi there, I have a mysterious affliction affecting my 18 month old Airedale.

Yesterday afternoon I noticed he was crying when he peed and wasn't able to cock his leg without pain. I took a urine sample to a friend who is a vet nurse. She rang back and told me it was full of struvite crystals, no blood or white blood cells and that he has a Ph of 9, which is at the top end. She told me I needed to take him to my vet ASAP due to the possibility of stones and that he would need prescription food from here on. She blames it on the "crap supermarket food" I've been feeding him. I made an appointment for the vet and they said they'd see him today.

So last night I fed him raw lamb and rice and gave him some yoghurt and a vitamin C tablet in the hope of alleviating it even a little. The next morning his flow was much stronger and he was once again able to cock his leg. I took him up to the vet and she took a urine sample for analysis and lo and behold found no crystals etc. and a normal PH. She couldn't feel any stones and everything in his rectum is AOK. She has prescribed Meloxicam for the next week to see how it goes.My dog is still uncomfortable after weeing (not during) and his flow is stronger than it was but still not up to his usual.

I dropped in on my friend, the vet nurse, later and she was staggered. She showed me the slide she'd made and sure enough it was full of crystals.

Does anyone have any idea what might be going on here? Can struvite crystals appear and disappear in the space of 24 hours?

If it's not crystals or infection (no white blood cells on either slide), any idea what might be causing his discomfort?

[juice]

could it be the crystals have gone back into the bladder? I didn't think they could dissolve that fast.

[schnauzer]

My rescue bitch had a bladder full of struvite stones, and one in each kidney. After urine analysis, she was x rayed which showed the stones. She had successful surgery and is now on CD diet.

Does your dog have a UTI? Maybe an X ray to diagnose and another urine analysis.

[~Anne~]

I doubt very much they could disappear overnight. In fact I'd pretty confidently say they couldn't.

A simple test you can do at home to see the presence of crystals is to get him to urinate on newspaper. Place the newspaper in the sun until it dries then hold it up to the light. If there are crystals, you will see the light glittering off the dried urine.

Someone has wrong or faulty test results. Could either test have been compromised? ie contaminated somehow?

If your dog is having trouble urinating I'd suggest the crystals are possibly large and causing a blockage. Either way he needs a retest and he needs the issue of painful or difficult urination to be resolved. Taking a sample directly from the bladder is the most accurate way to test.

[Rappie]

Does anyone have any idea what might be going on here? Can struvite crystals appear and disappear in the space of 24 hours?

It's difficult to make any conclusions based on the information here.

It's very easy to get 'excited' by the presence of crystals in urine but the context is a very important part of the interpretation. Crystals may be a feature of normal urine and are affected by a variety of other factors in stored urine including storage temperature, time from collection, pH and so on. While they may be a marker of underlying disease they are not a disease in themselves.

Struvite crystals in particular form from supersaturation of the urine with the various salts that are required for their formation, so they can appear in very well concentrated urine as a normal feature (and thus not be present in more dilute urine). They can also form as a result of bacterial infection and often the associated increase in urine pH.

The presence or absence of white cells, red cells and bacteria needs to be considered in teh context of urine concentration and clinical signs and the only way to rule out an infection is to take a sterile sample of urine from the bladder and culture it.

[CavsRcute]

This happened to my girl. I then gave her a cranberry tablet every day and when tested 2 weeks later, everything was back to normal

[Kolya]

Hey, all. Thanks for all your responses.

If the medication doesn't clear up whatever's ailing Archie, I'll get a urine sample for the vet and ask them to re-test (which they'll likely want to do anyway) and ask them for a culture this time. I would say xrays will also be on the cards. In the meantime I will definitely do the paper test. Thanks for the suggestion, Anne.

Re: Contamination - YES, there was undoubtedly contamination of the first sample that I collected. Arch peed on the garage floor as I was discussing his problem with my vet nurse friend on the phone. She said to try and get as much of it into a jar as possible and get it to her straight away, that getting off the garage floor wouldn't make too much difference if I could get enough of it. So improvising, and without syringe, i pushed quite a lot of it into a jar with a spatula (necessity is the mother of invention). After the other sample came back clear, I mentioned to her the possibility of contamination being the cause of the disparity in results and her response was that struvite crystals only come from one place, dog's urine, not off garage floors which seems a fair point.

It's an interesting point, Rappie, about struvites appearing in well concentrated urine but not more dilute - I wonder if that was a factor. My friend commented that it was a little dark and that he needed to drink more water while the vet described her sample only as "well concentrated". I took it as a compliment (lol!).

Cripes, Schnauzer, those stones look huge. Your poor girl! It must have been painful for her. I'm glad she's had them out and that the prescription food is doing its job as that may be Archie's future. I personally think he either has something akin to cystitis or some kind of obstruction in his bladder as sometimes after he sits/lies down he jumps back up like something's sticking into him and tries to find a more comfortable position. This can happen two or three times in a row. This may be evidence of a stone but it could also be his fur bothering his 'red rocket' which seems to be very sensitive. The vet wasn't able to feel any stones when she examined him. After urinating he rushes inside and promptly sits down to stop the irritation, which strikes me as being cystitis-like. If the medication doesn't settle him an x-ray and urine culture are next on the list.

Cavs, a very interesting comment re cranberry tablets. I am really tempted to try this and will mention it to my vet as a possible future couse of action should it reoccur and no other problem is found.

Because he's a male and runs the risk of a blocked urethra and fairly swift death, i would like him to have an xray just to make 100% sure he has no stones or large crystals in his bladder. His urine flow is much better today, back to normal, but he definitely still has discomfort. Hopefully the medication will start working in the next day or two but if not, I'm off to rob a bank just in case it's stones :) Will let you all know how it goes and thanks again for your thoughtful responses.

Edited January 18, 2014 by Kolya