A dog that cannot urinate or has trouble urinating is a veterinary emergency and should be seen immediately by a veterinarian. Owners may not recognize inappropriate urination in the house as a disease symptom, mistaking it as a behavioral issue. Once a veterinarian has diagnosed the disorder as bladder or kidney stones, potassium citrate may be recommended for treatment.
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Function
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Potassium citrate is an oral medication that alkalizes the urine of dogs who have, or who are at risk for, bladder or kidney stones (uroliths). These stones form when a natural protein in urine called nephrocalcin, which prohibits the formation of calcium oxalate crystals, becomes defective or abnormal. An excess of calcium in the blood, called hyperkalemia, is also a factor in dogs that develop this particular type of stone. At this time, surgical removal is the only option to rid dogs of calcium oxalate uroliths, but potassium citrate can prevent further formation of stones in dogs that are predisposed to them.
Considerations
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Calcium oxalate crystals predominantly form in middle-aged male dogs, five to 12 year of age. Small breeds such as shih tzus, miniature schnauzers, Yorkshire terriers, miniature poodles and bichon frises are at especially high risk to develop them. Dogs whose diets are high in animal protein show a higher propensity to form calcium oxalate crystals. Animals with Cushing's Disease, a metabolic disorder that can cause an increase in blood calcium, are also prone to these types of stones.
Disease Symptoms
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Dogs with bladder or kidney stones will often have trouble urinating or may urinate inappropriately due to a partial blockage of the urethra. The owner may see them straining in the house or yard with little result. There will often be blood in the urine and an increase in urinary tract infections. In extreme cases, the urethra may become totally blocked, resulting in uremic poisoning and kidney failure. Without veterinary treatment, the dog will become lethargic, go into shock and ultimately die.
Considerations
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Dogs with calcium oxalate stones must undergo surgery to remove them. A veterinarian will often want to take radiographs prior to surgery to determine the location of the stones. After surgery, the stones will need to be tested in a laboratory to determine their chemical make-up to aid in future treatment. Dogs will often be placed on a protein-restricted diet, such as Hill's Prescription U/D or K/D. Treatment also includes prophylactic antibiotics and use of potassium citrate tablets to prevent formation of more stones. The veterinarian will probably recommend periodic check-ups with blood work to check potassium levels and radiographs to make sure the uroliths have not returned. They may also want to screen for any metabolic condition that may have exacerbated the problem. If the dog is on prednisone or another steroid, or furosemide, a diuretic mostly used in heart conditions, the veterinarian may want to discontinue these medications, as they are conducive to an increase in blood calcium and further formation of crystals.
Warning
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Toxicity from high potassium levels in the blood can be deadly to the animal; the reason follow-up blood work is necessary. It can result in a slower heart rate and muscular weakness, with heart failure possible. Potassium citrate tablets, which are usually given twice a day, can cause nausea and possible stomach irritation. A veterinarian should be contacted immediately if any of these symptoms occur.
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