Tiny stones in bladder, no crystals

Hi,

My cat had some blood in his urine and upon taking him to the vet there were no stones found on X-rays however tiny ones were spotted on ultrasound. The urinalysis was normal with no crystals, the pH of the urine was 6.5. The vet says that it lends to calcium oxalate crystals and surgery is required though Im doubtful of putting my cat through that on such scant evidence as 6.5 is a good normal number for cats. Should I get a second opinion or another urinalysis? Thank you.

Calcium oxalate stones can form in any pH although it is more common in more acidic urine (below 6.0). If they are calcium oxalate, surgery is the only option as they cannot be dissolved through diet.

Are you doubting that they are in fact calcium oxalate stones? Was the urinalysis sent to an outside lab? I suppose you could get another urinalysis done if you are doubting the diagnosis.

A second urinalysis would not be unreasonable since it is a relatively cheaper lab test and urine pH does fluctuate throughout the day. Make sure kitty is urinating, though! Urinating as in reasonable sized balls of clumped litter and not little dribbles. If kitty is not urinating you have an emergency and cannot wait for further urine tests. This is especially true if your kitty is male. If your kitty is male and he has a blockage you have only have about 12 hours to get them to the vet.

Here is a thread that discusses urine readings. Posts #3 and #5 say about what time urine readings would be the "truest."

http://www.thecatsite.com/t/252912/measuring-urine-ph

If the stones are calcium oxalate you do need surgery, as they cannot be dissolved like struvite stones.

What are you feeding your kitty? If you are feeding dry food, this makes the urine more alkaline and more conducive to struvite stones.

If you are feeding dry food, you should switch to a 100% wet food after testing and dealing with the stones. A wet food diet helps hydrate your kitty so that stones are less likely to develop.

Well the urinalysis was done on a sample that was obtained from the surface of the X-ray machine because he peed out of fear and so there can be multiple issues with that as exposure to air alone can change the pH. Also 6.5 is an ideal target range pH in cats and there were no crystals at all found in the urinalysis and otherwise it was normal as well as no hypercalcemia in the blood draw. So makes me doubt the diagnosis of calcium oxalate stones. He is peeing normally albeit a little reddish tint and sometimes outside the box. The stones were tiny as they were invisible on X-ray and only seen via ultrasound. Just not totally sure where to go from here. Have him on antibiotics and dibenzalyine for relaxing the urinary muscles.

I feed a combination of dry and wet food, more wet recently. He seems to drink a good amount as well. Also he is about 3 years old which makes him on the young side for oxalate stones.

Rob Bronstein said:

Well the urinalysis was done on a sample that was obtained from the surface of the X-ray machine because he peed out of fear and so there can be multiple issues with that as exposure to air alone can change the pH. Also 6.5 is an ideal target range pH in cats and there were no crystals at all found in the urinalysis and otherwise it was normal as well as no hypercalcemia in the blood draw. So makes me doubt the diagnosis of calcium oxalate stones. He is peeing normally albeit a little reddish tint and sometimes outside the box. The stones were tiny as they were invisible on X-ray and only seen via ultrasound. Just not totally sure where to go from here. Have him on antibiotics and dibenzalyine for relaxing the urinary muscles.

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Most of the time they'll be looking for an infection when they suspect UTI, so you should insist on a needle draw (cystocentisis). Not all cats with calcium oxalate stones have hypercalcemia.

Rob Bronstein said:

I feed a combination of dry and wet food, more wet recently. He seems to drink a good amount as well. Also he is about 3 years old which makes him on the young side for oxalate stones.

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If he were on all dry he would need to get about 1/2 cup of water a day through drinking at minimum and 1 cup to get the equivalent that wet food provides him. Please make sure he is getting adequate water, as this is important for other health issues as well.