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임상세미나
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1.Patient - Gogo McNeely
Weight -11.4kg
Species -Canine
Breed -Miniature Schnauzer
Age -7 yrs old
Sex ?CM
Chief complaint -Hematuria
Case history - Pollakisuria over the last week
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Physical examination and Lab findings
1.Unremarkable physical and rectal examination
2.During Cystocentesis, three 2-3cm hyperechoic densities were found and cystic calculi are strongly suspected.
3.Urinalysis ; moderate calcium oxalate crystalluria
PH 6.0
USG 1.045 (high margin)
4.Blood work ; serum calcium was unremarkable
5.Surgery went well,
Stones were made of “100% calcium oxalate “
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Recommend Nutritional Therapeutic Diet
Q1. Which therapeutic diet would you recommend for Gogo and Why?
Based on a surrogate end-points
Changes in urine concentration of calcium
2…(생략)
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not clear
but lower protein diet → Ca excretion ↑ Citrate ↓
( chlelates Ca → soluble salt )
and higher protein diet → diuresis ↑
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Traditional Nutritional Recommendations
Increasing water intake to dilute urine calcium and oxalate
Sodium chloride restriction has been recommended which is based on the hypothesis that minimizing natriuresis would minimize hypercalciuria
Calcium & Phosphorus restricted because when dietary Ca is restricted, It was considered that urinary Ca will also be decreased
Reduced dietary level of Protein content for relieving kidney’s burden
Reduced oxalate precursors such as spinarochi
Q2, Traditional nutritional recommendations were made to decrease the risk of calcium oxalate urolithiasis recurrence, what are four of them and what are their proposed mechanisms.
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Brand-new Nutritional Recommendations
Q3. What are r
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