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d,l-Methionine in combination with amoxicillin-clavulanic acid successfully dissolves spontaneously occurring
Amber S M Harris1, Joseph W Bartges1,2, Tamberlyn D Moyers2
11College of Veterinary Medicine, University of Georgia, Athens, GA.
Objective:
To determine the efficacy and safety of a urinary acidifier (d,l-methionine [Methio-Form]) and an antimicrobial agent (amoxicillin-clavulanic acid [Clavamox]) without changing diet for dissolving infection-induced struvite urocystoliths in dogs.
Animals:
14 dogs were recruited for this prospective study; 11 completed it and 3 dogs withdrew due to inability of the owners to administer the treatment (n = 2) or refusal of treatment by the dog (1).
Procedures:
All dogs were administered d,l-methionine (approx initial dose of 75 mg/kg, PO, q 12 h) and amoxicillin-clavulanic acid (22 mg/kg, PO, q 12 h) based on urine culture and sensitivity. Urine pH, urinalysis, urine culture, venous blood gas and serum biochemical analysis, and lateral survey abdominal radiographic images were evaluated initially and every 4 weeks until urolith dissolution (success) or lack of change in size and/or shape of urocystoliths on 2 consecutive reevaluation points (failure) occurred.
Results:
Uroliths dissolved in 8 of 11 dogs in a median of 2 months (range, 1 to 4 months) with a final effective dosage of d,l-methionine of approximately 100 mg/kg, PO, every 12 hours. In 3 dogs, uroliths failed to dissolve and were removed surgically; they contained variable amounts of calcium oxalate. No adverse events occurred.
Clinical Relevance:
Infection-induced struvite urolithiasis is 1 of the 2 most common minerals occurring in canine uroliths. Results of this study supported the use of d,l-methionine and amoxicillin-clavulanic acid without changing diet for dissolution of infection-induced struvite urocystoliths in dogs.
Insights
This study shows that d,l-methionine and amoxicillin-clavulanic acid effectively dissolve infection-induced struvite urocystoliths in dogs. The treatment was safe and did not require dietary changes, offering a new approach for canine bladder stones.
Area of Science:
- Veterinary Medicine
- Urology
- Pharmacology
Background:
- Infection-induced struvite urocystoliths are common in dogs.
- Dissolving these stones often requires dietary modification.
- Alternative medical treatments are needed.
Purpose of the Study:
- To evaluate the efficacy and safety of d,l-methionine and amoxicillin-clavulanic acid for dissolving struvite urocystoliths in dogs.
- To determine if these treatments can be used without altering the dog's diet.
- To assess the safety profile of this therapeutic combination.
Main Methods:
- A prospective study involving 11 dogs with infection-induced struvite urocystoliths.
- Dogs received d,l-methionine and amoxicillin-clavulanic acid based on urine culture and sensitivity.
- Regular monitoring included urine analysis, culture, blood gas, serum biochemistry, and radiography.
Main Results:
- Uroliths dissolved in 8 out of 11 dogs within 1 to 4 months.
- The effective dosage of d,l-methionine was approximately 100 mg/kg every 12 hours.
- No adverse events were observed during the study.
- Three dogs had uroliths surgically removed, which contained calcium oxalate.
Conclusions:
- d,l-methionine and amoxicillin-clavulanic acid are effective and safe for dissolving infection-induced struvite urocystoliths in dogs.
- This treatment regimen can be used without dietary changes.
- This approach offers a viable medical alternative for managing canine struvite urolithiasis.
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