I feel sort of strange sending this note to "the world."
But I'm happy to report that Max's urine was without
crystals this morning.

Max, our 6.5 yr-old Havanese, had previously had surgery
to remove calcium oxalate stones from his bladder. He
eventually was put on a low-oxalate diet, formulated by a
veterinary nutritionist (http://www.petdiets.com/). The
diet was supplemented with potassium citrate to keep his
urine alkaline. In December his urine had a PH of 8 and
struvite crystals were evident.

Today, the urine had a PH of 7.4 and no crytals were
evident. Since his previous test, I had been gradually
reducing the amount of potassium citrate we added to his
diet. Max weighs about 18 lbs and a little over .035 gms
of potassium citrate, administered before bed seems to work.

Based on Max's weight, our veterinarian had originally
recommended 500 mg, twice a day. On the second
administration of 500 mg, Max vomitted and defecated!
Obviously, the "standard dose," based on body weight, was
much too high.

It took me months to find the "right" dose. Part of the
problem in finding an appropriate dose is the phenomenon
called "hysteresis": much time may pass between changing
the level of a treatment and its effect. For Max this meant
that over a week would have to pass between alterting the
dose and his urine PH stabalizing.

The vet asked me how I managed to measure .035 gms.

First, I kept on cutting the 1000 mg tablet into smaller
and smaller pieces. (About 1/8 of a tablet was the smallest
unit I could break off.) Eventually, I drilled a small hole
into a piece of plastic (an old toothbrush) that contained
about 1/2 of the volume of potassium citrate tablet that I
had been using (1/8 of a 1000 mg tablet). I then started
crushing the tablets and pouring the cystals into this
small hole. Later, I estimated the weight of crystals that
could fit into this small whole and a smaller whole about
half the size of the original whole. I did this by filling
up the wholes ten times with the crystals and weighing the
resultant amount with a precise electronic scalee and
dividing the value by 10. I eventually went from the large
whole, to the small whole, to increasing the size of the
small whole with an X-Acto knife.

I administered the potassium citrate at night because I
found Max's urine PH to follow a circadian rythym: it was
most acidic at 5:30 AM and became more alkaline as the
day passed. Right now, on this dose, his urine PH is
about 6.8 at 5:30 AM and increaes to about 8 at 11:00 PM.
The veterinary nutritionist recommended that his urine
PH be kept above 6.8.

Thanks for your interest!

--Marshall

Excellent!!!
Time, Patience and Perserverance will accomplish all things.

In article diddy
writes:

Hurray!! terrific job on your part Marshall.

Thanks Diddy.

Interestingly, my vet assumes that calcium oxalate urolith recurrence is
hard to prevent. In contrast, Diane Remillard, of www.petdiets.com, assumes
that if you can prevent the crystals then you can prevent the stones.

In fact, she was upbeat when last December only struvite crytals
were detected in Max's urine. Why? It is the rare dog who
has had calcium oxalate uroliths that then develops struvite
uroliths!

--Marshall

In article WFa0c.5222$Pc.479@okepread02 "Steve Crane" writes:

Excellent!!!
Time, Patience and Perserverance will accomplish all things.

Steve, thanks for the kind words AND all your advice and help but your
comment is hyperbolic.

For example, does this mean that Walter could convince you of using the BARF
diet??

--Marshall

In article diddy writes:
I had excellent results with Dr Remillard with Danny's diet also. She built
Danny a natural diet about 4 years ago.

Diddy,

What problems did Danny face?

--Marshall

(Marshall Dermer) wrote in
:

In article diddy
writes:
I had excellent results with Dr Remillard with Danny's diet also. She
built Danny a natural diet about 4 years ago.

Diddy,

What problems did Danny face?

--Marshall


total Mucosal stripping of his stomach
combined with a pyloric valve reconstruction and stomach reconstruction.
He was reacting with EVERYTHING that went in. And he could only tolerate
foods that had been strained through cheescloth before eating.And for
months he could only eat a tablespoon of food every two hours around the
clock.
Anything that didn't pass cheesecloth straining, even if it was the size of
rice, got immediately rejected in projectile vomiting.

The problem was that he was reacting to everything as an allergy because
his stomach was so raw.
And they needed some healthy flesh to operate, and he had none.
They went in several times weekly and sucked 300 cc's of blood out of his
stomach.
Getting a balanced diet in him that still passed the cheesecloth test
proved futile, and many of the nutrients she proposed, his system outright
rejected.

But she kept him alive until finally there WAS some healing.
And then Science Diet released ZD/ULTRA which we soaked until liquid, and
forced through cheesecloth, and because of the shortened protien chains,
even though these were substances that he had previously reacted to, he
couldn't because the protiens had been altered.


His first REAL steps towards recovery was once Hills Science Diet was able
to provide him with a diet he could eat completely without reacting.
Dr Remillard kept him alive until we got lucky. ZD/Ultra came not a moment
too soon.

In article diddy writes:
]] What problems did Danny face?
]]
]] --Marshall
]]
]
]total Mucosal stripping of his stomach
]combined with a pyloric valve reconstruction and stomach reconstruction.
]He was reacting with EVERYTHING that went in. And he could only tolerate
]foods that had been strained through cheescloth before eating.And for
]months he could only eat a tablespoon of food every two hours around the
]clock.
]Anything that didn't pass cheesecloth straining, even if it was the size of
]rice, got immediately rejected in projectile vomiting.
]
]The problem was that he was reacting to everything as an allergy because
]his stomach was so raw.
]And they needed some healthy flesh to operate, and he had none.
]They went in several times weekly and sucked 300 cc's of blood out of his
]stomach.
]Getting a balanced diet in him that still passed the cheesecloth test
]proved futile, and many of the nutrients she proposed, his system outright
]rejected.
]
]But she kept him alive until finally there WAS some healing.
]And then Science Diet released ZD/ULTRA which we soaked until liquid, and
]forced through cheesecloth, and because of the shortened protien chains,
]even though these were substances that he had previously reacted to, he
]couldn't because the protiens had been altered.
]
]
]His first REAL steps towards recovery was once Hills Science Diet was able
]to provide him with a diet he could eat completely without reacting.
]Dr Remillard kept him alive until we got lucky. ZD/Ultra came not a moment
]too soon.

Wow! Such a story!!

How is Danny doing now?

How are you doing??

--Marshall

"Marshall Dermer" wrote in message
...
In article WFa0c.5222$Pc.479@okepread02 "Steve Crane"
writes:

Excellent!!!
Time, Patience and Perserverance will accomplish all things.

Steve, thanks for the kind words AND all your advice and help but your
comment is hyperbolic.

For example, does this mean that Walter could convince you of using the
BARF
diet??

--Marshall

Oh indeed, even that might be possible, remote though it seems. The
combination of ex cop and scientist makes me the original cynic. But even I
may be persuaded - if some peer reviewed published studies came along that
showed some positive advantage. The "Time, Patience, & Perseverance will
accomplish things" is part of the third degree lecture. It has helped many
times when frustration was the meal of the day. Of course getting old helps
in that regard as well. :-)) I have commented to my wife recently that I
have noticed my own patience is much different today than it was when I was
25 or 30 years old. Today I have much more patience than I used to have for
children and for people learning new skills and new tasks. On the other hand
my patience for people who damn well ought to know better has nearly
vanished, perhaps I can find some more of that version eventually.

In article diddy
writes:
How is Danny doing now?
Danny turns 14 in May

Great!! Such a heart warming story!



How are you doing??
I'm poor

Veterinary bills? :-) I don't think vets running a small animal
practice become financially wealthy.

I actually took pictures of him yesterday at the playground
http://aad.lomag.net/diddy/dogs/DanBridge.html

Such a handsome boy and so many beautiful thumbnails!

Thanks Diddy,

--Marshall

In article uVt0c.6343$Pc.2791@okepread02 "Steve Crane" writes:

Today I have much more patience than I used to have for
children and for people learning new skills and new tasks. On the other hand
my patience for people who damn well ought to know better has nearly
vanished, perhaps I can find some more of that version eventually.

Steve, this may be a repeat post because earlier I was having trouble with
my ISP.

Years ago, I gave up assuming that people have free will. Although
I don't assume that predetermination is true, I do assume that
behavior is completely determined by genetic endowment, history
of interaction with the environment, and current circumstances.

So, many times I find behavior to be troublesome but I don't
explode at the behavior.

--Marshall