Surgical and Dietary Management of Struvite Cystolith in a Neutered Male Cat: A Case Report

Background: Struvite uroliths are one of the most common types of urinary stones in cats. They typically form when there are high concentrations of magnesium, phosphorus, and ammonium in urine that has become alkaline. Factors that contribute to this condition include dry food with high ash content, dehydration, obesity, and stress. This report describes how a struvite cystolith was diagnosed and managed in a neutered male Domestic Shorthair cat. Materials and Methods: Cystotomy was done under general anesthesia and sterile conditions to remove the bladder stone. We induced anesthesia using diazepam (۰.۵ mg/kg, IM) and ketamine (۱۰ mg/kg, IM), and maintained it with isoflurane. After standard preparation, we made a lower midline abdominal incision to expose the bladder. Once isolated with sterile gauze, we performed a ventral cystotomy to take out the stone and flushed the bladder with sterile saline. We closed the incision in two layers (Vicryl ۳-۰) and sutured the abdominal wall routinely. A urinary catheter was placed for ۴۸ hours. Postoperatively, we administered ceftriaxone (۲۵ mg/kg, IM, once daily for three days). Results: This case highlights the significant role diet plays in the oversaturation of urine and the formation of struvite stones in cats. Even though we kept the urine pH below ۶.۵, we still observed relative supersaturation (RSS > ۱.۰) with struvite. This indicates that mineral concentration is more important than pH alone. In this case, switching from a Monello commercial dry diet to a Fidar dry diet for three months contributed to conditions that led to struvite formation. Conclusion: This case stresses the importance of early diagnosis, diet management, and proper treatment decisions in feline struvite urolithiasis. Maintaining urine acidity, ensuring enough hydration, and providing low-magnesium and low-phosphorus diets are key preventive strategies. Depending on the situation, both surgical and minimally invasive techniques can lead to great outcomes.

کلیدواژه ها:

Struvite urolithiasis ، Feline ، Cystolith ، Cystotomy ، Diet modification