[Dailydrool] Cystine Stones

[Laura Tancredi]

These are the things I saw as far as dissolution of cytine stones.  The first one isn't available everywhere but I know is available at Purdue University.

- Extracorporeal shock wave lithotripsy may be another effective means of treating nephrolithiasis and ureterolithiasis in dogs.

- 2 MPG (Thiola; Mission Pharmacal): 15-20 mg/kg PO q 12 hrs dogs in conjunction with diet. In dogs with re-formed cystine uroliths, dissolution may be induced by increasing the tiopronin dosage to 40 mg/kg body weight per day.

- Medical dissolution: A combination of 2-mercaptopropionylglycine (2 MPG) (thiola or tiopronin)and Hill's U/d diet may dissolve stones. This combination reduces urinary excretion of cystine, promotes formation of alkaline urine, and reduces urine concentration. The mean dissolution time is 10 weeks with a range of 2-30 weeks. 2-MPG reduces the urine concentration of cystine by combining with cysteine to form cysteine-2-MPG which is more soluble than cystine. Drug-induced adverse events associated with 2-MGP are uncommon in dogs but could include Coomb's positive spherocytic anemia, thrombocytopenia, and elevated hepatic enzyme activity. 2-MPG has not been evaluated in cystinuric cats. Monitor urolith dissolution at 30-day intervals by urinalysis and imaging (survey/contrast radiography or US). 


Laura
Flash 
and Ryu