stone in ureter

[finawong]

My cat Mini is a 6-year old male cat and has recently diagnosed CRF. Also kidney stones are found in the L kidney and one in the L ureter.  The vet in Hong Kong said there's nothing we can do to get rid of the stone in the ureter, only surgery of removing the L kidney, but since his R kidney is not healthy as well (calcium deposits found  in the R kidney), complication rate is very high, death rate is like 60%.   His creatinine level is slightly high as 250 umol/L and vet suggested that he should get more water intake - 150cc water per day and we need to start considering subcut fluid, and start Azodyl.  

Is there any way to remove the stone in the L ureter without removing the whole kidney? A RSPCA vet found some US reference about a medicine to relax the ureter with enough urine to flush the stone out the ureter to bladder, and a simply and safer surgery can be performed to the bladder.  Is it true? or is there any other method to dissolve the stone?

Here's Mini's profile:
Age: 6 years old
Breed: domestic shorthair
Sex: Male
diet: R/D canned food (he used to take dry food only)
Water intake: not sure if he drinks water himself as we don't have anyone at home in day time to monitor. We feed him about 100cc - 120cc of water by syringe every day.
Status: he has good appetite and he is pretty active, but he will get tired easily.  He is FCoV positive but doesn't have FIP symptoms

latest urinalysis:
UREA 11.3 mmol/L
CREA: 250 umol/L
HCT 26.5%
HGB 8.6 g/dL
MCHC 32.5g/dL
WBC 16.0 x 10 /L
GRANS 10.8 x 10/L

Could you please help? I really don't want to see him suffered from the stone...

Thanks very much!

[Aleda M Cheng, D.V.M., C.V.A]

I am sorry about your cat and hope I can help.

The medication that relaxes the smooth muscle in the ureter and bladder is called Phenoxybenzamine.  I hope that it can be obtained in Hong Kong as it may help your cat to pass the ureter stone.

There are patented Chinese herbal formula's that may help dissolve any kidney and ureter stones including Calcium Oxalate stones.  

These formula's include:

1.  Jie Shi Ling.  This is a human formula that can be used for pets. This should be available over the counter in Hong Kong.  The dose is 3 teapills orally twice daily.

2.  Crystal Stone Formula.  This is manufactured specifically for pets.  The dose is one capsule per 10 pounds.  Crystal Stone Formula is a modification of the patented formula: Ba Zheng San and is only available by prescription from Dr. Xie's Jing Tang Herbal company (tcvmherbal.com/).  I am sure that it can be mailed to Hong Kong.

The Chinese herbal formula: Eight Flavor Rehmannia, (which is available over the counter in Hong Kong as a human product)  is very valuable for kidney disease and would be a helpful addition to a holistic protocol.  It does not help to eliminate stones, though it is just for kidney disease.  The dose is 3 teapills orally twice daily.

[finawong]

Thanks very much Dr. Cheng! I'll definitely try the CHinese herbal treatments but since there are too many suggestions on local cat forums, I don't know which one is the best and your advice is very useful!

So if he can successfully pass the stone out from the ureter to the bladder, does he still need to do an open bladder suergery?  Also, do you think Mini should also take the C/D diet to prevent from developing stones in future?

Thanks again!

[finawong]

Hi Dr. Cheng, I also heard that there's HAC Kidney Flow Diuretic & Emulsifier is also very effective to stimulate proper urine production to encourage cat to pass the stone.  Is it safe to try even in Mini's renal failure situation?

Many thanks.