Dear Doctor: The therapeutic diet doesn’t seem to be working

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Q. We had a little dog who needed surgery to remove bladder stones made of calcium oxalate. After that, she was prescribed a diet to make the stones less likely to form again. But they keep com-ing back. Why isn’t the diet working?

Colette Lanier
Dover, New Hampshire

Dear Ms. Lanier,

A. We often find that when a therapeutic diet is not leading to the desired health effect, it’s not the diet that’s failing the dog but the treats the dog is getting on top of the prescribed meal plan. Perhaps your dog regularly gets bits of rawhide, which has an amino acid that breaks down into oxalate. That could mean that the oxalate keeps precipitating out of the urine to form stones, undoing the work of the therapeutic food.

There are lots of ways to undercut the benefits of a medically therapeutic diet: feeding high-sodium treats to a dog on a low-salt diet for heart disease; high-protein treats to a dog on a low-protein diet to slow the progression of kidney disease; “extras” while a dog is on an elimination diet to see if she has a food allergy; and so on.

If your dog is prescribed a therapeutic diet, speak with the vet about what treats are advisable under the circumstances. Believe it or not, sometimes sweet treats like mini marshmallows can work — as long as the dog doesn’t have diabetes. Even small amounts of vanilla cake frosting or cream cheese might work if the dog is not required to be on a low-fat diet and the product doesn’t contain more than 100 milligrams of sodium per 100 calories. Not surprisingly, vegetables and fruits also tend not to wreak havoc with a therapeutic diet.

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