Basic science knowledge underlies clinical science knowledge and clinical problem solving: evidence from veterinary medicine.

Medical sciences education emphasizes basic science learning as a prerequisite to clinical learning. Studies exploring relationships between achievement in the basic sciences and subsequent achievement in the clinical sciences generally suggest a significant positive relationship. Basic science knowledge and clinical experience are theorized to combine to form encapsulated knowledge- a dynamic mix of information that is useful for solving clinical problems. This study explores the relationship between basic science knowledge (BSK), clinical science knowledge (CSK), and clinical problem-solving ability, as measured within the context of four veterinary colleges using both college-specific measures and professionally validated, standardized measures of basic and clinical science knowledge and problem-solving ability. Significant correlations existed among all variables. Structural equation modeling and confirmatory factor analysis were used to produce models showing that newly acquired BSK directly and significantly predicted BSK retained over time and newly acquired CSK, as well as indirectly predicted clinical problem-solving ability (mediated by newly acquired CSK and BSK retained over time). These findings likely suggest a gradual development of schema (encapsulated knowledge) and not an isolated development of biomedical versus clinical knowledge over time. A broader implication of these results is that explicitly teaching basic science knowledge positively and durably affects subsequent clinical knowledge and problem-solving ability independent of instructional strategy or curricular approach. Furthermore, for veterinary colleges specifically, student performance as measured by both course-level and standardized tests are likely to prove useful for predicting subsequent academic achievement in classroom and clinical settings, licensing examination performance, and/or for identifying students likely in need of remediation in clinical knowledge.

Impact of fatty acid composition on markers of exocrine pancreatic stimulation in dogs.

Chronic pancreatitis in dogs is typically managed with a low-fat diet. Human research suggests that consumption of medium-chain triglycerides (MCT) may lessen pancreatic enzyme release compared to consumption of long-chain fatty acids (LCFA). Twelve healthy adult colony dogs were fed a meal of cod and rice with either 3% metabolizable energy (ME) fat (control), high MCT (25% ME MCT oil, 25% ME butter), high saturated LCFA (50% ME butter), or high unsaturated LCFA (50% ME canola oil) in a 4-period by 4-treatment crossover design. Serum concentrations of canine pancreatic lipase immunoreactivity, gastrin, cholesterol, triglycerides, and serum activities of amylase and DGGR lipase (1,2-o-dilauryl-rac-glycero-3-glutaric acid-(69-methylresorufin) ester lipase) were measured at times 0 (fasted), 30, 120 and 180 minutes post-prandially. Following a 3-or 4-day wash-out period, each dog was assigned a new diet and the process was repeated for all treatments. Data were analyzed as a repeated-measures mixed model ANOVA. Post-hoc pairwise comparisons were run using Tukey-Kramer adjusted p-values. Shapiro-Wilk tests were used to evaluate residual normality. All statistical assumptions were sufficiently met. Statistical significance was defined as P<0.05. Of the markers tested, only serum triglyceride concentrations were affected by treatment, with consumption of high MCT resulting in lower triglycerides than both LCFA groups at times 120 and 180 minutes (P<0.0001). As expected, the high MCT group had higher triglycerides compared to the control group (P<0.0001). The type of dietary fat consumed had little acute impact on most markers of exocrine pancreatic stimulation in healthy dogs.

Effect of a Leucine/Pyridoxine Nutraceutical on Caloric Intake and Body Composition of Obese Dogs Losing Weight.

The aim of this 29-week randomized, positively and negatively controlled study was to investigate whether a nutraceutical containing 1 g leucine and 13 mg pyridoxine can enhance weight loss while maintaining lean muscle mass in obese dogs. Twenty-four healthy, 2-year-old beagles were initially divided into obesification (n = 18) or ideal body weight groups (n = 6). After obesification, the 18 dogs were divided into three weight loss groups and fed one of the following over 12 weeks: nutraceutical with canned adult diet (CAD; ObN), placebo with CAD (ObP), or a canned therapeutic weight loss diet (WLD). Dogs in the ideal body weight (IBW) group were fed maintenance calorie requirements with CAD over 12 weeks. Based on MANOVA, ObN and WLD lost similar amounts of total weight (3.6 ± 0.9 vs. 4.4 ± 1.1 kg, respectively) and fat mass (3.1 ± 0.6 vs. 3.9 ± 0.8 kg, respectively) after 12 weeks of treatment, and more than ObP (1.1 ± 1.2 kg weight; 0.9 ± 1.0 kg fat; p < 0.0001). These data show the nutraceutical is a promising option for successful weight loss in dogs. Maintenance levels of CAD were able to induce weight loss without risk of hypo- or anorexia, or the need to switch diets or restrict energy intake.

Comparison of a human portable blood glucose meter, veterinary portable blood glucose meter, and automated chemistry analyzer for measurement of blood glucose concentrations in dogs.

OBJECTIVE: To compare blood glucose concentrations measured with 2 portable blood glucose meters (PBGMs) validated for use in dogs (PBGM-D) and humans (PBGM-H) and an automated chemistry analyzer. DESIGN: Validation study. SAMPLE POPULATION: 92 samples of fresh whole blood and plasma from 83 dogs with various diseases. PROCEDURES: Each PBGM was used to measure whole blood glucose concentration, and the automated analyzer was used to measure plasma glucose concentration. Passing-Bablok linear regression and Bland-Altman plots were used to determine correlations and bias between the PBGMs and the automated analyzer. Calculated acceptability limits based on combined inherent instrument imprecision were used with Bland-Altman plots to determine agreement. Clinical relevance was assessed via error grid analysis. RESULTS: Although correlation between results of both PBGMs and the standard analyzer was > 0.90, disagreement was greater than could be explained by instrument imprecision alone. Mean difference between PBGM-H and chemistry-analyzer values was -15.8 mg/dL. Mean difference between PBGM-D and chemistry-analyzer values was 2.4 mg/dL. Linear regression analysis revealed proportional bias of PBGM-H (greater disagreement at higher glucose concentrations); no proportional bias was detected for PBGM-D. No constant bias was detected for either PBGM. Error grid analysis revealed all measurements from both PBGMs were within zones without an anticipated effect on clinical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Neither PBGM had exact agreement with the automated analyzer; however, the disagreement detected did not have serious clinical consequences. Our findings stressed the importance of using the same device for monitoring trends in dogs and using instrument-specific reference ranges.

Changes in hepatic gene expression in dogs with experimentally induced nutritional iron deficiency.

BACKGROUND AND OBJECTIVE: We investigated hepatic gene expression in dogs with experimentally induced nutritional iron deficiency (ID). Our hypothesis was that ID would result in decreased hepcidin gene expression, and possibly in altered expression of other genes associated with iron metabolism. METHODS: Liver biopsies were collected from each of 3 dogs before induction of ID, at the point of maximal ID, and after resolution of ID. Using Affymetrix microarray technology and analytical tools specifically designed for microarray data, we identified genes that had at least a 2-fold change in expression in response to ID. Four genes were selected for further analysis by reverse transcriptase PCR (RT-PCR). RESULTS: Dogs with ID had markedly decreased expression of the hepcidin gene (mean decrease of 40-fold for one probe and >100-fold for another probe) and increased expression of the transferrin receptor gene (mean increase of >7-fold). There was also mildly decreased expression of the "similar to calreticulin" gene and a gene of unknown function. Results of RT-PCR analysis were consistent with microarray findings. CONCLUSION: Changes in hepcidin and transferrin receptor gene expression were consistent with the known biology of iron metabolism. The decrease in expression of a gene identified as "similar to calreticulin," while not statistically significant, was consistent with the findings of other investigators that suggest iron plays a role in calreticulin expression.

Body composition of lean outdoor intact cats vs lean indoor neutered cats using dual-energy x-ray absorptiometry.

OBJECTIVES: The objectives for this study were to compare the body composition of adult indoor neutered domestic cats with outdoor intact cats with an ideal body condition score using dual-energy x-ray absorptiometry, and to report the body composition findings of free-roaming cats, as this has not been previously reported. Most domestic house cats differ from free-roaming cats as they are confined indoors and neutered. Indoor neutered cats have reduced activity and hormonal alterations that may result in lower muscle mass and higher body fat percentages vs outdoor intact cats, despite similar body condition scores. METHODS: Twenty-one outdoor intact cats (10 male, 11 female) were selected from a trap-neuter-return program and 16 indoor neutered domestic cats (10 male, six female) were client-owned. Inclusion criteria included an estimated age between 1 and 6 years, complete blood count, biochemistry panel, urinalysis, total thyroxine, feline leukemia virus/feline immunodeficiency virus screening and a body condition score of 4-5/9. RESULTS: Indoor neutered cats had a higher body fat percentage (22.1% [range 17.3-28.2%]) than outdoor intact cats (17.3% [range 10.0-33.6%]; P = 0.002). Indoor neutered male cats had a higher body fat percentage ( P <0.001) than outdoor intact cats. No difference in body fat percentage was observed in female cats ( P = 0.159). Indoor neutered domestic cats had a higher bone mineral density than outdoor intact cats ( P = 0.023). CONCLUSIONS AND RELEVANCE: The results of this study suggest indoor confinement and neutering increase body fat percentage and bone mineral density in cats with an ideal body condition score.

Aflatoxicosis in nine dogs after exposure to contaminated commercial dog food.

The purpose of this study was to characterize light and electron microscopic findings from 9 dogs that had consumed aflatoxin-contaminated commercial dog food from recalled batches. Four dogs died and 5 were euthanized after signs of liver failure. Analysis of feed and liver samples confirmed exposure to aflatoxin. Of the 9 dogs, 8 had classic signs of liver failure, and 1 had signs of liver failure. Enlarged, pale yellow livers were seen macroscopically at necropsy in the dogs with subacute hepatopathy, and cirrhosis was noted in the dog with chronic hepatopathy. Histopathologic findings included hepatic lipidosis, portal fibroplasia, and biliary hyperplasia, which supported a diagnosis of subacute toxic hepatopathy in the 8 symptomatic animals. Marked lobular atrophy, bridging portal fibrosis, and regenerative hepatocellular nodules characterized the dog with chronic hepatopathy. Electron microscopy revealed marked hepatocellular lipid vacuolation and early fibroplasia in the dogs with acute hepatopathy and marked fibrosis and regeneration in the dog with chronic hepatopathy. Analysis of feed for aflatoxin consistently revealed high levels of aflatoxin B1 (range of 223-579 ppb), and hepatic tissue contained elevated levels of aflatoxin B1 metabolite M1 (0.6-4.4 ppb). Although dogs are not commonly affected by aflatoxicosis, they are highly susceptible and can present with classic signs of acute or chronic hepatopathy. Characteristic gross, histologic, and electron microscopic changes help pathologists determine a presumptive toxic insult. Detecting aflatoxins or their metabolites in feed or liver specimens can help confirm the diagnosis of aflatoxicosis.

Influence of prednisolone on urinary calcium oxalate and struvite relative supersaturation in healthy young adult female domestic shorthaired cats.

Prednisolone (10 mg PO q24h) or placebo was administered to healthy cats for 2 weeks in a masked, placebo-controlled, crossover-design study, and 24-hour urine samples were collected. When cats received prednisolone, 24-hour urine pH was lower and 24-hour urine excretion of creatinine, magnesium, phosphate, and potassium was higher than when cats received placebo. No significant difference was found in urinary relative supersaturation for calcium oxalate (CaOx) or struvite between treatment groups. Prednisolone administration did not induce diuresis, nor was it associated with increased calcium excretion or urinary saturation for CaOx in these healthy cats. Results of this study, however, should not be extrapolated to cats that form CaOx uroliths associated with idiopathic hypercalcemia.

Influence of hydrochlorothiazide on urinary calcium oxalate relative supersaturation in healthy young adult female domestic shorthaired cats.

Hydrochlorothiazide (1 mg/kg PO q12h) or placebo was administered to healthy cats for 2 weeks in a masked, placebo-controlled, crossover-design study, and 24-hour urine samples were collected. When cats received hydrochlorothiazide, 24-hour urine volume, ammonia, chloride, creatinine, magnesium, oxalic acid, phosphate, potassium, and sodium were significantly higher than when cats received placebo. Hydrochlorothiazide was associated with significantly lower urinary saturation for calcium oxalate, but no difference was found in 24-hour urine calcium and citrate, urinary saturation for struvite, or blood ionized calcium. Hydrochlorothiazide decreased urinary saturation for calcium oxalate and could be useful in managing cats with calcium oxalate uroliths. Results of this study, however, should not be extrapolated to cats that form calcium oxalate uroliths.

Evaluation of two raw diets vs a commercial cooked diet on feline growth.

Objectives The objective of this study was to determine if two raw feline diets were nutritionally adequate for kittens. Methods Twenty-four 9-week-old kittens underwent an Association of American Feed Control Officials' (AAFCO) 10 week growth feeding trial with two raw diet groups and one cooked diet group (eight kittens in each). Morphometric measurements (weight, height and length), complete blood counts, serum chemistry, whole blood taurine and fecal cultures were evaluated. Results Overall, the growth parameters were similar for all diet groups, indicating the two raw diets used in this study supported feline growth, within the limitations of an AAFCO growth feeding trial. Kittens fed the raw diets had lower albumin ( P = 0.010) and higher globulin ( P = 0.04) levels than the kittens fed the cooked diet. These lower albumin levels were not clinically significant, as all groups were still within normal age reference intervals. A red cell microcytosis ( P = 0.001) was noted in the combination raw diet group. Increases in fecal Clostridium perfringens were noted in all groups, along with positive fecal Salmonella serovar Heidelberg and Clostridium difficile toxin in the combination raw diet group. Conclusions and relevance The majority of the parameters for feline growth were similar among all groups, indicating the two raw diets studied passed an AAFCO growth trial. In theory, it is possible to pass an AAFCO growth trial but still have nutrient deficiencies in the long term due to liver and fat storage depots. Some of the raw feeders had elevated globulin and microcytosis, likely associated with known enteropathogenic exposure. Disease risks to both pets and owners are obvious. Additional research in this area is needed to investigate the impact of raw diets on the health of domestic cats.

Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats.

Objective-To determine whether a renal diet modified in protein, phosphorus, sodium, and lipid content was superior to an adult maintenance diet in minimizing uremic episodes and mortality rate in cats with stage 2 or 3 chronic kidney disease (CKD). Design-Double-masked, randomized, controlled clinical trial. Animals-45 client-owned cats with spontaneous stage 2 or 3 CKD. Procedures-Cats were randomly assigned to an adult maintenance diet (n = 23 cats) or a renal diet (22) and evaluated trimonthly for up to 24 months. Efficacy of the renal diet, compared with the maintenance diet, in minimizing uremia, renal-related deaths, and all causes of death was evaluated. Results-Serum urea nitrogen concentrations were significantly lower and blood bicarbonate concentrations were significantly higher in the renal diet group at baseline and during the 12- and 24-month intervals. Significant differences were not detected in body weight; Hct; urine protein-to-creatinine ratio; and serum creatinine, potassium, calcium, and parathyroid hormone concentrations. A significantly greater percentage of cats fed the maintenance diet had uremic episodes (26%), compared with cats fed the renal diet (0%). A significant reduction in renal-related deaths but not all causes of death was detected in cats fed the renal diet. Conclusions and Clinical Relevance-The renal diet evaluated in this study was superior to an adult maintenance diet in minimizing uremic episodes and renalrelated deaths in cats with spontaneous stage 2 or 3 CKD.

Feline diabetes mellitus: low carbohydrates versus high fiber?

Treatment of diabetes mellitus (DM) in the cat relies primarily on the adequate insulin therapy and controlled dietary intake. The goals of managing DM in the cat have changed from attaining glycemic control to achieving diabetic remission (transient diabetes) in a large proportion of cases. Remission rates of up to 68% have been published. The used of low-carbohydrate foods for cats improves the odds of achieving diabetic remission by fourfold. Nonetheless, some cats show an improved response to high-fiber food. Clinical judgement, trial, and personal preference to currently dictate which diet to offer an individual animal.

Nutrition and lower urinary tract disease in cats.

Lower urinary tract disease occurs commonly in cats and is often associated with crystal-related disease. Dietary modification is beneficial in managing some of these diseases, including idiopathic cystitis, urolithiasis, and urethral matrix-crystalline plugs. Altering dietary formulation may result in decreasing urinary concentrations of crystallogenic compounds, increasing urinary concentrations fo crystallogenic inhibitors, and diluting urine composition.

Effects of sodium chloride on selected parameters in cats.

This study used 36 cats with varying renal insufficiency and physiologic status to evaluate the effect of a food high in sodium chloride (HSC) compared with a low sodium chloride (LSC) food on selected blood parameters and blood pressure. Cats eating the HSC food had an increase in serum creatinine, urea nitrogen, and phosphorus compared with cats eating the LSC food. Also, cats eating the HSC food had increased fractional excretion of calcium and increased fractional shortening during cardiac contraction. There was no effect of food on systolic, diastolic, or mean arterial pressure.

Reticulocyte indices in a canine model of nutritional iron deficiency.

BACKGROUND: Reticulocyte indices, especially reticulocyte hemoglobin content (CH retic), have shown promise as markers of iron deficiency (ID), but there have been no prospective investigations of reticulocyte indices in experimental models of ID. OBJECTIVES: The objective of this study was to compare reticulocyte indices with conventional hematologic and biochemical indices as markers of ID in dogs. METHODS: Iron deficiency was induced in 7 dogs by feeding an iron-deficient diet, and corrected by restoring dietary iron and by giving iron parenterally. Blood samples were collected at weekly intervals. Results of hematologic and biochemical tests were compared using t-tests and receiver operator characteristic (ROC) curve analysis. RESULTS: Comparing mean values on days 0 and 35, by which time hemoglobin concentration decreased to 90% of baseline in all dogs, % Macro retic, % Hypo retic, % Low CH retic, and % High CH retic differed by greater than 3-fold, whereas no conventional hematologic or biochemical indices differed by as much as 2-fold. Comparing conventional hematologic and reticulocyte indices by ROC curve analysis using 4 different biochemical diagnostic criteria of ID, CH retic, % Hypo retic, % Low CH retic, and % High CH retic had higher areas under the curve (AUC) than either MCV conv or MCHC conv according to all 4 criteria, and % Macro retic and MCV retic had higher AUC values according to 3 of 4 criteria (differences were not always statistically significant). CONCLUSIONS: Results of this study support the value of reticulocyte indices in the diagnosis and monitoring of ID in dogs. Species similarities in the pathophysiology and hematologic manifestations of ID suggest these findings also may be relevant to ID in people.

Apparent nutrient digestibility of two raw diets in domestic kittens.

OBJECTIVES: The aim of the study was to evaluate overall dry matter, organic matter, crude protein, crude fat and gross energy digestibility of a feline commercial raw diet and a homemade raw diet compared with a canned, heat-processed diet. METHODS: Six domestic shorthair kittens (20-28 weeks old) were fed three different diets in a Latin square crossover design. Diet A was a commercially available, canned, heat-processed diet. Diet B was a complete commercial, prefrozen, raw diet (commercial raw), and diet C was a raw diet supplement mixed with ground raw meat obtained locally (homemade raw). Both diets A and B were formulated to meet nutritional profile levels for cats at all life stages. Kittens were given specific diet amounts to maintain a 2-4% weight increase per week. Food was measured before and after feedings to determine the amount eaten, and all feces were collected, weighed and frozen prior to submission. Composite food samples and all feces were submitted to a national laboratory for proximate analysis of crude protein, crude fiber, ash, crude fat, moisture and caloric density. RESULTS: Significantly higher digestibility of dry matter (P <0.001), organic matter (P <0.001), crude protein (P <0.001) and gross energy (P <0.001) was seen in the raw diets compared with the heat-processed diets. This difference resulted in significantly less fecal matter (P <0.001) despite similar levels of intake and kcal ingested, and evidence of no difference in fecal scores. CONCLUSIONS AND RELEVANCE: Higher dry matter, organic matter and protein digestibility was seen in two commercial raw diets compared with a heat-processed diet. Digestibility differences could have been due to variance in dietary protein, fat and carbohydrate concentrations between the diets, variance in dietary ingredients or quality, alterations in protein structure secondary to heat processing, as well as alterations in gastrointestinal flora. Future research examining digestibility in diets with the same macronutrient proportions and ingredients, and mechanisms for any differences, is warranted.

Prevalence of asymptomatic urinary tract infections in morbidly obese dogs.

Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI) may be more prevalent in the obese. Asymptomatic bacteriuria (AB) is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was undertaken to explore a possible association between obesity and asymptomatic bacteriuria. Records from lean, overweight, and obese dogs receiving both a dual energy absorptiometry (DXA) scan and urine culture were included. Results. Six positive urine cultures were identified among 46 dogs fulfilling search criteria. All six positive cultures were found in dogs with body fat percentage of >45%. In dogs with body fat percentage of <45%, there were no positive urine cultures. Discussion. There was an increased prevalence of asymptomatic bacteriuria in the morbidly obese dogs in this study compared to those that were lean, overweight, or moderately obese. Whether antibiotic therapy is necessary in such cases is still being debated, but because asymptomatic bacteriuria may be associated with ascending infections, uroliths, or other complications, the data reported herein support the screening of obese patients for bacteriuria.

Evaluation of the association between initial proteinuria and morbidity rate or death in dogs with naturally occurring chronic renal failure.

OBJECTIVE: To determine whether urine protein-to-creatinine ratio (UP:C) > or = 1.0 at initial diagnosis of chronic renal failure (CRF) is associated with greater risk of development of uremic crises, death, and progression of renal failure in dogs. DESIGN: Prospective cohort study. ANIMALS: 45 dogs with CRF PROCEDURE: Dogs were prospectively assigned to 2 groups on the basis of initial UP:C < 1.0 or 2 > or = 1.0. The association between magnitude of proteinuria and development of uremic crises and death was determined before and after dogs with initial UP:C > or =1.0 were assigned to 3 subgroups and compared with dogs with initial UP:C < 1.0. Changes in reciprocal serum creatinine concentration were used to estimate decrease in renal function. RESULTS: Initially, dogs had similar clinical characteristics with the exception of systolic blood pressure and UP:C. Relative risks of development of uremic crises and death were approximately 3 times higher in dogs with UP:C > or =1.0, compared with dogs with UP:C < 1.0. Relative risk of adverse outcome was approximately 1.5 times higher for every 1-unit increment in UP:C. The decrease in renal function was of greater magnitude in dogs with UP:C > or =1.0, compared with dogs with UP:C < 1.0. CONCLUSIONS AND CLINICAL RELEVANCE: Initial UP:C > or =1.0 in dogs with CRF was associated with greater risk of development of uremic crises and death, compared with dogs with UP:C < 1.0. Initial determinations of UP:C in dogs with naturally occurring CRF may be of value in refining prognoses.

Associations between dry dietary factors and canine calcium oxalate uroliths.

OBJECTIVE: To identify factors in dry diets associated with the occurrence of calcium oxalate (CaOx) uroliths in dogs. ANIMALS: 600 dogs with CaOx uroliths and 898 dogs without urinary tract diseases. PROCEDURE: Univariate and multivariate logistic regression were performed. RESULTS: Compared with diets with the highest concentrations of sodium, dry diets with the lowest concentrations of sodium, phosphorus, calcium, chloride, protein, magnesium, or potassium were linearly associated with increased risk of CaOx urolith formation. Significant nonlinear associations between increased occurrence of CaOx uroliths and urine acidifying potential and low moisture content were observed. Significant nonlinear associations between decreased occurrence of CaOx uroliths and carbohydrate and fiber contents were observed. A significant association between the occurrence of CaOx uroliths and dietary fat was not observed. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that dry diets formulated to contain high concentrations of protein, calcium, phosphorus, magnesium, sodium, potassium, and chloride may minimize formation of CaOx uroliths. In addition, comparison of risk and protective factors of various diet ingredients fed to dogs with CaOx uroliths suggests that although similar findings were observed in canned and dry formulations, in general, greater risk is associated with dry formulations. However, before these hypotheses about dietary modifications are adopted by food manufacturers, they must be investigated by use of appropriately designed clinical studies of dogs with CaOx urolithiasis.

Associations between dietary factors in canned food and formation of calcium oxalate uroliths in dogs.

OBJECTIVE: To identify dietary factors in commercially available canned foods associated with the development of calcium oxalate (CaOx) uroliths in dogs. ANIMALS: 117 dogs with CaOx uroliths and 174 dogs without urinary tract disease. PROCEDURE: Case dogs were those that developed CaOx uroliths submitted to the Minnesota Urolith Center for quantitative analysis between 1990 and 1992 while fed a commercially available canned diet. Control dogs were those without urinary tract disease evaluated at the same veterinary hospital just prior to or immediately after each case dog. A content-validated multiple-choice questionnaire was mailed to each owner of case and control dogs with the permission of the primary care veterinarian. Univariate and multivariate logistic regressions for each dietary component were performed to test the hypothesis that a given factor was associated with CaOx urolith formation. RESULTS: Canned foods with the highest amount of protein, fat, calcium, phosphorus, magnesium, sodium, potassium, chloride, or moisture were associated with a decreased risk of CaOx urolith formation, compared with diets with the lowest amounts. In contrast, canned diets with the highest amount of carbohydrate were associated with an increased risk of CaOx urolith formation. CONCLUSIONS AND CLINICAL RELEVANCE: Feeding canned diets formulated to contain high amounts of protein, fat, calcium, phosphorus, magnesium, sodium, potassium, chloride, and moisture and a low amount of carbohydrate may minimize the risk of CaOx urolith formation in dogs.