Dr. Paul Hodges
Minimally Invasive Procedures
"Rocky" the Dog
"Rocky", a 3 year old Shih-Tzu presented to his veterinarian for blood in his urine, increased urinary frequency, and some straining to urinate. Otherwise Rocky was eating well and seemed to be in good spirits. There had been no dietary changes or alterations to his routines leading up to this.
Prior to this Rocky had been treated for 2 urinary tract infections. On one urinalysis there were crystals present, but a repeat urinalysis was not performed after treatment for the UTI.
In both cases, Rocky improved only to have the infection return in 3-4 weeks.
At this presentation a urinalysis was repeated which showed struvite crystals along with another urinary tract infection.
X-rays showed clear evidence of stones in the urinary bladder (see image to right)
A discussion was had regarding surgery vs. attempting to dissolve the stones and ultimately surgery was the decision
Rocky's veterinarian recommended having the stones removed with the aid of cystoscopy and urethroscopy.
An operating laparoscope was utilized to grasp the urinary bladder and bring it up to the body wall. The bladder was temporarily attached to the skin (to prevent leakage), and the bladder was entered.
Multiple stones were removed and a cystoscope was introduced into the bladder. Multiple remaining stones were seen (see image to right) and systematically removed using different instruments, suction, and flushing.
Prior to closing a small scope was passed to ensure all stones had been removed and none were lodged in the urethra.
Rocky recovered well and went home the next day. He was back to his normal activity in a couple of days.
The stone analysis confirmed the stones were primarily struvite in nature & Rocky has since transitioned to a diet aimed at urinary tract health.
Unfortunately, bladder stones can be quite common in both dogs and cats leading to discomfort, recurrent urinary tract infections, and sometimes urinary obstruction. While the exact cause is not fully understood, it is believed that a combination of factors predisposes stone formation. Diet as well as a hereditary component are just 2 generally accepted factors. In some cases the stones can be dissolved with special food or removed with lithotripsy (very specific cases), but surgery is quite often the ultimate treatment needed. The #1 goal of surgery is to remove all stones from the bladder - if any are left behind they serve to help more stones form in the future. By using cystoscopy and urethroscopy, we can be more certain that we have removed all of the stones when compared to a traditional surgical approach.