That’s right, what you’re looking at in this picture is a bladder stone! From all accounts, the presence of a stone in the urinary tract is a very uncomfortable condition (or downright painful, apparently). That’s exactly the situation we had to face with Emmy Lou, a little Westie we treated recently.
Unfortunately, urinary tract infection or inflammation is a common problem in both dogs and cats. In some cases, this can lead to the formation of crystals in the urine. As we saw with Emmy Lou, it’s not uncommon for this to progress to the formation of bladder stones, particularly in dogs. How do these show up? Well here are some of the more common signs we see:
- More frequent efforts to urinate
- Straining
- Blood flecks in urine
- General discomfort.
Bladder stones are a major problem for dogs for a number of reasons.
- They’re painful
- As we mentioned, the presence of stones can be pretty uncomfortable
- On occasion, a small bladder stone will work its way down the urethra and become completely blocked. This is very, very painful and a medical emergency
- Infection
- Inflammation and then infection in the bladder wall is not uncommon due to trauma caused by stones
- Secondary backflow problems
- In severe cases, we can see damage to the kidneys due to outflow obstruction
Dr Alana was the attending vet when Emmy Lou came in and her history made Alana suspicious of a least a urinary tract infection. The next steps in working this up were as follows:
- Palpation of the bladder
- Often, we can actually feel a mass in the bladder. In some cases, it even feels like a ‘bag of marbles’ if there are a few stones present
- Urinalysis
- Inflammation and blood are indicators of possible stones
- Crystals – there are various types of crystals which form when urine is too alkaline or too acidic
- Specific gravity – this tells us if the kidneys are functioning normally
- X-rays or Ultrasound exam
- Bladder stones show up clearly on either of these
- Ultrasound can identify abnormalities in the bladder wall and also tell us if there are any soft tissue masses present
With Emmy Lou, we just couldn’t get much of a urine sample as she was passing very small amounts each time (and she has very short legs so hard to collect!). From the history, though, we were concerned about a possible stone and so Dr Bec carried out an ultrasound exam that same afternoon. Sure enough, this confirmed that there was a large stone (2cm x 1 cm) and a very thickened bladder wall.
Having made our diagnosis, we had a couple of options with treatment.
- Diet
- With small stones and clinically well patients, we can sometimes dissolve these by using a specially designed diet. This can take a number of weeks to take effect.
- Surgery
- For Emmy Lou, the stone was too large to go with the diet option and so surgery was the only solution.
Dr Lys went straight into surgery with Emmy Lou and removed the offending object. Emmy Lou recovered well and was much more comfortable with her urination. Following surgery, however, the job wasn’t quite finished as we needed to ensure that there was no recurrence of the stone. How do we do this?
- Analysis of urine and the stone
- Hills Pet Nutrition offers a free stone analysis through their laboratory in the United States and the results give us the make-up of the stone
- A sterile urine sample was collected during surgery and sent to the lab for culture. This allowed us to get on top of infection in the bladder
- Regular health checks and testing for life
- Crystals (and then stones) generally form in urine which is either too alkaline (most commonly) or too acidic.
- Testing the urine allows us to prescribe medication or specific diet to correct the urine pH.
- Early detection of crystals or stones allows for rapid treatment to avoid surgery in future. Emmy Lou will be on a regular monitoring program from now on.
Reports from the owner are that Emmy Lou is back to her normal, happy self again so well done Drs Alana, Bec and Lys along with the nursing team. If you’re concerned that your dog or cat is showing similar signs, please don’t hesitate to give our lovely receptionists a call on 8522 3500. Even better, go online to book an appointment directly.
