11-year old, 10.9# (4.95kg), Female (Spayed), Yorkshire Terrier
History: Owner reported patient has a history of cystic calculi (Diagnosed at least a year ago) and has developed urinary incontinence.
Clinical Exam: Patient bright, alert, and responsive with normal mentation. Body condition score – 5/9. Bladder was distended and very firm upon palpation.
Diagnostic Findings: Radiographs show that the bladder contains 2 very large radiodense calculi that take up the complete bladder. No nephroliths (Kidney stones) seen. Pre-operative bloodwork showed no significant findings; kidney values were normal.
Treatment: Patient taken to surgery under general anesthesia, for a cystotomy (Surgical incision into the bladder) to remove the calculi. Patient received IV (intravenous) fluids during procedure, vitals monitored, and abdomen prepped aseptically for procedure. Bladder was flushed thoroughly and checked for other small calculi where a single small calculi was found and removed as well. A urinary catheter was placed, and bladder was flushed several times prior to closing surgical site. Submit uroliths for analysis. Post op IV fluids for 24 hours to flush bladder, and urinary catheter removed at that time.
Urolith Submission: Magnesium Ammonium Phosphate (Struvite) and Calcium Phosphate Carbonate. Canine struvite and calcium phosphate carbonate uroliths form as a consequence of urinary tract infection with bacteria that produce the enzyme urease. Prevention therapy should not increase the risk for calcium oxalate (i.e. do not overly acidify urine)
Patient Recommendations: Exercise restriction, monitor urine production. Continue oral antibiotics for additional 30 days. Patient will need periodic urine cultures (every 3 months) to manage recurrent infections before uroltihs occur. Consider a dietary change to a food that is lower in protein, phosphorus, and calcium, (e.g. c/d Multicare)
History: Owner reported patient has a history of cystic calculi (Diagnosed at least a year ago) and has developed urinary incontinence.
Clinical Exam: Patient bright, alert, and responsive with normal mentation. Body condition score – 5/9. Bladder was distended and very firm upon palpation.
Diagnostic Findings: Radiographs show that the bladder contains 2 very large radiodense calculi that take up the complete bladder. No nephroliths (Kidney stones) seen. Pre-operative bloodwork showed no significant findings; kidney values were normal.
Treatment: Patient taken to surgery under general anesthesia, for a cystotomy (Surgical incision into the bladder) to remove the calculi. Patient received IV (intravenous) fluids during procedure, vitals monitored, and abdomen prepped aseptically for procedure. Bladder was flushed thoroughly and checked for other small calculi where a single small calculi was found and removed as well. A urinary catheter was placed, and bladder was flushed several times prior to closing surgical site. Submit uroliths for analysis. Post op IV fluids for 24 hours to flush bladder, and urinary catheter removed at that time.
Urolith Submission: Magnesium Ammonium Phosphate (Struvite) and Calcium Phosphate Carbonate. Canine struvite and calcium phosphate carbonate uroliths form as a consequence of urinary tract infection with bacteria that produce the enzyme urease. Prevention therapy should not increase the risk for calcium oxalate (i.e. do not overly acidify urine)
Patient Recommendations: Exercise restriction, monitor urine production. Continue oral antibiotics for additional 30 days. Patient will need periodic urine cultures (every 3 months) to manage recurrent infections before uroltihs occur. Consider a dietary change to a food that is lower in protein, phosphorus, and calcium, (e.g. c/d Multicare)
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Client Education
Bladder stones, also known as urolithiasis or cystolithiasis, are solid mineral deposits that form inside the bladder of dogs and cats. Stones start out as crystals that form in the urine. These crystals form when a combination of events takes place, such as urine pH change, increased urine concentration, and changes in the mineral makeup of the urine being formed. Over time, the crystals combine and layer together to form bladder stones.
Bladder stones can range from one to two stones to hundreds. Some bladder stones are small and grit-like, whereas others are can grow to be larger than 2 inches in diameter. Bladder stones are quite common in dogs and cats. Kidney stones, more common in humans, occur much less frequently in dogs and cats. Only 2% of stones found in the urinary tract of our pets are found in the kidney.
There are many types of bladder stones, and each type forms under specific circumstances. In almost all cases, struvite bladder stones in dogs are caused by bladder infection with specially enabled bacteria. Not just any bladder infection can make a struvite bladder stone; the bacteria must be able to take the urea (the protein waste product for which urine is named) and break it down into ammonia and bicarbonate. The ammonia mixes with magnesium and phosphorus in the urine to make the mineral known as struvite, and the bicarbonate makes an alkaline urine preventing the struvite from dissolving. Staphylococci (often simply called Staph) and Proteus bacteria are the usual culprits, and they gain access to the bladder by simply crawling up from the lower urinary tract.
Some patients with bladder stones show no symptoms of any kind and the stones are discovered incidentally but there are some symptoms that might promote a search for stones. Bloody urine, recurrent bladder infection (especially by the same organism and especially if Staphylococci or Proteus is cultured) or straining to urinate all would raise suspicion. Fortunately, struvite stones are radio-opaque, which means they show up readily on radiographs.
Types of Bladder Stones
Struvite bladder stones can occur with bladder infections. Certain bacteria will change the urine’s pH to grow and replicate better. This pH change causes the urine to be more alkaline, promoting struvite crystals to form. Struvite stones can also form without an infection, which is seen more commonly in cats than dogs.
Less is known about why struvite stones form without an infection. They often play a role in idiopathic cystitis in cats (also known as feline lower urinary tract disease), a condition associated with stress and straining to urinate. Calcium oxalate stones tend to form with a more acidic pH and are rarely caused by bacteria. Other types of stones can occur with toxins (such as antifreeze poisoning) or can be breed-related as occurs in Dalmatians.
Consequences
If left untreated, bladder stones can grow in size to the point that urination will be difficult or impossible. This is especially problematic if stones pass from the bladder into the urethra and get stuck. Inability to urinate is a life-threatening situation. Other issues associated with bladder stones are chronic pain and increased risk of urinary tract infections.
Prevention
Once you know your pet can have these stones, prescription diets selected for the specific type of stone can help prevent recurrence. It is extremely important that only the prescription food be fed to the pet. No additional treats (unless specific for the diet), bones, or flavored chew toys can be given. Even a small change in the diet can change the pH and mineral content of the urine and lead to the stones reforming.
Increase water consumption as much as possible to help dilute the urine to further decrease chances of bladder stone formation.
Brister, Jacqueline, DVM. Cystotomy for Bladder Stones in Dogs and Cats. 3 Dec 2019. veterinarypartner.vin.com/default.aspx?pid=19239&id=9421365
Bladder stones, also known as urolithiasis or cystolithiasis, are solid mineral deposits that form inside the bladder of dogs and cats. Stones start out as crystals that form in the urine. These crystals form when a combination of events takes place, such as urine pH change, increased urine concentration, and changes in the mineral makeup of the urine being formed. Over time, the crystals combine and layer together to form bladder stones.
Bladder stones can range from one to two stones to hundreds. Some bladder stones are small and grit-like, whereas others are can grow to be larger than 2 inches in diameter. Bladder stones are quite common in dogs and cats. Kidney stones, more common in humans, occur much less frequently in dogs and cats. Only 2% of stones found in the urinary tract of our pets are found in the kidney.
There are many types of bladder stones, and each type forms under specific circumstances. In almost all cases, struvite bladder stones in dogs are caused by bladder infection with specially enabled bacteria. Not just any bladder infection can make a struvite bladder stone; the bacteria must be able to take the urea (the protein waste product for which urine is named) and break it down into ammonia and bicarbonate. The ammonia mixes with magnesium and phosphorus in the urine to make the mineral known as struvite, and the bicarbonate makes an alkaline urine preventing the struvite from dissolving. Staphylococci (often simply called Staph) and Proteus bacteria are the usual culprits, and they gain access to the bladder by simply crawling up from the lower urinary tract.
- 85% of patients with struvite bladder stones are female.
- Breeds felt to have an increased risk for the formation of struvite stones are the Miniature Schnauzer, Shih Tzu, Yorkshire terrier, Labrador retriever, and Dachshund.
- The average age of patients with struvite bladder stones is 2.9 years.
Some patients with bladder stones show no symptoms of any kind and the stones are discovered incidentally but there are some symptoms that might promote a search for stones. Bloody urine, recurrent bladder infection (especially by the same organism and especially if Staphylococci or Proteus is cultured) or straining to urinate all would raise suspicion. Fortunately, struvite stones are radio-opaque, which means they show up readily on radiographs.
Types of Bladder Stones
Struvite bladder stones can occur with bladder infections. Certain bacteria will change the urine’s pH to grow and replicate better. This pH change causes the urine to be more alkaline, promoting struvite crystals to form. Struvite stones can also form without an infection, which is seen more commonly in cats than dogs.
Less is known about why struvite stones form without an infection. They often play a role in idiopathic cystitis in cats (also known as feline lower urinary tract disease), a condition associated with stress and straining to urinate. Calcium oxalate stones tend to form with a more acidic pH and are rarely caused by bacteria. Other types of stones can occur with toxins (such as antifreeze poisoning) or can be breed-related as occurs in Dalmatians.
Consequences
If left untreated, bladder stones can grow in size to the point that urination will be difficult or impossible. This is especially problematic if stones pass from the bladder into the urethra and get stuck. Inability to urinate is a life-threatening situation. Other issues associated with bladder stones are chronic pain and increased risk of urinary tract infections.
Prevention
Once you know your pet can have these stones, prescription diets selected for the specific type of stone can help prevent recurrence. It is extremely important that only the prescription food be fed to the pet. No additional treats (unless specific for the diet), bones, or flavored chew toys can be given. Even a small change in the diet can change the pH and mineral content of the urine and lead to the stones reforming.
Increase water consumption as much as possible to help dilute the urine to further decrease chances of bladder stone formation.
Brister, Jacqueline, DVM. Cystotomy for Bladder Stones in Dogs and Cats. 3 Dec 2019. veterinarypartner.vin.com/default.aspx?pid=19239&id=9421365