Surgery Slide Show

Warning: This slide show contains graphic imagery that may not be appropriate for children!

Bladder Stone (Urolith) Formation In Dogs and Cats

Brief Overview:
Uroliths (bladder stones) are most commonly formed when the ph (acid/alkaline) of urine changes because of chronic bacterial infections (frequent urinary tract infections) or abnormal diets.  Some breeds are predisposed to certain types of uroliths. These rock-like collections of minerals form in the bladder and can range in size from a grain of sand to a small chicken egg. The bacteria involved with the infection alter the urine ph, which causes minerals to precipitate out of the urine solution instead of leaving the body as waste. These minerals begin to stick together with help of the mucus commonly found in urine and form crystals. Gradually uroliths are formed and over time increase in size. Growth of the crystals depends on the quantity of crystals present and degree of infection or length of time that the ph has been altered.

Common signs:

1. Blood in urine (hematuria)
2. Straining to urinate (dysuria)
3. Frequent urination (many trips outside or in the litter box)

Hematuria is due to the stones within the bladder irritating the tissue lining the bladder wall. The straining occurs when the stones grow big enough to partially or completely obstruct the urine from leaving the bladder. When full obstruction occurs, the bladder becomes extremely enlarged and painful. Unless the blockage is removed, the animal will die.

Diagnostics:
When an animal is presented with bloody urine we first evaluate the urine under the microscope. A sample is collected by the owner while the animal is urinating, or via cystocentesis (a small needle is placed through the body wall into the bladder and a sterile sample of urine is collected). The sample is analyzed for WBC, RBC, bacteria, and crystals, all signs of urinary tract infection. The animal is then placed on appropriate antibiotics for a period of time to clear the infection up and return the bladder environment to normal. If the patient returns with a reoccurring infection, radiographs are taken to rule out uroliths in the bladder. Most uroliths are visible with radiographs (radiolucent), though ultrasound may be used if uroliths are suspected and the radiograph is inconclusive. Sometimes special dyes (contrast media) are injected into the bladder which will make stones more visible.

Treatment:

1. Diet
   Special diets are used to dissolve the stones.
   Not real appetizing and the pet must eat only this diet in order for the food to work.
   Not successful for all types of stones.
   Slow - takes many weeks to dissolve.
   
   
2. Long term antibiotic treatment
   Costly
   Resistance can occur.
   
   
3. Surgery
   Fastest solution (see slide show)
   Removing the stones is the fastest way to clear up the condition. The stones are surgically removed from the bladder and analyzed. The doctor then makes recommendations on diets that will help prevent reoccurrence.
   More expensive then diet option.

Slides: This set of slides shows a cat undergoing surgery for the removal of bladder stones.

1. Bladder is exteriorized and isolated with surgical towels.
   
2. Incision into bladder is made and the first stone is removed.
   
3. The 2nd stone is isolated and the surgeon prepares to remove it from the bladder. The 1st stone lies on the surgical towel.
   
4. Both stones have been removed and placed on the surgical towel. These stones will be sent off for analysis and a special diet will be suggested to help prevent reoccurence.

Begin slide show >>

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