What Happens When Dogs Have Bladder Stones? (Vet Interview, Videos, Pictures)
Struvite Stones in Dogs
Bladder stones are painful and cause your pet to suffer. While it is rare to see it occur in puppies, dogs of almost any age can develop bladder stones.
Consequently, as a pet owner who doesn't want your pet to be in pain, you may have lots of questions or concerns. about how your dog got bladder stones or what you can do to ease the suffering.
In the following interview, Dr. Cathy Alinovi of Hoofstock Veterinary Services answers some of the most commonly asked questions about canine bladder stones.
Question 1: What are bladder stones (urolithiasis)?
Dr. Cathy: A bladder stone is also called a urolith – uro = bladder, lith = stone. Urolithiasis is the condition of having a bladder stone – iasis = condition. Bladder stones start as tiny seed or crystals that get bigger with time.
Q2: What is the difference between urolithiasis and cystitis?
Dr. Cathy: Cystitis means inflammation (itis) of the bladder (cyst). Many things, including bladder stones, can cause cystitis. Other causes of cystitis include: bacterial infection, bladder cancer, and idiopathic cystitis, which is common in cats who eat too much dry food. (Idiopathic means it just happens and we don’t know why.)
Q3: What are the signs of bladder stones?
Dr. Cathy: The same symptoms that suggest bladder infection suggest bladder stones: straining to urinate and blood in the urine. The best red flag, though, is recurrent bladder infections. In patients that are treated for garden variety infection, if the infection comes back, I insist on a full bladder work-up because the risks of a urinary stone in dogs is too great and must be ruled out.
Oxalate Stones in Dogs
Q4: How many types of bladder stones are there?
Dr. Cathy: There are six types of bladder stones: struvite, calcium oxalate, urate, cysteine, calcium phosphate, silicate. Struvite stones in dogs are the most common.
Q5: What causes a dog to develop bladder stones?
Dr. Cathy: In cases of struvite, usually, it starts with a bladder infection. The tiny little bacteria act as a starting point (a nidus) for minerals in the urine to form around the bacteria. It gets bigger and bigger, and then forms first a crystal, then a stone.
Dr. Becker Discusses Dog Bladder Stones
Q6: Are bladder stones life-threatening?
Dr. Cathy: Bladder stones can be painful, cause moderate to severe bleeding in the urine, and, if they are just the right size to get into the urethra, but too big to pass out the end, they can cause blockage, especially in males. If the blockage is not detected in time, the dog’s bladder can rupture, complications of which can be fatal. This is a very common problem in male cats.
Q7: How are bladder stones diagnosed?
Dr. Cathy: Any dog with recurrent bladder infections really should have a full bladder work-up to determine if there are stones and to determine the bacteria causing the infection. By knowing which bacteria are present, you know where they came from, and you know which antibiotic to use to treat them. However, imbalance in the bladder can lead to formation of stones.
Stones can be seen on a radiograph (x-ray). Some stones are hard to see with a regular radiograph because they are the same “color” as the urine in the bladder.
Therefore, many vets place a urinary catheter into the bladder, inject air through the catheter into the bladder, and then the stone can be visualized. The air/fluid/stone differences are much easier to see on a radiograph than just fluid/stone. Some veterinarians will use ultrasound to find the stone.
X-ray Showing Dog Bladder Stone
Q8: How are bladder stones treated?
Dr. Cathy: Most commonly, stones are treated by surgical removal. Struvite stones can be dissolved with acidifying diets. However, the risk in male dogs is getting the stone just small enough to get into the urethra but not small enough to pass all the way out, so as to cause a blockage.
Q9: What happens if the treatment does not dissolve the urinary stones?
Dr. Cathy: Persistent irritation. I once treated a Yorkie who had urinated blood for two years because she had been misdiagnosed. After the removal of a giant bladder stone, she was normal in three days.
Q10: How can urinary stones be eliminated or prevented?
Dr. Cathy: The key is good diet. Dry foods make very concentrated urine. Food needs to be based on meat. Meat acidifies the urine. Real meat, like what we use in the kitchen, also has moisture. Urine pH should be slightly acidic – 6.25-6.75. Too acid (pH<5) predisposes to urate crystals. Too alkaline (ph>8) predisposes to struvite formation.
These days, there are prescription diets meant to prevent stone formation. I’ve treated patients who formed stones on these diets. These diets are supposed to work by making the urine acid with chemicals.
What makes urine acidic? Meat – protein from the meat. This is why a meat-based diet is so important. Just because it’s a prescription diet doesn’t mean it isn’t made with inferior quality ingredients that can lead to other health issues.
Pet Bladder Stones (Urolithiasis) Informational Presentation
Q11: What breeds are susceptible to bladder stones?
Dr. Cathy: Dalmatians and some Bulldogs are prone to urate stones because their livers do not break down protein as well as in other breeds. This leads to a buildup of urate in the urine. Calcium oxalate stones are common in several cute little breeds like Yorkies, Lhasa Apsos, Bichon Frise, Miniature Schnauzers, Miniature Poodles and Shih Tzus.
Q12: What's the prognosis for dogs undergoing bladder stone removal?
Dr. Cathy: Prognosis is good; most patients do fabulously well. The biggest risks are associated with anesthesia. Once the stones are removed, they need to be identified to understand why they formed in the first place. With that knowledge, prevention of future problems is key to preventing future bladder stones.
Q13: What does the surgical process entail?
Dr. Cathy: The patient is anesthetized and placed on its back. A urinary catheter is placed through the urethra into the bladder. The surgery site is prepped – shaved, scrubbed, and draped. The surgery site is lower than the standard abdominal incision because the bladder is at the pubic rim.
In male dogs, the penis needs to be moved slightly to the side so the incision can still be made on mid-line, and you have to watch out for the blood vessel that runs alongside the penis. The incision is made long enough to get the bladder out of the hole – the bladder is basically a water balloon so it can move around and stretch a lot.
Once the bladder is out of the hole, a lot of dressings are packed around the bladder so no urine leaks into the abdominal cavity. An incision is made into the bladder in an area that doesn’t have a lot of blood vessels. This can be hard in some cases as the bladder is really irritated from the stone.
The incision needs to be big enough to get a sterile glove-encased pinky finger in the hole and/or a stone out of the hole. In some cases there are many small stones, and they all need to be removed and counted to make sure they match what was on the x-ray.
When the stone(s) are removed, sterile saline is flushed through the catheter into the bladder to flush it out. The incision is closed with one of a few suture patterns that rolls the edge of the cut inside the bladder, and this helps it seal better.
Sterile saline is again flushed into the catheter, enough to distend the bladder and makes sure there are no leaks at the incision. When there are no leaks, the bladder is put back in the abdominal cavity and everything is sewn up.
I use a therapeutic laser after surgery to speed healing and decrease the pain associated with inflammation. The laser cuts healing time in half, in my experience. The catheter is left in place until the urine is no longer bloody, which usually occurs within a day.
Warning: Video Contains Actual Surgical Footage
Q14: How risky is the surgical procedure?
Dr. Cathy: Again, anesthesia is the biggest risk. Normally, it’s a very routine surgery with excellent outcome.
Q15: What are some of the common complications?
Dr. Cathy: Honestly, the incision gets really itchy by day five when healing is the most active, and so this is when dogs try to chew out their incisions. That’s the most common complication I see. Since everything is going fine, the pet parents take off the donut or cone, and then when day five hits, out come the sutures. Frustrating. Scary. I’ve even seen dogs chew all the way through and have the intestines hanging out. Consequently, I harp at my clients to leave the donut on!
Q16: How long after surgery before my dog can urinate normally?
Dr. Cathy: When the urine is no longer blood tinged, the urinary catheter is removed. Fluids are given the whole time to flush out the kidneys and bladder and encourage hydration. In most cases, dogs will urinate normally within 24-48 hours, depending on when the catheter is removed.
Q17: How long will it take my dog to recover from surgery?
Dr. Cathy: Once your dog is able to urinate on his or her own, he or she is ready to go home. This usually takes about one to two days. Most dogs are back to normal activity within two to three days. Occasionally, they feel a little pull from the sutures and will have a little hitch in their giddy-up while moving around.
Q18: What should I do if my dog has a loss of appetite after surgery?
Dr. Cathy: Call your vet because that is often a reaction to the medication (antibiotics or pain meds) that were sent home with your pet.
Q19: How is pain controlled after the surgery?
Dr. Cathy: Most commonly, non-steroidal pain relievers are given. Other things that help with pain include therapeutic laser (which also helps with healing time), B vitamin injections, and movement. Actually, getting up and moving around helps inhibit pain. So, the sooner we get your dog home, the better. A few other things to help with pain are Hypericum 200C right after surgery and Arnica 30C through the healing process.
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Q20: What are the chances of a re-occurrence of the bladder stones?
Dr. Cathy: If the underlying reason for the bladder stones is not addressed, they may come back. This is the reason for finding out what type of stone it is and testing for infection. Then, by addressing the diet we can work hard to head off future problems.
I recommend checking urine samples a month after surgery, and then one to two times per year thereafter, just to be sure. Better to catch an early bladder infection than a late bladder stone.
While bladder stones in dogs are usually not life-threatening, they are extremely painful and require immediate treatment. If you notice any warning signs of urinary tract infections or the possible formation of bladder stones, be sure to take your dog to your veterinarian for a checkup as soon as possible.
Dr. Cathy Alinovi's Office Locations
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