Friday, September 14, 2012

1097. Toa Payoh Vets - Advices after struvite bladder surgery

Today, Saturday Sep 15, 2012, I reviewed a case of struvite  urinary stones removed by my associate vet from the bladder of a Samoyed, female, 3 years old.

Jun 17, 2012
Three dogs (labradpoodle, corgi and Samoyed)  came for check up and vaccination. Vet A palpated a few bladder stones in the Samoyed and advised surgery.

Jun 22, 2012
Urine test   pH 9.0,   Blood 4+,  Bacteria 2+,  Crystals Triple phosphate 2+, Amorphous phosphate 2+  

Jun 22, 2012 
Cystostomy. Bladder stones removed. >6 pieces of different sizes. Stones sent for analysis.

Jun 28, 2012
Stone analysis report - Calcium trace, Phosphate +ve, Oxalate trace, Magnesium +ve, Ammonia +ve
Vet A informed owner on Jun 30, 2012 and recorded "advised s/d diet".

Jun 25, 2012. Records showed 6 cans of S/D were purchased. No more.

CONCLUSION
This is a typical case. Many owners feel that since stones are removed and a couple of cans of S/D diet has been given, that is the end of the story. The dog shares the dry food again with the other 2 dogs and struvite stones recur again later.

ADVICES
There needs to be montly urine check up and X-rays 3-monthly for bladder stones.
SD diet for 1-3 months and CD diet for another 3 months and do above-mentioned tests till no stones and no abnormally  high alkaline pH + bacteria in the urine. However, owners seldom follow up and as you can see, from a sad case of the Shih Tzu with the blocked bladder I did recently, a lot of emotions and money had to be spent for recucrring bladder surgeries.

Simple prevention by check up and special dietary management will have prevent recurrences and expenses but sadly,  many Singapore owners do not appear to be interested in follow ups or check up after stone removal surgeries. Many may just get the dog put to sleep if there is recurrence again and again as surgical expenses can be too much for them.

For this Samoyed owner, I wrote a letter to the owner to advise the check ups and monitoring.

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