Tuesday, September 25, 2012

1118. Bladder stones in a 13-year-old dog



 "Is an operation needed to remove the bladder stones?" the lady asked me over the phone. "Much depends on the size and composition of the stones," I said. "If they were small struvite stones, they may be dissolved by eating a special diet."

The dog was a Golden Retriver X, medium sized, 13 years old and lethargic. A high anaesthetic risk. So I did not advise surgery. Catherised urethra 2 days. Today, could pee normally but vomited canned food.

The dog could pee normally and had a good appetite today. So I did not operate as he is very old and thin. Will S/D diet help? But his urinary pH is 6.0 and not alkaline. The urine crystals are nil and so the only way to know what composition of the urinary stones in his bladder would be to do surgery. But the dog may die on the operating table since he is 13 years old. So, this is the difficulty. The dog was given K/D diet by Vet 1 before I was handling the case. Could K/D bring down the urinary pH to below 7.0?

A trial of S/D may not be effective since the composition of the urinary stone is not known. It may be calcium oxalate but it may also be struvite. S/D diet dissolves struvite stones. The dog had antibiotics and a can of S/D diet with informed consent from the owner. For the past 2 days, he was urinating normally and had excellent appetite. I dare not do any cystotomy surgery as the risks outweigh the benefits. An S/D trial is one alternative and it may be worth a trial. It is not evidence-based, I informed the young lady owner. She understood.   

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