Tuesday, May 1, 2018

3144. A male dog cannot pee - urethral stone. Surgery: perineal urethrostomy

May 1, 2018

The lady owner rushed rhe dog to Vet 1 some 9 days ago as the dog could not pass urine at all. Not a drop. Vet 1 "scanned" the dog and said there was no urinary stones. Yet she could not pass the urinary catheter into the bladder. The dog objected and wanted to bite her. The dog pulled out the catheter. For around 3 days, Vet 1 tried catheterisation which cost around $300 including sedation. She also asked the owner to go to the Veterinary Specialists which meant high medical expenses.   

The owner remembered me as I had treated her dog for stroke some 10 years ago and contacted me. She brought the dog over for a second opinion as Vet 1 wanted to neuter the dog on suspicion of prostate enlargement or disease causing dysuria. She also gave a Tardak injection for prostate enlargement. But the owner declined neutering. She wanted her dog to be able to pee normally.

 Dr Daniel performed a urethrostomy and removed the sole urethral stone. X-rays post surgery revealed no other stones in the bladder, kidneys or urinary tract. So, it was only one stone. .


Owner wanted the dog to be discharged since he can pee normally for the past 6 days of hospitalisation. I will not advise it as the urethral opening may close up if the owner does not do a good nursing job.

The dog bites the nurses, hence the e-collar and the need for 2 nurses to clean his urethral wound daily for the past 6 days. Today he is wanted home.






X-rays after surgery to remove one urethral stone show no urinary stones




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Urethrostomy surgery
The urethral stone is lodged inside the perineal urethra, obstructing urine flow. So the dog had great difficulty urinating. This perineal urethra is opened up. The stone is taken out. The dog can now pass urine freely. X-rays were not done by Vet 1. Vet 1 said there was no stone after "scanning." Yet the urinary catheter could not pass into the bladder, meaning that there would be a stone stopping the passage of the catheter.


At Toa Payoh Vets, the urinary catheter was similarly stopped at the perineal urethra from entering the bladder. Urethostomy (opening up the urethra) enabled Dr Daniel to extract the stone, permitting free urine flow. The urethra was left open for the dog to pee from this location. No more difficulty in urination since surgery for the past 6 days before going home.

 




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Video shows the dog can pee after perineal urethrostomy surgery and hospitalised at Day 5 after surgery.



 

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