Sunday, October 21, 2012

1151. Kidney & stone Schnauzer not eating

Today is Monday, 48 hours after operation to remove the 13 stones and an exploratory laparotomy to find that the left kidney was 3X larger than normal, as big as a golf ball, congested and red, hepatititis and congested spleen with bleeding spots around the omentum of the right kidney and one dark brown patch on the omentum, an abnormal finding. Was the right kidney breaking down due to the long delay in getting the bladder stones removed since X-ray by Vet 1 had shown their presence in August 2012?

Some bleeding from the posterior end of the wound. Bleeding and infections are complications of surgery. No fever. Could it be infection? I needed to take out two stitches to drain.  A protein and glcouse drip will be given. Other than that, the dog looks alert.

Never delay bladder stone surgery. Best is to have routine urine analysis to detect presence of stones esp. in breeds prone to bladder stone, e.g. Miniature Schnauzer. The couple with their two young children visited yesterday Sunday and the dog wagged her tail and was wanting to go home yesterday. There was already redness in the cranial part of the stitch which I presumed was due to licking as the e-collar was smaller. "My dog is great at licking," the husband said. Today, fluid came out from this part and I review again with Dr Daniel. This is a teaching case for him as this dog could have right kidney stones as shown in the X-ray.

Vets usually take the bladder to check for stones and in nearly all cases, there will be no need to check for kidney stones. But this case shows that exceptions do occur. Now what to do with the right kidney stones?

The only good news is that this dog does not vomit for the past 2 days. She was vomiting daily before surgery for at least 6 days including the day of surgery.   

"It is due to infection," my assistant Min said. "Pus comes out."
"Since the area is so clean with no blood clots unlike the cranial part of the wound, I would say it was due to licking." But the dog does not lick in the presence of Mr Min or owners and so many assume that licking could not exist with an e-collar being worn. I got Min to change to a bigger collar and got Dr Daniel to take out two stitches. "Nothing inside the wound," he said as I followed up. So it was inflammation and swelling due to traumatic licking. We gave a drip. The cephalic veins had been bust due to previous IV drips at Vet 1 where the dog had one bladder surgery to remove the stones and another surgery to spay 2 years ago.

Prevention of diseases is cheaper than treatment as Vet 1 had quoted $1,200 for the bladder stone surgery for the 2nd time and the owner said he had paid $1,800 for the first bladder stone removal surgery. That would total at least $3,000. Yearly or half-yearly urine analysis would be much cheaper but no Schnauzer owner would ever do it.


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