Saturday, November 29, 2014

1118. Sunday's interesting case. Second Opinion. The Shih Tzu has bladder stones 3 years after surgical removal

Nov 30, 2014

A referral case. The couple wanted to know whether the 13-year-old, female, spayed Shih Tzu would be able to survive anaesthesia if the operation to remove the recurrent calcium oxalate bladder stones is to be performed. A health screening was done as a routine by the family vet. X-rays show bladder and kidney stones. The dog had bladder stones of similar composition removed 3 years ago and had been on dry U/D diet since. But with dog biscuits fed daily and bread sometimes. After bladder stone removal, the urine was checked 3 months later. There were positive calcium oxalate crystals as the dog was still fed her usual dry food and not U/D. After switching to U/D, the urine were negative for 2 more times and there was no more urine check up since.

"There is no urine analysis report," I said on this fine Sunday morning at 9.10am. A client had referred this couple to me as regards the bladder stones. 

The husband phoned the clinic and the results were faxed over. "Urine pH is 6.0, few calcium oxalate crystals, red blood cells and white blood cells were present," I said. This low pH shows that the urine is acidic, favourable for calcium oxalate crystals to form.

I palpated the throat and the abdomen. The dog coughed and winced in pain when I palpated the whole abdomen. Yet the owner reported that the dog did not vomit but had lost 10% of appetite and that the night urine was in a small puddle nowadays, instead of one large amount.

"Based on the health reports of the dog 1.5 months ago from your family vet showing normal liver and kidney and blood cells,  and my examination of the heart and lungs, there is a high chance that your dog will survive anaesthesia" I said. "However, the pain in the throat and the abdomen shows that something is not right with the dog. Most likely a start of inflammation of the kidneys and bladder."

The dog was on antibioitc medication for 14 days and strictly no more dog biscuits. U/D canned food for the next 14 days and if the dog has normal appetite, instead of being coaxed to eat, the dog will be Ok for surgery. 

Feeding U/D prescription diet must be exclusive. No other dog biscuits, bread etc to be given to the dog. Urine test every 3-monthly and then 6-monthly will be advised but NO Singaporean dog owner ever bother to do this monitoring after bladder stone surgery.


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