3332. *****2018 Case Study. A 12-year-old male neutered Shih Tzu has bladder stones again - recurring bladder stones

Nov 1, 2018 review of case of dysuria again one year after bladder stone removal by Vet 2.



Oct 27, 2018. Recurrence. Consulted Toa Payoh Vets
The owner regretted that she did not accept the advice to feed struvite prevention therapeutic diet
as advised one year ago when Vet 1 operated and removed the big stone and small ones. Vet 1's report from the University of Minnestoa Urolith Centre's stone analysis indicate a Magnesium Ammonium Phosphate (struvite) with ammonium urate stone.



 
Oct 27, 2018 
Came to Toa Payoh Vets
Urine test
pH 7.0  (5-8)
SG 1.033  (1.005-1.030)

Protein 2% Ketones +, Blood 4+ , Bacteria +, Crystals are triple phosphate +, Amorphous phosphate 3+. 

Dr Daniel catheterised the urinary bladder. Irrigated and remove multiple small stones. No X-rays were done to save owner the medical cost.

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FLASH BACK - ABOUT ONE YEAR AGO

Sep 23, 2017
The dog had great difficulty peeing and dribble urine all over the apartment. The owner went to Vet 1 whose X-rays did not show urinary stones clearly. Vet 1 advised ultrasound to be done by Vet 2 but the owner declined the offer.

Sep 26, 2017. The crying dog had great difficulty in peeing and the abdomen was much swollen.
Rushed to Vet 2 who X-ray and saw a big stone.

Ultrasound guided cystocentesis drew out stinking urine. Quoted $4,000 for surgery. The owner went back to Vet 1 who charged around $1,600.