Bladder stones (uroliths) occur frequently in both dogs and cats. While diet and medication can help dissolve some types of stones, others require procedures to remove them; which often means an open abdominal surgery with hospitalization and recovery time. We are happy to now offer new minimally-invasive options to treat bladder stones in pets so they can recover and return home to their families more quickly.
What is a Bladder Stone?
A bladder stone is a collection of crystals that bind together to form a stone. These crystals are typically microscopic and able to dissolve or pass naturally in the urine unnoticed. If they form into a stone, they can cause problems by rubbing against the bladder wall or harboring infection. They can also block the flow of urine out of the bladder.
Different types of crystals form different types of bladder stones. The two most common are calcium oxalate and struvite. It’s important to know the difference so the doctor can determine the best treatment option and create a plan for preventing them. Causes for bladder stones most commonly include:
• Genetic factors
• Dietary factors
• Urinary tract infections
Not all crystals found in your pet’s urine will lead to bladder stones. Most do not require treatment if they are not causing any clinical issues.
Pets may have bladder stones but not show any symptoms. Others may have one or more of the following:
• Inappropriate urination (outside of the litter box or in the house)
• Painful urination
• Frequent urination
• Straining during urination
• Urinary tract infections
• Bloody urine
Bladder stones can also pass into the urethra and become lodged. This is more common in male animals, but can occur in females. Symptoms of a urinary blockage include a painful and distended abdomen, straining to urinate with minimal to no urine production, vomiting, loss of appetite, and lethargy. This is a life-threatening situation and pets should be seen by a veterinarian immediately.
A physical examination and health history will help your veterinarian diagnose bladder stones. Additional diagnostics should include:
• Abdominal x-rays
• Urinalysis (to assist in determining stone type)
• Urine culture (to look for a bladder infection)
If needed, further testing may include genetic testing and/or an abdominal ultrasound.
Current Treatment Options
• Prescription diets and medications designed to dissolve stones. This is only useful for certain types of stones and typically takes 2-4 weeks.
• Cystotomy – surgical incision in the bladder. This is used when stones cannot be dissolved, the pet also has a urinary obstruction, or the stone is causing significant discomfort. This surgery usually requires an approximately 5-8cm incision into the abdomen and 1-2 nights of hospitalization. Exercise should be restricted for two weeks and most pets require the use of an e-collar.
New Minimally Invasive Options
• Voiding Urohydropropulsion (VUH) – using a catheter, the bladder is filled with saline and then squeezed to flush out the stones (for small stones).
• Cystoscopic Guided Removal– a video camera guides a ‘basket’ inserted through the external urethral opening which grabs and removes the stones (for small stones)
• Laser lithotripsy – this procedure is currently used to treat bladder stones in humans. A laser is used to break the stones into smaller pieces so they can be removed or passed more easily during urination.
• Percutaneous cystolithotomy (PCCL) – this is performed by making a small incision (approximatly 1-2cm) in the abdomen and then creating an opening into the bladder to retrieve the stones under video guidance. This is the only procedure that requires an incision but is still an outpatient procedure.
Benefits to Minimally-Invasive Procedures
Even after treatment, and with appropriate medications, diet, and follow up, bladder stones can recur. This is not only frustrating for the owner and veterinarian but it is costly because pets may require multiple surgeries over their lifetime. If bladder stones cannot be dissolved, minimally-invasive procedures offer a great alternative:
• Removes all stones
• Cost effective
• All are outpatient procedures
• Minimal pain
• Decreased post-operative recovery time
*PCCL is the only procedure that requires exercise restriction
• Patients rarely require an e-collar during recovery
Red Bank Veterinary Hospital is very excited to offer this new technology to treat pets with bladder stones. To learn more, ask your veterinarian or call us at (732) 747-3636.