Cystotomy: Bladder Stone Removal

Many large breed dogs do not have problems with bladder stones and as a non-veterinarian I am assuming that this may be because it is easier for stones to pass in large breed dogs since the passageways are larger. Breeds that are susceptible to bladder stones are mini schnauzers, dalmatians, shih-tzus, dachshunds and bulldogs. Bladder and urethral stones may be large or small, single or multiple, and may pass spontaneously or potentially obstruct the urinary tract. Stones in the bladder may also make it very painful for the animal to urinate as well cause blood in the urine.

There are several different types of bladder stones, the most common being struvites which are composed of magnesium ammonium phosphate. Other stones are calcium oxalate, cystine and silica stones. Some companies offer genetic testing to see if your dog is affected with this problem or is a carrier.

Large and/or numerous stones can sometimes be felt by hand when the abdomen is gently squeezed but in most cases are definitively diagnosed by x-ray, although small and/or difficult to see stones may require a contrast dye study, ultrasound, or video imaging. A urinalysis is also almost always obtained.

If possible, stones that are removed surgically or passed spontaneously should be sent out for analysis so it can be determined what type of bladder stone it is. Depending on the extent of the condition, treatment may include a very specific diet in which the stones will dissolve by themselves over an extended period of time. However, sometimes a pet is presented to the vet with a bladder literally filled with bladder stones. This can be a very dangerous situation because the bladder could rupture and may well cause the death of the animal. In cases such as this, surgery is almost always recommended barring any underlying medical conditions.

If you change veterinarians, it is imperative that you make your new vet aware of any previous conditions so that the first sign of any regularity in urination should be addressed immediately to determine the degree of the problem. The purpose of this article is to make pet owners fully aware of how potentially painful and life threatening this condition can be. It is so important to communicate fully with your vet and bring the subject up before your dog is in a life-threatening situation.

This x-ray is of an 8-year-old dachshund. It was determined immediately upon viewing x-rays that this dog had a chronic case of bladder stones that could only be corrected by surgery. When the bladder was exposed, it could best be described as engorged. It took 90 minutes to complete the surgery which entailed scooping out the stones, which ranged in size from slightly larger than a grain of salt to 3/8 of an inch squared. The particular dog had 349 bladder stones.

In this particular case, even after considerable time in removing the stones and flushing, post operative x-ray showed there was still one stone left in the bladder. With proper diet, this stone should dissolve over time but will need periodic x-ray monitoring to be sure.

Photos below indicate the progression of the surgery and the display of all of the bladder stones removed.