Thursday, November 8, 2012

Bladder Stones, The Case of Princess and the Pee

Bladder stones, (also called urocystoliths), are an all too common affliction of our canine and feline companions. The how and why of their development varies by species and breed and even by individual.

(X-ray of bladder stones. Courtesy of
Almost 50% of bladder stones in dogs involve a urinary tract infection. The microscopic bacteria in the urine do two things that promote urolith formation. First, they alter the pH of the urine, making it more alkaline and causing minerals to precipitate or solidify out of solution. Second, the bacteria themselves provide a nidus or starting point for crystal formation. The remainder of bladder stones form due to a combination of an individual's genetics, metabolism, and diet.

(Courtesy of

Urinary crystals can grow into visible and sometimes huge stones causing trauma to the bladder, frequent and/or bloody urination, and occasionally life-threatening urethral blockage. For many years, treatment of bladder stones involved a combination of antibiotics, dietary management and surgery. However, thanks to voiding urohydropropulsion, a technique developed by Dr. Jody Lulich of the University of Minnesota Urolith Cnter, there's a non-surgical option to resolve small bladder stones. And that's where Princess comes in.


Princess is a 9 year old Rat Terrier owned by Mrs. Maria Wethington and our Case of the Month.

To say that Princess and her housemates Prince and Baby are doted upon or that Ms. Wethington is merely a concerned pet owner would be serious understatements. They travel on pillows, lots and lots of pillows. Originally from Germany, Mrs. Wethington has lived in the United States for 45 years. She retains a charming accent and, despite some serious health concerns of her own, the indomitable courage and sense of humor of a woman who's seen too much difficulty not to appreciate every sunrise.

Careful as she is with her canine babies, it's no surprise that when Princess began to act a little oddly Mrs. Wethington was quick to seek veterinary care. It was that early intervention that made voiding urohydropropulsion an option. Briefly, the technique involves placing a urinary catheter and instilling sterile saline into the bladder to gently distend it. A finger is placed over the urethra to prevent leakage while the dog is held upright, tipping the bladder stones down. The bladder is gently squeezed, the finger pressure is released and the stones are flushed to the outside. This technique works if the stones are relatively small, (which usually means of short duration), in relation to the dog.

And that's exactly how it worked in Princess's case. The initial flush produced almost two dozen tiny stones, and a subsequent flush 2 more. Following a post-procedure x-ray she was still a little sleepy but sitting up and back in her mom's arms in less than an hour.

As you can see Princess is relatively large for a Rat Terrier, but nonetheless loved by her mom. An analysis of her bladder stones is pending. With those results and careful monitoring for recurrence we hope to keep Princess healthy and out of surgery in the future.

1 comment:

  1. those can be quite painful and dangerous...we posted about them on Cat Chat quite some time ago