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Monday, April 9, 2012

Little Dog, Big Stone

Several weeks ago I saw a chihuahua mix for a problem of bloody urine.  I realized that this wasn't a routine urinary tract infection when I did my exam and felt something rather large and hard in her abdomen. A quick x-ray later and my suspicion was confirmed...there was a particularly large stone in her bladder.

For those who aren't used to looking at radiographs, the stone is the big egg-shaped object on the right near the femur.  

Unfortunately, the owner couldn't afford surgery and went home with antibiotics.  A couple of weeks later she came back because her dog seemed to be whining and uncomfortable.  After another exam and checking a few things I concluded that she was painful from the stone, and only removing it would help.  I sent her home with some pain medications, and thankfully the owner was able to get an extension on her Care Credit.  We scheduled the surgery quickly and I went to work.

**Graphic images to follow**

That object is the urinary bladder before I cut into it.  The surgical approach is actually rather simple, not much different than doing a spay.  In fact, we went ahead and spayed this dog while we were in the abdomen, something the owner said she wished she had done years ago.

This is the stone coming out of the bladder.  As you can tell, the stone pretty much filled the entire bladder, and the bladder wall was very thickened and inflamed because of the irritation.  In this particular case it was one single stone, which is less common than having several smaller ones.

Here is the stone after surgery with a scalpel handle for scale.  This is nowhere near the largest stone I've removed.  The winner would be one that was the size of my whole palm, removed from a large dog many years ago.

The patient recovered and is doing fine.  We're waiting on the results of analysis of the stone to determine its composition which will allow us to determine the best way of preventing it from happening again.