By Dr Joanna De Klerk
Has your dog been recently diagnosed with bladder stones? If you’ve ever had them yourself, you’ll be the first to say how horrible they are! It’s a painful condition, that can cause real problems in the toilet department, and sorting them out should be top priority for your pup.
What are Bladder Stones?
Bladder stones are also known as urinary calculi or uroliths. They are mineralised formations which occur within the bladder. They can be anywhere between the size of a grain of sand and the size of a plum, and it’s not necessarily the case that the bigger they are, the worse they are; small ones can cause your canine friend a lot of distress too.
Bladder stones can form quickly, over the course of a few weeks, or slowly over the course of a few months. There are several different types which are common in dogs, depending on the environment in the bladder. Struvite, calcium oxalate, urate and cysteine stones are often the ones which form.
When stones form, your furry friend might develop any or all of the following symptoms:
- Pain when urinating
- Blood in the urine
- Needing to urinate frequently
- Difficulty urinating and/or only passing small volumes
- Inability to urinate
If your dog is unable to urinate, he must see a vet immediately. This can be caused by a stone blocking the exit of the bladder, which can be life-threatening.
Why Does My Dog Have Bladder Stones?
Bladder stones can form due to a number of reasons. Microscopic crystals in the urine cause micro-inflammation, which results in the bladder wall secreting mucus. The mucus and crystals come together, and over time, harden and mineralise to form stones. But the crystals shouldn’t be there in the first place. The following reasons contribute to the increased likelihood of crystals, and therefore stones, in the bladder:
- Diet: An imbalanced diet can lead to excess minerals being present in the urine, which create crystals. This is most commonly seen in dogs who are fed a home-cooked or raw diet, when the owners have not consulted a veterinary nutritionist to work out a menu which ensures the diet is appropriately balanced. This is most likely to result in calcium oxalate stones forming.
- Urine pH: The acidity of the urine influences the saturation point of certain crystals in the urine. When the pH changes (typically, when it becomes more alkaline), the crystals precipitate out of the urine. Bacterial bladder infections can result in the pH increasing. This is most likely to result in struvite stones forming.
- Genetics: Some dog breeds (for example, Dalmatians), struggle to manage purines, which are found in proteins. As a result, it can lead to urate stones forming. Liver diseases can also mimic the same problem that Dalmatians have. Other genetic conditions can also lead to the inability of the kidneys to reabsorb cysteine, resulting in cysteine stones.
How to Care For Your Dog After Stone Removal Surgery
Bladder stone removal surgery results in an immediate improvement for your dog, but surgery can be quite an ordeal. Your dog may need to stay overnight in hospital for monitoring after the surgery, to ensure he can urinate properly.
When he is allowed home, he will probably have some medications to be administered, such as antibiotics and pain relief. It’s really important to follow your vet’s guidelines to ensure there is no gap in the administration of the medication.
You should also monitor your pup’s urine output, and general health. Your dog should have no problem urinating, and after a couple of days, feel perfectly normal, however he needs to be kept quiet until the stitches come out, which will be two weeks after surgery.
If your dog starts to feel unwell in the week after surgery, immediately take him to the vet. It is a major abdominal surgery where an incision is made into the bladder. Contamination of the abdomen with urine is a rare complication, however it can lead to peritonitis if the bladder stitches break down or there is leakage during the surgery. This can be serious, and require immediate treatment. In addition to this, if your dog has any trouble urinating, this is another reason to immediately take him to your vet.
Stone Dissolution Diets
Some stones can be dissolved with prescription diets. In fact, it is the treatment of choice for struvite stones, as it changes the pH of the urine so that they cannot form or exist. It’s really important the diet is fed until the stones are fully dissolved (this means no treats!). Your dog will need to be monitored every four to six weeks with x-rays, and if the stones have reduced in size by over 20%, the diet can continue.
It usually takes two to three months for the stones to no longer be seen on an x-ray, but the diet should be continued for at least another month afterwards.
Since dietary dissolution is a slow process, monitoring your dog is vital. Stones can still get lodged in the urethra exiting the bladder, which can cause a life-threatening obstruction.
If your pup has a history of pancreatitis, kidney disease, heart disease or high blood pressure, a dissolution diet might not be for them. This is because they are high in fat and salt, which can worsen these conditions, and therefore another treatment option will need to be considered.
Other Options for Treatment of Bladder Stones
There are also other veterinary treatments which can treat bladder stones. If the stones are small and so is your dog, urohydropropulsion might be an option. This is when your pup is sedated, and the vet will fill the bladder with saline, agitate the urine-saline mix, then push the bladder to generate a high pressure whilst holding your dog vertically to expel the stones from the bladder.
Another option for treating stones is a procedure called cystoscopic retrieval. This is when a tiny piece of equipment containing a camera (called a cystoscope) is passed into your dog’s bladder, and a laser is used to break down the stones into tiny pieces. That then allows the cystoscope to retrieve the small pieces with forceps or a basket and pull them back out the bladder. Most vets do not have this specialist equipment though, and therefore it is usually only performed at a referral hospital.
How to Prevent Bladder Stones in the Future
Once the stones have been removed of dissolved, it’s really important to continue to prevent them. Diet plays a large role in deterring formation again, and therefore it is worth having a discussion with your vet about what balanced, commercial diet would best suit your dog. This might differ depending on which stones your dog had.
In addition to that, increasing water intake reduces the chances of crystals and stones forming, as they are less likely to develop in dilute urine. Water intake can be increased by feeding wet food or adding water to dry food.
Finally, catching infections early and monitoring the urine for crystals will help prevent further stone formation. This can be done with periodic urine tests and bacterial cultures.
Take Home Message
Bladder stones are uncomfortable for your dog and can also be very dangerous. Therefore it’s important to get them sorted sooner rather than later. There are many different options when it comes to treating and preventing bladder stones, but the thing that makes the most impact is ensuring your dog is fed a nutritionally-balanced diet.