**Warning: there are actual surgery pictures posted in this blog. Content may not be appropriate for all audiences**
“Hello, North Lake Veterinary, how can I help you?”
“Hi, my cat keeps going into the litter box, squats, but nothing comes out. It’s like he’s trying to pee but can’t. Now hes yowling like hes in pain. What should I do?”
If you’ve ever been in his situation with a cat or a dog you know that the answer is “Get your pet to the vet ASAP!! “ Do not wait. This is an emergency!
There are a number of things that can cause a urethral or urinary blockage, but if you’re pet can’t urinate, they can’t expel the toxic byproducts produced by the body and they will die unless helped. One of the things that can cause a blockage is a “urolith” or bladder stone. A bladder stone is a mineral deposit that can form in the bladder and cause symptoms like bloody urine, urinary accidents in the house, increased frequency of urination and pain. If a bladder stone forms in bladder and starts to move down the urethra it can often become trapped in the urethra rather than being urinated out. This happens more often in male pets, due to their narrow urethra, than females (although I have seen it happen to females as well). If the stone blocks the entire urethra the pet will not be able to urinate.
Lets meet a couple of pets who had bladder stones recently and hear their stories…
This is Charley, a 7 year old male neutered cat. He presented to North Lake Vet for going to the litter box multiple times and not producing any urine.
When Dr. Oliver examined him she was able to get him to urinate but she was concerned about his symptoms. She collected urine for a urine analysis (urinalysis). She also took an x-ray and found…
Charley’s urinalysis showed acidic urine (pH 6). The most common bladder stone in acidic urine is called a “calcium oxalate”. Certain stones called “struvites” occur usually at a basic pH level and sometimes can be dissolved with a prescription urinary food. Unfortunately oxalates usually can not be dissolved, so without surgery they can continue to grow, and pose a daily threat of urinary obstruction. Bladder stones are also irritating to the bladder wall, are a nidas for urinary infection, and are often painful so the quickest path to a healthy pet is a “cystotomy” (a surgery to remove the stones).
Dr Oliver checked blood work to make sure Charley was otherwise healthy. She then started Charley on pain medication, gave him an antibiotic (since she was concerned about infection), and started him on a special urinary food to help decrease the risk of new stones forming. She then scheduled Charley for surgery.
This is Rudy, a 9 year old Yorkie/Bichon dog. He presented to North Lake Veterinary for his annual exam and vaccines. His owner reported that everything had been going well for Rudy but then we noticed him urinating blood in the lobby.
We collected a urine sample and took an x-ray. Here is what we saw… how many bladder stones do you count?
Ok look again…
The Stones in Rudy’s bladder pose a high risk of causing a urinary obstruction. Fortunately he was currently urinating around them. Blood work was drawn and Rudy was started on pain medication. He was scheduled for a cystotomy surgery the following day.
Charley and Rudy both had their surgeries the same day!
Both Charley and Rudy recovered well from anesthesia and from their surgery.
Whats next for them?...
Prevention, prevention, prevention. Think back to Rudy’s first x-ray. He had quite a few large stones that likely took months to form and yet he did not show his owner any symptoms until he urinated blood at the vet. This is another reminder that animals are very good about hiding symptoms and pain, so we need to take preventative measures to keep new stones from forming again; we cannot wait for them to show us signs. That includes continuing a special urinary diet, rechecking frequent urinalyses and rechecking x-rays.
The urinalysis helps alert us to risk factors that can cause stones to form again such as a high urine pH level, bladder infection, and crystals in the urine. If we catch these problems early we can fix them before new stones form. A special urinary diet helps decrease these risk factors. A diet is chosen based on the type of stones recovered from surgery. If bladder stones start to reform (despite the above precautions) we hope to catch them early on x-ray and flush them from the bladder while they are tiny enough to fit through the urethra (avoiding surgery).
Special thanks to Rudy and Charley’s families for letting me share their stories.