I walked into an appointment for a sore ear last week. While I was getting a history, the owner happened to mention the dog had just urinated on the floor and thought there was blood in it. Well against all of Murphy’s laws, little Molley squatted again and out came some bloody urine.
I always start at the head and work my way back when doing a physical exam. By doing the same pattern over and over again, you know you will get everything covered. I got a sample of the ear debris and gave it to one of the techs for cytology analysis. I continued on and when I got to the caudal abdomen (back half of the abdomen), I had to maintain a poker face. I felt a kiwi sized moveable yet firm mass. What was running through my mind – this is where the bladder should be but what in the world is this. Is this a mass benign or malignant? I told the owner that I had found an abnormality and could I take Molley back to the treatment room so I could do a cystotomy (get urine directly from the bladder).
I wish I could have seen my face when I inserted the needle. It hit something hard. I pulled the plunger back and got bloody urine. That’s when I started to get an idea of exactly what I was up against. I stuck my head back in the room to ask her owner if I could do a radiograph of her abdomen. Well, I think the picture speaks for itself. The red outline is of the irritated bladder wall. The stone itself is 4.4cm by 3.5cm.
Now for the part that makes me see red. A number of our small breed dogs are predisposed to developing crystals in their urine as well as bladder stones. The two most common stones are struvite and calcium oxalate. Look at the size of the stomach and try to figure out what is in it. Look again where the green arrow is. Can you see the outline of the chicken necks that are made up of…..bones? Let’s think this through folks. I know we all want to feed the best quality food we can to our pets. But feeding raw diets is not the way. (If you are currently feeding a raw diet, I dare you to send a portion away for laboratory analysis. I will bet that the diet will not come back as balanced. The mineral/vitamin levels will not be appropriate for long term feeding.) So, guess what can happen when a dog is fed high levels of calcium? Some will develop bladder stones.
We are doing the surgery later this week. We elected not to do it immediately as I wanted to give the antibiotics time to heal the bladder wall so it will be a little less delicate to work on during surgery. Don’t worry, I’ll be taking more pictures and will update the case on Thursday or Friday.
