|"Buddy" the Bassett's Urinary Bladder Stone X-ray|
Urology, or the study of urinary tract health, is a topic near and dear to my heart. My Welsh Corgi, "Bunny," enjoyed good health until she developed chronic kidney disease at the age of twelve. During our nine month journey with Bunny's kidney failure, she taught me a lot about treating patients with her condition. While I do not enjoy diagnosing kidney failure in pets, managing this condition gives me the opportunity to utilize both my experience and training to improve the quality of life for patients that face this terminal disease.
Besides managing kidney failure patients, another enjoyable area of urology for me is correcting urinary incontinence in pets. Surprisingly, this condition is quite common, especially in dogs. One of the best ways for a dog to get its parents' attention is to literally wet the bed. An incompetent bladder sphincter is usually the culprit. With a little help from oral sphincter control medication or hormone replacement therapy, a pet's leaky plumbing can be readily treated so Fido will be invited back into the bed again.
Perhaps the most fun and satisfying area of veterinary urology is diagnosis and treatment of bladder and urethral stones. While urinary stones are not fun for the patient, seeing the "treasures" that grow inside an animal's urinary tract can be quite amazing. "Buddy," the Basset Hound, reminded me of this recently when I surgically retrieved over 140 stones from his bladder, varying in size from millimeters to the size of a plum. His diagnosis was actually made by feeling the grating "bean bag" that was his urinary bladder during his physical examination.
Dogs and cats get a variety of urinary stone types, the two most common being struvite (magnesium ammonium phosphate) and calcium oxalate stones. Urates are the third most frequent stone type, and similar to oxalates, are usually genetic in origin. Struvite stones, on the other hand, are unique in that they are formed secondary to bacterial infections of the urinary tract, and may be treated surgically or by feeding diets designed to dissolve them (Hill's Prescription Canine or Feline s/d or Feline c/d).
Once urinary stones have been removed, analyzed and identified, veterinarians will prescribe an appropriate dry diet with added water or a canned formula to help prevent stone re-occurrence. Feeding the recommended diet exclusively is essential!
Unfortunately, urinary stones can become a life-threatening emergency if they become lodged in the narrow outflow tube of the bladder or "urethra." In addition, in male dogs, the urethra is very long and makes a "U-turn" at the back end of the dog's body before it reaches the tip of the penis. This bend in the urethra is a likely site for stones to get hung up, and is difficult to reach during stone removal attempts.
Please be aware that if your dog strains to urinate and no urine is produced, it is experiencing great discomfort associated with either obstruction of the urethra, an over-distended bladder or bleeding and inflammation of the lining of the urinary tract. Likewise, cats that are frequenting the litter pan more than usual, standing or lying in the litter pan for extended periods, or urinating blood are in distress! If your cat or dog experiences any of the above symptoms, please seek immediate advice from your veterinarian.
Finally and sadly, cancers also occur in the urinary tract of pets. The most common urinary cancer is transitional cell carcinoma of the bladder or urethra. These tumors are initially difficult to detect and their symptoms may mimic a urinary tract infection. For this reason, it is important to do regular urine testing, especially for senior pets, to provide early diagnosis, when cancers are most treatable.
Prostate cancer in un-neutered male dogs is yet another concern. This cancer may cause difficult to treat urethral obstruction and is preventable with routine neutering at an early age. Both urinary and prostatic cancers are treated and palliated with oral chemotherapy drugs that are also non-steroidal anti-inflammatory medications, including piroxicam and meloxicam.
Lastly, don't wait for "Tommy" or "Toto" to have to make the decision "to pee or not to pee" inappropriately. Ask your veterinarian to perform blood wellness testing for kidney health on your pet regularly because, as always, an ounce of prevention is worth a pound of cure!
Dr. Bonnie Jones is co-owner of Delphos Animal Hospital which she operates with her husband, John H. Jones, DVM . She was valedictorian and Outstanding Senior Clinician of The Ohio State University College of Veterinary Medicine Class of 1985.