Bladder Stones: Now You See Them, Now You Don’t

March 4, 2015

The two x-rays seen below are from the same canine patient, taken one month apart. The one on the left shows two bladder stones. On the right you can see the stones are no longer present in the bladder. How did this magic happen? Surgery? Laser therapy? Antibiotics? Food? Magic wand?

canine bladder stones

Canine x-rays. Left image indicates 2 bladder stones. (Click to enlarge.)

Surgery?
Nope. Surgery may be the fastest and most common treatment for bladder stones, but for this lucky duck dog surgery was not necessary. Bladder surgery is performed under general anesthesia. The surgeon makes an incision in the abdomen near the back legs and finds the bladder just inside the body wall. Because the bladder is a hollow organ, it will collapse when the surgeon makes an incision in the bladder wall. Special sutures are placed in the bladder to hold it up and keep it open while the stones are scooped out of the bladder with a bladder stone spoon.

Bladder spoons

Bladder spoons (click to enlarge)

PCCL?
Huh? This acronym stands for per cutaneous cystolithotomy. Using laparoscopy equipment, a pinhole incision is made in the bladder. A small camera is threaded into the bladder and its magnifying properties are used to visualize the tiniest stones. Using this non-invasive method, stones are busted up using the laser and then easily removed.

Laser therapy?
Guess again. For dogs of the right size with not too many stones, non-invasive bladder stone removal is possible. Stones can be fragmented using a special laser which is passed up the urethra and into the bladder. Once the stones are broken into small enough pieces, they are either flushed out of the bladder or removed with a special stone-removing basket which is passed up the urethra and into the bladder to gather up the stone fragments.

Antibiotics?
Yes, but only in part. I can hear you saying, “Wait a minute, this makes no sense. Stones are hard chunks of mineral. Antibiotics treat bacterial infections, they do not dissolve stone.” But, this dog’s urinalysis showed an infection in addition to the stones. The infection played a role in the development of the stones and without treating the infection, the stones will not disappear.

Diet?
Stones form in the bladder as a sequel to infection and also because there are too many minerals in the urine. Drinking more water dilutes the minerals and helps dissolve the stones. Taking advantage of that information, a diet was formulated to promote water drinking in dogs fed the special stone dissolving diet. The diet is also low in magnesium and phosphorus, the building blocks of a type of bladder stone called struvite. This diet does not work in every type of bladder stone, only the struvite ones. Antibiotics are necessary since as the stone dissolves, it releases bacteria, and thus the dog needs antibiotics until the stones are completely gone. Antibiotics alone will not dissolve the stone and diet won’t work unless the infection is controlled, so the correct answer for the magical disappearance of the bladder stones in this dog is diet AND antibiotics.

Signs of bladder stones
Dogs with bladder stones urinate more frequently than is normal, have accidents in the house and blood in their urine. If you see any signs like this, be sure to have your dog evaluated immediately by your veterinarian. View a prior blog post on bladder stones to see diagnostic images of stones.


Pumps and Valves: February is American Heart Month <3

February 25, 2015

heart monthIn February, we celebrate Valentine’s Day with flowers and candy hearts. February also focuses on another type of heart – the one beating inside your chest! This is American Heart Month, raising awareness of heart disease. Both dogs and cats get heart disease, but the common type in each species is different. Cats’ hearts have pump problems and dogs’ hearts have valve problems. Although the problems are different, the outcome for both pump and valve problems is heart failure, or inadequate delivery of blood throughout the body for normal function to continue.

Poor pumping = heart disease in cats <3
The heart is a sophisticated muscle, but it still performs the basic muscle function – contract and relax. When the heart relaxes, the pumping chambers fill. The next muscular contraction expels the blood from the heart into the blood vessels. When the heart muscle is diseased, it can do one of two things – get thicker or thinner. Both are bad. A thick heart pumps less blood with each beat since the thick muscle occupies space inside the heart where the blood to be pumped normally collects. When the heart is thin, the muscles are weak and do not adequately pump blood. Thick or thin, neither heart pumps blood well.

Leaky valves = heart disease in dogs <3
A normal dog heart consists of four chambers, and the flow of blood between chambers is controlled by little valves. Normal valves remind me of alabaster: translucent and white, but unlike alabaster, they are flexible. Especially in small dogs, the valves degenerate as a dog ages, becoming thick and lumpy and inflexible. The distortion of their shape prevents them from closing normally. Abnormal valves leak and blood is not pumped efficiently through the rest of the heart and blood vessels. Over time, the portion of blood leaking out of the heart chambers increases and blood pumped to vital organs decreases.

Congestive heart failure <3
Even though the underlying heart problem in dogs and cats is different, the result is often the same. Poor pumping in cats and leaky valves in dogs can lead to congestive heart failure. These disparate problems both decrease the blood flow to vital organs, such as the kidneys. To compensate, the kidneys retain fluid and when the fluid reaches a critical level, it floods into the lungs, causing pulmonary edema. Acute congestive heart failure is a common reason for admission to the hospital from The Animal Medical Center’s ER. Congestive heart failure can be treated with medications to remove fluid, help the heart pump more vigorously and dilate the blood vessels, allowing them to hold more fluid.

Keeping your pet’s heart healthy <3
I know you want to keep your pet out of the animal ER, so here are some tips for being heart healthy:

  • Keep your pet at an ideal body weight. Obesity increases stress on the heart and it has other negative effects on health as well.
  • Exercise daily with your pet. Folks who walk their dog daily have better heart health themselves.
  • Ask your primary care veterinarian if a consultation with a board certified cardiologist could benefit your pet. Changes in heart valves and muscles cannot typically be reversed; new medications can prolong good quality of life in both dogs and cats with heart disease.

The 139th Westminster Kennel Club Dog Show: Old and New

February 11, 2015
Coton de Tulear

Coton de Tulear | Photo: AKC

This coming weekend begins the multi-day canine spectacular known as the Westminster Kennel Club (WKC) Dog Show. The annual event is the second oldest continuous sporting event in the United States, ranking number two to the Kentucky Derby, one year its senior. Dog lovers can spend Valentine’s Day watching the second annual Master’s Agility Competition at Westminster or meeting over 100 different purebred dogs at the AKC Meet the Breeds show. The WKC Show takes place Monday and Tuesday, February 16 and 17. Daytime events are at Piers 92 and 94 (711 12th Avenue at 55th Street). The evening events, Best of Group and Best in Show, can be seen at Madison Square Garden where the Show has been held for 139 years.

Every Year Beau-tee-ful Dogs!
Nothing new here. The WKC Show will feature nearly 3,000 gorgeous dogs, at least one dog representing each of the American Kennel Club’s (AKC) 184 registered breeds. Leading the pack in terms of numbers are America’s family dogs, the Golden Retriever with 58 entries and Labrador Retrievers with 56. The breed represented by the fewest number of entrants is the Norwegian Lundehund with one ‘lone wolf’ entrant. These truly are rare dogs; I checked The Animal Medical Center’s (AMC) 57,638 dog registrations and found only three Norwegian Lundehunds. This Norse breed features six toes on each foot and a neck so flexible, the top of their head can touch their back, both advantageous adaptations for hunting puffins on the icy slopes of Norway. Like most Artic breeds, they have a thick coat to help them withstand frigid temperatures.

New Breeds at the Show
The list of 184 AKC breeds includes two breeds newly recognized by the American Kennel Club that will be seen at Westminster for the first time: the Coton de Tulear in the Non-Sporting Group and the Wirehaired Vizsla in the Sporting Group. The veterinarians at The AMC know the Coton well as they are popular pets in NYC and we have 145 of them as patients. Since the Wirehaired Vizsla was not imported to the United States until the 1970s, they are not well known. Seeing the Wirehaired Vizslas at the WKC Show will be a special treat since none of these Hungarian hunting dogs have been seen as patients at The AMC.

New Arrivals for 2016
We already know that next year there will be four new breeds ready for participation in the 2016 WKC Show: the Spanish Water Dog, the Cirneco dell’Etna, the Bergamasco and the Boerboel. Except for the Spanish Water Dog, the list appears to be more like a spelling bee challenge than names of dogs!

As Always, The AMC Will Be There
The AMC’s veterinarians will be in attendance for emergency care at both the Piers and the Garden from Saturday until the 2015 Best in Show is named. The AMC will also have an information booth at Meet the Breeds on Saturday (Booth #131 Pier 92) and at the WKC Show on Monday and Tuesday (#44 Pier 94). Please stop by and say hello.


Hound’s Tooth and Cat’s Teeth: A Photo Blog in Honor of National Pet Dental Health Month

February 4, 2015

Baby, It’s Cold Outside: Winter Tips for Pet Owners

January 21, 2015

Five Tips for Keeping Your Pet’s Weight Loss Resolution

January 7, 2015

Since New Year’s has passed, I suspect many pet families are hard at work on their list of resolutions. Weight loss is a common human New Year’s resolution and since estimates of overweight and obese pets range from 25-40%, I suspect it is on the list of many pet families as well. If you have a Labrador Retriever, Beagle, Cocker Spaniel, Basset Hound, Dachshund or Sheltie, breeds at high risk for obesity, weight loss is probably perpetually on your to do list.

Here are my tips to help your pet keep its resolve when it comes to weight loss:

  1. Many pet owners don’t recognize chubbiness in their favorite furry friend. Have your veterinarian assess your pet’s body condition score. This will help determine if weight loss is necessary.

    weight loss for pets

    Pet Body Condition Score Chart

  2. Using your pet’s body condition score, decide how much weight loss is necessary and have your veterinarian calculate the number of calories required daily to attain that weight. Ask if a weight loss food would be nutritionally better than simply cutting back on the current daily portion.
  3. Determine how many calories are in each can, bag or box of your pet’s food and calculate exactly how many ounces, grams or portions of a can are required to meet your pet’s daily calorie allotment. Then feed that number of calories – no more, no less.
  4. Limit treats to 10% of the calculated daily calorie allotment AND include treats in the daily calorie total. Treats can look deceptively calorie free and help to pack on the pounds. A small Milk Bone biscuit contains 20 calories and a Bully Stix has up to 22 calories per inch. A six inch stick could be nearly 25% of your 30 pound dog’s calorie allotment for the day.
  5. Keep your pet active. Throw a ball. Use the laser pointer with your cat. Exercise with your pet. Scientific research has shown exercising your dog is good for those on both ends of the leash.

Here are more weight loss suggestions for pets.

Let’s clink our glasses of no calorie seltzer water to a healthy, happy and thinner 2015 for the whole family!


Veterinary Year in Review: 2014

December 31, 2014

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