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Pet Health Watch with Dr. Main
My dog has bloody urine. What could it mean?
T
here are multiple causes of bloody urine that include
trauma, infections, bladder stones, cancer of the
bladder or kidney, and in cats, stress. Bladder stones and
infections of the bladder are by far the most common
causes of bloody urine.
After the specialist arrived
we went back to work on
our patient. We confirmed
the stone was indeed lodged
in the ureter (the tube
connecting the kidney to the
bladder). Should the ureter be
incised to remove the stone
or was there another way?
If your pet has bloody urine, a visit to the veterinarian is
advised. With a physical exam, urinalysis, and image of
the urinary tract, cause and treatment can be determined.
Focusing more on bladder stones, which are fairly
common, a case example will be presented. First of all,
there are several types of stones and causes. Stones can
be caused by infections, diets, and genetic predisposition.
In some cases infections lead to by-products that form
into stones. In other cases the kidney allows certain
minerals to pass into the bladder in excess, which leads
to stone formation.
The specialist found another
way! A small instrument was
passed from inside the bladder up into the ureter and the
stone was retrieved. Urine began to flow from the left
ureter into the bladder and all was working well.
The bladder was routinely closed followed by lavage of
the bladder and abdomen. The post-operative radiograph
was perfect and Lucky was on his way to recovery.
Regardless of cause, bladder stones irritate the bladder
wall, cause bloody urine and discomfort for the patient.
Further stones in the bladder can lead to urethral
obstruction when the stone moves from the bladder into
the urethra. Urethral obstruction is life threatening and is
characterized by the patient straining to urinate without
any success.
This was an interesting case demonstrating the
unpredictability and variety of clinical presentations in
veterinary medicine. Not only is this an interesting case, it
gives a window into the life of a veterinary hospital as well.
Hopefully Lucky will recover well, and be managed with
diet to prevent further stone formation.
Recently, a dog named “Lucky” presented to our hospital
with a history of previous bladder stones and surgeries
to remove those stones. All previous stones were
“calcium oxylate stones” which tend to be recurrent.
Radiographs confirmed that more stones had formed
and surgery was scheduled.
This would be Lucky’s fourth surgery! At the time of
surgery the urinary bladder was opened; and using a
urethral catheter the stones were flushed up and out of
the bladder. The bladder and urethra were checked and
double checked and all was clear. Surgery was thought
to be complete, until the post-operative radiograph
revealed one remaining stone.
Back into surgery for Lucky! Upon inspection the bladder
was again found to be clear, yet just outside the bladder
lodged in the left ureter, very near the bladder wall, was
the missing stone. Fortunately our surgical specialist was
on his way to our practice. A specialist was needed for
this most unusual stone location. We kept Lucky warm
and stable under anesthesia while we waited for the
surgeons arrival.
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