Evaluation and management of urolithiasis in dogs
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Date
2004
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Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Mannuthy
Abstract
Ten clinical cases of canine urolithiasis were studied for age, breed and sex incidence, clinical signs, radiological evaluation, site of obstruction, effect of surgery and its complications, urine analysis, urolith composition and recurrence.
The mean age of incidence was found to be 6.3 years. Incidence were more in German Shepherd Dog followed by Pomeranian and Labrador. There were nine males and one female in the study. Urethral obstruction was seen in all cases including one female.
Out of ten animals one animal (D8) was dull and weak in appearance and all others were active. Difficulty in urination was reported in all the animals. Haematuria was present in five animals (D3, D5, D6, D7 and D10). Moderate abdominal distention was noticed in nine animals. Palpation of the abdomen revealed distended urinary bladder in all animals except in one animal (D8), where bladder could not be palpated and fluid thrill was felt on abdominal palpation indicating rupture of urinary bladder.
Radiographic study revealed that the most common site of obstruction was in the groove of the os penis.
The ten clinical cases of urolithiasis were subjected to fourteen operations viz., nine urethrotomy, two urethrotomy and cystotomy (four operations) and one cystotomy. The study revealed that relieving obstruction by surgical correction was effective, as it ensures immediate relief of obstruction and stress. Urethrotomy was found to be satisfactory in removing urethral calculi in males and compression and flushing of bladder enabled to remove small cystic calculi through the urethrotomy incision. Cystotomy was required to remove large cystic calculi. The surgical intervention adopted was found effective in relieving obstruction.
The pH of the urine collected during surgery ranged from 6.5 to 8, colour varied from straw coloured to dark red. Consistency of the urine was turbid in all the animals.
On microscopical examination of urine, sediments were present in all the animals. In one dog (D5) crystals were present and identified as triple phosphate and oxalate.
In all animals urine samples showed growth of the microorganisms were more sensitive to ciprofloxacin followed by ampicillin and amoxycillin.
Catheter tolerance was poor in all the animals. Catheter was found removed on the same day itself by all the animal.
Healing of the surgical wound by granulation was good except in two animals where swelling and oedema of the scrotal sac was seen ( D1 and D8) which were subjected to post scrotal urethrotomy. In all these animals swelling subsided and healing was completed by 30th post operative day.
Bleeding was noticed during and after completion of the surgery in two dogs D4 and D7. In dog D7, injury to cavernosus tissue during the removal of calculi was the cause and was controlled by suturing. In animal D4 bleeding was controlled by administering ethamsylate 1 ml intramuscular for two days.
Recurrence was observed in two cases (20%). In these cases numerous cystic calculi were present when it was originally presented for treatment which might be due to migration of cystic calculi.
The haematological examination showed low haemoglobin content, erythrocyte count, volume of packed red cell in all cases before surgery which increased significantly and reached towards normal by 30th post operative day. There was leucocytosis with shift to left and increase in erythrocyte sedimentation rate which decreased significantly and were normal by 30th post operative day.
The biochemical examination showed elevated blood urea nitrogen, serum creatinine, phosphorus, serum calcium and potassium levels in all the cases before surgery and lowered significantly by 30th day. The fall in serum sodium level seen before surgery showed rise by 30th day and attained near normal value.
Composition of the urolith were analysed by Atomic Absorption Spectroscopy, calcium formed the major component of the calculi followed by phosphorus and magnesium.
Histopathological study of the urinary bladder revealed inflammation and haemorrhage in the submucosa indicating chronic irritation and injury produced by the calculi to the bladder wall.
Electron microscopic study of one of the calculi (D9) was conducted which revealed deposition of concretions around the nidus in concentric rings of varying density and the outer surface showed porosity of varying diameter
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172330