Like humans, cats and dogs experience bladder stones, a painful medical condition in which blood or urine minerals and salts harden and clump together in the animal’s urinary tract. Bladder stones, also called urinary calculi, can form in the bladder, kidneys, ureters, and urethra. However, most form in the bladder and urethra.
There are two common bladder stone types: struvite and calcium oxalate. Both dogs and cats can develop struvite stones, which mostly result from urinary tract infections. Calcium oxalate stones, on the other hand, may form due to dietary factors and urine mineral concentration and are more common in cats than dogs. Female dogs are more susceptible to bladder stones than male dogs. However, male dogs are more likely to experience bladder stone obstruction than female dogs. Obstruction happens when bladder stones block ducts and other transport vessels in the urinary tract. For cats, males are more likely than females to develop both bladder stones and obstruction. Surgery is often needed for large bladder stone removal, since these stones can cause the animal to develop infections and experience excruciating pain. Veterinarians use two main surgical procedures, namely laparotomy (also known as traditional surgery or open surgery) and minimally invasive surgery (MIS). Laparotomy involves a surgeon cutting a large incision in the tissue to gain a full view of the affected bladder areas. Minimally invasive surgery involves surgical procedures requiring smaller incisions than the cuts required in traditional surgery. These procedures employ a cystoscope, a thin camera surgeons use to view inside the bladder. What makes minimally invasive bladder stone removal in dogs and cats superior to traditional surgery? This question can be best answered by examining a common MIS bladder removal procedure called percutaneous cystolithotomy (PCCL). Veterinary surgeons use PCCL to remove bladder stones in male and female dogs and cats. In this procedure, a veterinary surgeon makes a small incision measuring 6 millimeters into the bladder, then inserts a cystoscope to view the bladder and remove the bladder stones. Since the cystoscope magnifies what the surgeon views on a monitor, the chances of leaving any calculi behind are minimal. The cystoscope’s magnification, together with saline flushing, allows the surgeon to view the bladder and urethra with great detail. MIS bladder stone removal procedures are also superior to open surgery in several other ways. For instance, because they involve smaller incisions than those required in open surgery, the animal experiences less pain and heals more quickly. A 2012 to 2017 study on 68 dogs and cats sought to describe PCCL’s use and outcomes in bladder and urethral stone removal. The study reported that PCCL allowed bladder and urethral stone removal with faster recovery times and led to few postoperative complications. Notably, not all dogs or cats are good candidates for MIS procedures such as PCCL. The pet’s general health condition and size determine whether the surgeon will use open surgery or an MIS procedure for bladder stone removal. MIS procedures are most effective in large dogs and cats, since the surgeon can easily place portals and scopes during surgery. Nonetheless, some small dogs and cats have undergone successful MIS bladder stone removal procedures.
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AuthorA board-certified veterinary internal medicine specialist, Joseph Bisignano, DVM, recently completed advanced residency training before joining the staff of VCA West Los Angeles Animal Hospital as a veterinary specialist. Archives
September 2023
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