Meet March pet of the month - Buddy
Buddy was brought to us as a second opinion having had a history of urinary stones, reaching back into his puppyhood. He had previously undergone open surgery at a referral centre to remove these calculi from his bladder which left him with a 10 inch scar, the size necessary to access his bladder for the procedure. A year later he had re-developed many more stones and came to see us. Three large stones were residing in his bladder with another sixteen or so queing up in his urethra close to his penis, which were blocking his urinary flow.
The owners sought our advice because they wanted to minimise Buddy's surgical trauma and hoped that we may be able to correct his problems with keyhole surgery. Good call! We accepted the challenge and addressed the following to do list with particular attention placed on prevention.
- The problem that will present as a potentially life threatening emergency is acute blockage of his urine out flow. To permanently remove this possibility in a dog prone to forming stones, we create a new opening for urine flow at the base of the penis. This is called urethrostomy and works by allowing small stones to pass, that would otherwise block his penis. This works because the urethra is wider here.
- Castration has a positive effect to minimise the formation of Buddy's type of calculi and is necessary with a urethrostomy, so this was performed and the surgical site was then used to create an opening for the urethrostomy mentioned previously.
- Clearly the large stones had to be removed from his bladder surgically so for this we used a keyhole technique to access his bladder via a small incision in front of his sheath. This operating port was approximately 3cm long, the size required to remove the stones.
- Unblocking his tubes involved a mixture of grasping and flushing under endoscopic visualisation. The short video clip shows our catheter flushing from both directions viewed from inside the bladder neck. This catheter is only 2mm wide and demonstrates the ease with which we can assess patency even in the very narrow canal of the neck of the bladder.
Having successfully performed the four stages of this procedure, we were able to send Buddy home that evening with a detailed management plan to help him avoid developing further stones. Buddy returned for his stitches out after 10 days and took top marks for happiness. Us too!