Internal Medicine Update | Advancements in Bladder Stone Management
Central Toronto Veterinary Referral Clinic | Internal Medicine Clinical Update
Michael Goldstein, DVM, Diplomate ACVIM
Did you know?
According to the 2016 “ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats,” bladder stones too large to pass through the urethra should be removed by medical dissolution, intracorporeal laser lithotripsy, or percutaneous cystolithotomy instead of cystotomy.
Why consider minimally invasive techniques have over traditional surgical removal?
- Shorter hospitalization stays; often an outpatient procedure
- Shorter anesthesia times
- Minimize risk of suture induced urolith recurrence
- 9% of recurrent uroliths are associated with suture
- Better visualization of stones allowing for fewer residual stones
- Avoids urethrotomy in cases of urethral obstruction with decreased risk for urethral stricture formation
- Decreased post-procedural cystitis or pneumoperitoneum and improved patient comfort
What minimally invasive techniques are available at CTVRC?
- Medical dissolution
- Voiding urohydropulsion
- Basket retrieval
- Laser lithotripsy
- Percutaneous cystolithotomy (PCCL)*
- Technique that facilitates removal of cystic and urethral calculi with the aid of cystoscopy through a small abdominal incision
- Runge JJ, Berent AC, Mayhew PD, et al. Transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi in dogs and cats: 27 cases (2006–2008). J Am Vet Med Assoc 2011;239:344–349.
What factors are taken into account in determining the most appropriate technique for your patient?
- Cat or dog
- Patient size
- Patient Sex
- Urolith composition
- Urolith burden
*PCCL is a cystoscopic technique with minimal limiting factors and suitable for most patients regardless of the factors list above.
If you have a case and would like to see what options would be recommended for your patient, please do not hesitate to contact Dr. Kimberly Ho at CTVRC (kho@ctvrc.ca, 416-784-4444). Sending patient signalment, urinalysis results, previous urolith analysis (if available) and any abdominal imaging can aid in the recommendations made.
Posted by: Michael Goldstein, DVM, Diplomate ACVIM
Categorised as: Clinical Updates, Internal Medicine
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