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Bladder Stones in Dogs Diagnosis and Treatment

Bladder Stones in Dogs Diagnosis and Treatment

Urinary Calculi, Urolithiasis

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Updated on September 26, 2024
SUMMARY OF CONTENT
Bladder stones are formed by minerals, which first precipitate out in the urine as individual microscopic crystals. Over time, these crystals can unite to form bladder stones or calculi if certain conditions exist within the bladder. Depending on the type of bladder stones present different treatment options are available, ranging from specialized prescription diets to surgery. Most urinary calculi in dogs are from struvite, calcium oxalate, urate, or cystine crystals.
SEVERITY:
Severity can be mild to moderate, or severe if stones cause an obstruction
  • Diagnosis Icon
    Requires a diagnosis by a veterinarian
  • Time to Cure
    Most cases can resolve in weeks to months with appropriate treatment and diet, though recurrence is possible
  • Treatment Icon
    Treatable by a veterinarian and by the pet parent
  • Prevention Icon
    Diet and water intake play important roles in prevention of some stones.
  • Spread Icon
    Transmission is not possible between animals, or from animals to people
  • Lab Icon
    Diagnosis requires physical exam, urinalysis, ultrasound, abdominal x-ray +/- contrast
VERY COMMON IN
Dalmatians and Bulldogs are prone to urate bladder stones. Certain liver diseases can cause stones.

Symptoms & Signs

Dogs with bladder stones may have blood in their urine and may urinate frequently, passing only small quantities of urine each time. Often, they will strain while urinating, holding their body in the urinating posture for much longer than normal. They may lick their genital area more than normal or may show signs of pain or discomfort when urinating. It is also common for dogs with bladder stones to have accidents within the home. Some dogs with bladder stones may show no signs at all, and the stones are discovered while palpating the abdomen during a routine physical exam. Urinary obstruction caused by calculi would cause much more severe clinical signs. These symptoms may include abdominal pain, firm and distended bladder, vomiting, dehydration, lethargy, and collapse.

Diagnosis

Some stones are noted during palpation of the abdomen during a routine physical exam. In other cases, the diagnosis of bladder stones in dogs is made or confirmed with abdominal x-rays or ultrasound of the bladder. Most stones are radiopaque, meaning they show up on the radiographic film as obvious white objects within the urinary bladder. A few are radiolucent and they do not show up on x-rays. Radiolucent stones may require diagnosis using a contrast dye and x-ray or ultrasound.

Causation

There are several different types of bladder stones in dogs. Struvite stones are composed of magnesium, ammonium, and phosphate. Others are made of calcium oxalate, calcium phosphate, cystine, ammonium urate, or other chemical compounds. Some stones can actually be a combination of these. Each type of stone has its own different peculiarities as to which breed is most often affected and what factors affect the formation. See below for a summary.

 

Struvite: These stones typically form in alkaline urine. Treatment may include antibiotics for any urinary tract infection, a prescription diet to dissolve stones or surgery to remove them if indicated. Specific prescription diets that may dissolve struvites include Hill's s/d or 
Royal Canin Urinary SO. Hill's c/d, w/d or Royal Canin Urinary SO are diets your veterinarian may recommend for prevention.

Oxalate: These stones typically form in acidic urine that is high in calcium, citrates or oxalates. Treatment typically requires surgery to remove them or urohydropropulsion if stones are very small. Oxalates cannot be dissolved using a special diet. Hill's u/d, Royal Canin Urinary SO or Purina NF Kidney Function may be prescribed by your veterinarian to prevent oxalate crystal or stone formation in susceptible dogs. If Hill's u/d is used long-term, your veterinarian should monitor your dog for signs of protein depletion. 

Urate: These stones form more frequently in Dalmatians and Bulldogs as well as a result of certain liver related conditions. Once liver disease has been ruled out in breeds urate formation is not frequently seen in, treatment may include a special diet along with medication,such as allopurinol, which can be dispensed by your veterinarian. If there is liver disease or an obstruction, surgical removal of stones may be recommended. Urates can only be dissolved using a special diet if they are pure, although they are often a combination of different substances. Hill's u/d, or Royal Canin Vegetarian may be recommended by your vet to prevent urate crystal or stone formation in susceptible dogs. If Hill's u/d is used long-term, your veterinarian should monitor your dog for signs of protein depletion.

Cystine: These stones form more frequently in acidic urine and in dogs with the SLC3A1 gene mutation. Treatment may include Hill's u/d diet, Potassium citrate and 2-Mercatopropionylglycine if there is no obstruction present. Cystine crystals or stones may be dissolved using Hill's u/d diet. In some breeds cystine stone development has been linked to testosterone, and neutering is thought to be curative of the disease in Cystinuria Type III. 

 

With all diets, it is extremely beneficial to also increase the amount of water consumption.

Bladder stones are formed by minerals, which first precipitate out in the urine as individual microscopic crystals. Over time, these crystals unite and small grains of sand-like material may be formed. Once these grains are present, additional precipitates form on their surface and the tiny specks are gradually built into stones that sometimes reach 3" to 4" in diameter.

The process by which bladder stones develop is really quite simple, but what causes it to occur only in certain dogs, cats, or humans? Factors that influence the development of stones include genetic predisposition, the concentration of the stone constituents in the urine, urine pH, and the presence of bacterial infections.

Genetics: The genetically controlled physiology of some animals causes them to produce higher levels of substances that are precursors of crystals. These substances are then excreted or formed in the urine.   

Concentration of stone constituents: When there are more building blocks to create urinary bladder stones, then there is a higher likelihood of forming the stones. The concentration of these building blocks can be influenced by the amount of minerals and protein in the diet, the amount of water the animal drinks, and the animal's unique metabolism.

Urine pH: The acidity or alkalinity of the urine influences whether the stone constituents will remain dissolved or form stones. Some stones, such as struvite, form in alkaline urine, whereas others, including calcium oxalate stones, are more apt to form in acidic urine. The urine pH is largely influenced by diet, however, infection and metabolic disease can affect pH as well.

Bacterial Infections: Bacterial infections of the bladder (referred to as cystitis) play the major role in struvite stone information for two reasons.

  1. Bacterial infections tend to make the urine more alkaline (with a pH higher than 7.0) which enhances the formation of struvite crystals. If the pH can stay lower than 7.0, then the struvite crystals are more likely to remain dissolved in the urine and no crystals would form. 

  1. Many of the bacteria that cause cystitis also produce an enzyme called urease. Urease reacts with urea molecules found in the urine to form ammonia and carbon dioxide. The ammonia is slowly converted to ammonium ions, while the carbon dioxide unites with other compounds, freeing up phosphates. Then, through a chain of chemical reactions that seem to feed on each other, the magnesium that is normally present within the urine unites with the ammonium and phosphate to form magnesium ammonium phosphate crystals (struvite). If the crystals are formed rapidly and in large quantities, they will unite together to form stones. However, if only small amounts are formed over a longer period of time, they may simply be flushed out in the urine without causing any noticeable problems.

Treatments

icon AT-HOME CARE
Treatment of bladder stones at home depends on the type of stone and size. A prescription diet may be helpful in the medical treatment of struvite and ammonium urate stones. Specially formulated diets can actually cause the stones - even large ones - to dissolve completely in some cases. These diets often take 2-5 months to completely dissolve stones. They work by decreasing the intake of certain minerals, changing urine pH, and increasing salt intake which increases water consumption to dilute and flush out crystals. Some prescription urinary diets are not safe for use after the stones are dissolved, so frequent rechecks with a vet are necessary. All prescription diets should only be used as directed by your veterinarian. Another change that can be made at home is helping your pet increase water intake. You can do this by using canned food instead of dry food or adding water or diluted broth to the food. You can even use clicker training to train your dog to drink more water. If your dog is eating a prescription diet, always discuss any changes or additives to the diet with your veterinarian.
icon SUPPORTIVE CARE
Diet modifications and increasing water intake may help depending on the type of stone diagnosed.
icon MEDICATIONS
Antibiotics are commonly prescribed for dogs with struvite stones caused by a urinary tract infection. Infections may also be secondary to the damage caused by stones rubbing on the urinary bladder wall. The veterinarian may recommend a urine culture to identify the bacteria and choose the best antibiotic. While many medications are often administered for ‘off-label’ or 'extra-label' use in veterinary medicine, it is important to know that off- or extra- label use of a medication can only be done by a veterinarian when there are no other more appropriate medications for a particular pet's circumstances. Your veterinarian must also know all vitamins, supplements, medications etc. your pet is taking to help avoid complications. You must also be sure to follow all instructions provided by your vet carefully and consult your veterinarian with any questions or concerns if they arise.
icon SURGERY
Surgery to remove bladder stones (cystotomy) is required for large stones or stones that cannot be dissolved with a therapeutic diet. Some dogs may require a urethrotomy (incision into the urethra) or penile urethrostomy (permanent opening in the urethra) to remove stones that are causing a urinary obstruction.
icon SPECIALISTS
A general practice veterinarian can manage most cases of bladder stones in dogs. A referral may be required in complicated cases, or for cases which lithotripsy is recommended.

Cost Of Treatment

Treatment costs may vary greatly depending upon the size of the patient, severity of the condition and the method of treatment. Conservative treatment with diet and medication will vary based on patient size and length of treatment. Prescription diets can range between $40 and $80 per case or bag for canned or dry diets. Antibiotics may cost between $50 and $100. Urohydropropulsion, including sedation, typically cost between $400 and $800. Laser lithotripsy may range between $800 and $1500. The cost for a cystotomy surgery may start at around $1500 for a small dog and $2000 or more for larger breeds. These costs are broad estimates. Most clinics will provide an estimate for services, when requested, as a matter of hospital policy.

Recovery

The recovery period will depend on both the size and type of stones present. Surgical and medical treatments will result in a faster recovery time. Dietary dissolution is slower and can take several weeks to a few months to dissolve a large stone. During this time the dog may continue to have hematuria, dysuria, and recurrent infections. In addition, urethral obstruction risk remains high before the stone is completely dissolved. If your dog underwent any type of surgical procedure for stone removal, be sure to restrict exercise and have your veterinarian fit your dog with a surgical cone to allow proper healing of the surgical site.

Monitoring

Routine monitoring may include bloodwork, urinalysis, x-rays, and/or ultrasound. Close monitoring for return of clinical symptoms is very important and would indicate a return trip to the veterinarian immediately.

Prevention

Diet plays an important role in preventing recurrence of some stones. Prescription diets have been formulated to reduce the reformation of struvite, calcium oxalate, urate, and some types of cystine crystals. Encouraging an increase in water intake is also important since many forms of crystals are less likely to form in dilute urine.

Questions about Bladder Stones

My dog I heated uses tampon is it an emergency

Unfortunately I'm having a little trouble understand your question as I'm not sure what you mean by "My dog I heated uses tampons..." I'm wondering if Bella ate a tampon or if you wanted to use one on her while she is in heat. I will answer both to be safe. If she ate a tampon, then yes this is a medical emergency and she has to see a vet now. Tampons can easily cause obstructions in the GI tract, especially since they are absorbent and can get large in the stomach from liquid in there. if Bella ate a tampon, you need to take her into a vet immediately to get it removed. If she is on heat, no you cannot use a tampon to control her bleeding. It's not safe to use at all, and are not meant for dogs. You can put a diaper on her to catch any bloody discharge. There are dog specific diapers online and at pets stores, or you can use one made of a human child. Just cut a hole in it for her tail. Hopefully this answers your question. If it doesn't, I'm sorry and ask you post again in the forum for free to it can get answered!

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My puppy had parvo virus. If I bring a fully vaccinated dog here, can it infect the new dog? Is there still a risk?

If they new dog is a year old and you are completely sure that that it is 100 percent vaccinated there is a very minimal risk that it will be infected. However, that being said, vaccines are never 100 percent effective so there is always a 0.09 percent chance that the new dog could get the virus. But you should be safe bringing the new dog home. I would make sure that the home environment has been cleaned as thoroughly as possible (this means with bleach to all surfaces) and make sure that the outdoor surfaces have been cleaned as well. Parvo can live in the environment for an annoyingly long time (up to 6 months) so it wouldn't hurt to apply a safe mixture of bleach product to your yard as well. This is probably going completely overboard, but you know how scary parvo can be!

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I have a cat that as a kitten was very ill. We got him from 7 months old. We knew he’d had cat flu prior to him coming here. He is now nearly 5 yrs old. He picks huge fights with our other cat. He keeps urinating and scratching at doors and windows around the house. We allow him to go out via the cat flap unlimited. What is happening to him

I'm glad to see that Pippin has been neutered because this eliminates that possibility of hormone-fueled behavioral changes and aggression. Behavioral changes in cats can occur at any point in time, and could be related to anxiety or stressful situations (even rearranging furniture or introducing new people to the home can be stressful to cats). Without a lot more information and observing Pippin's behaviors, I can't precisely tell you why these changes are occurring. It may be best to consult a veterinary behaviorist in your home so that they can observe everything firsthand. You can also try using calming pheromone collars or diffusers (Feliway is one example), and discussing the use of anxiety medication with Pippin's vet. I hope that all goes well!

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Hi! My cat was recently diagnosed with diabetes. He’s taking insulin and taking antibiotics for a Uti. It’s been 4 weeks and he wobles when he’s walking. He can’t jump up on the bed like he used to.He’s blood sugar is 250 it’s better than it used to. I don’t understand why he’s so wobbly.

Cats can develop what's called diabetic neuropathy, where their hindlegs become progressively weak. The best thing to do is try to get his diabetes under control as quickly as possible. Here is a link describing the conditon: http://www.diabeticcatcare.com/DCCCOK/Neuropathy.htm

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Can I reapply flea treatment early? It’s been 2 weeks with no results.

A [flea](https://www.petcoach.co/article/fleas-life-cycle-anatomy-disease-transmission) infestation on your pet or in your home can be [difficult and frustrating](https://www.petcoach.co/article/why-are-fleas-so-hard-to-kill) to deal with. Yes, if after two weeks the [flea preventive you applied isn't working](https://www.petcoach.co/article/6-reasons-your-flea-prevention-isnt-working), you can reapply flea treatment early, or switch to another brand. I recommend using Advantix or a chewable prescription product from your vet, like Bravecto, Nexgard, Simparica, or Credelio. This recommendation is unrelated to Petco or PetCoach. If you are seeing fleas on Mia now, you can give her Capstar ([Nitenpyram](https://www.petcoach.co/pet-medication/nitenpyram)). It's a one time pill that starts killing adult fleas in 30 minutes and is safe to use with a topical treatment. Use a monthly preventive on all pets for at least 3 consecutive months to break the flea life cycle. Year round use is preferred. You will also have to [treat the environment](https://www.petcoach.co/article/5-tips-to-get-rid-of-fleas). Wash all bedding in hot soapy water, and vacuum the furniture and carpet surfaces. Discard of the bag or empty the canister outdoors immediately afterwards. Use a spray, such as Indoorex or Knockout ES, in the house and to prevent reinfestation.

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My senior cat has metastized cancer.17 yrs old. My vet gave her predizone1 and one half tabs a day.i wanted to know if i can just stop the meds.

Is there a reason you want to stop the prednisone? I would recommend not stopping it and if you feel it is better to stop the prednisone then I would recommend weaning off of the prednisone. I would discuss how to wean the prednisone with your veterinarian. Thank you for using Boop by Petco.

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Disclaimer

The information contained on this page is for educational purposes only. This medication should only be given under the advice of a veterinarian who has examined your pet under the laws applicable to your state of residence.