Concerned about my dog's kidney stones and urethra blockage

I am not sure what path to take with my shih tzu concerning his kidney stones and urethra blockage. I just got back from my vet concerning my Shih Tzu. He is 11 years old has an enlarged heart, and a heart mummer. He has always been a little slow to pee and has been that way for aprox 6 years. He recently started only eating a very small amount, losing weight and the other night was showing major signs of discomfort. The vet did just about everything except the ultrasound to determine if one of the kidneys had a stone blocking it. The x-rays shows 4 stones in the kidneys, 1 small stone in the bladder and a blockade of dozens of stones the entire length of his urethra. Right now we have him on meds for the UTI they said he had and pain pills. They tried to flush some of those back up into his kidney but we have not done a second x-ray to see how well that worked. I doubt it did much and was VERY painful for my dog. We are on our third day now and he still will not eat. I am trying to get him on the S/D food to attempt to dissolve the stones but feel it might just be too much to handle for him at once. He does not show interest in his old can or dry food either. The blood tests showed that he was dehydrated so they gave him some fluids and I am making sure he is getting lots of water and frequent bathroom breaks. Surgery is obviously the option in front of us, but I just don't know if we should go down that road with him. And if we do put him through that it could happen again. How invasive or hard on a dog in his condition would the surgery be? The x-rays shows dozens of small stones along his urethra and it appears to me this would require some major work. What would you suggest in this situation. I am planning on trying to clear this UTI up and seeing if he go back to his old self, then switch to the diet and see if we get lucky with the stones dissolving.

  • Vetinfo

    By: Kara McCarty El Segundo, CA

    Replied on 04/19/2011

    You are in a difficult situation with a dog that has multiple problems, and the stones may reoccur even if you do everything you should. If his stones (calculi) are struvite (magnesium ammonium phosphate) then the S/D diet has a great track record in dissolving those types of stones. Unfortunately it must be the only diet fed for the entire time it takes to dissolve the stones, and one for month after all the stones are gone on a radiograph, and many dogs don't like the taste. Also some patients with heart disease worsen on this diet as it is high in salt and can be more than a weakened heart can handle.

    How high were his kidney values (BUN and creatinine) and have they been rechecked since his fluid therapy? If they were elevated and remained high after fluid therapy that could indicate permanent kidney damage which could be why he doesn't want to eat. This may complicate his recovery from surgery. Definitely continue encouraging him to drink and urinate frequently.

    Is he able to urinate well now even with stones in his urethra? It sounds as if he needs a cystotomy to remove the stones in his bladder and a possible perineal urethrostomy, especially if the stones in his urethra won't budge. A perineal urethrostomy is the creation of a new urethral opening above the area where the stones are blocking his urethra to allow him to urinate freely. This opening is usually made under the anus where his urethra curves around the bottom of his pelvis. It is usually wider and hopefully will allow the stones in his kidneys to pass if they move into his bladder. This is a longer surgery with longer anesthesia, which is a concern in a heart patient, but is probably his best chance of being comfortable in the long run, especially as he doesn't want to eat the S/D.

    The antibiotics will help with the infection but as long as stones are present the infection will likely not go away as calculi are hiding places for bacteria. The chances of him feeling better aren't good until the stones are gone and his kidney values are as low as possible. If you cannot get him to eat the S/D the only chance of him feeling better is surgery and that stress may worsen his heart and kidney disease. Only you can decide if you're willing to risk surgery or not.


    Kara, DVM

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