Detailed Explanation of Surgical Treatment Methods for Canine Urethral Stones

1 Case Description

A white Pekingese dog, male, 2.5 years old, weighing 8 kg, kept by a dog owner in Zhichunli, Haidian, Beijing. According to the pet owner: the dog initially showed signs of difficulty urinating, frequent urination, with only a few drops each time. It had been seen at another pet clinic and underwent a puncture once, which slightly relieved the symptoms, but the next day it was no better, and although furosemide was used, it was still ineffective, with the symptoms becoming more severe. In the morning, it was observed making urination postures but no urine was passed, and the dog was in obvious distress. Therefore, it was brought to our hospital for treatment.

2 Clinical Examination

The dog's abdominal wall was sensitive and tense, refusing palpation, the bladder was distended, and the glans penis was red and slightly swollen. X-ray revealed 2 stones approximately 3 mm in diameter at the base of the penis, lying close together. No stone-like suspicious bright spots were seen in the bladder or the posterior urethra. It was initially diagnosed as urethral stones, and urethrotomy was decided upon.

3 Surgical Treatment

846 compound and ketamine were mixed at a ratio of 3:1 for a total of 0.8 ml, administered by intramuscular injection for anesthesia. The dog was positioned in dorsal recumbency, and routine shaving and disinfection were performed. Aligning with the X-ray film, the base of the penis was carefully palpated by hand to locate the exact site of the stones. At the site where the stones were present, the penis was lifted with the left hand to make the skin taut. A 1 cm longitudinal skin incision was made, then the corpus spongiosum was carefully incised, with hemostasis performed at all times to clearly identify the incision location, ensuring a single clean cut without damaging more tissue. Finally, the urethral mucosa was incised, and 2 earth-yellow stones were removed with hemostatic forceps. After examination confirmed there were no smaller stones, a urinary catheter was pushed from the opening of the penis into the bladder, taking care when passing through the incision site, as rough force would damage the urethra. Observation of the urine drained from the distended bladder showed no fine powdery gravel, confirming that all stones had been removed. Warm normal saline was used to flush repeatedly 2 times, and the catheter was left in place. The urethral tissue was sutured continuously with size 15 catgut, and 0.2 g of ampicillin powder was sprinkled on, followed by interrupted sutures of the skin. Finally, the urinary catheter opening was sutured to the glans penis to prevent it from being expelled by straining or pulled out by the dog itself.

To prevent the dog from licking or biting the wound, an "Elizabethan" collar was applied; at the same time, "Band-Aid" was applied to the surgical incision (with iodine tincture applied immediately after surgery). Ampicillin was injected intramuscularly twice daily, 0.5 g each time, for 3 consecutive days. Baytril 0.8 ml/day was injected subcutaneously, and after 5 days the urinary catheter was removed. The wound healed well, and urination was normal.