Surgical Treatment Methods for Canine Bladder Stones
Bladder stones are stones that form within the bladder and are the most commonly occurring bladder condition among canine urinary tract stones, seen mostly in older dogs. The main component of the stones is mostly phosphate. In August 2005, a Pekingese dog owned by Zhang in Mishan Town, Wendeng City developed bladder stones and recovered after surgical treatment.
1 Clinical symptoms
The owner reported that this dog was female, 4 kg, 8 years old, and its daily food was mainly meat. Recently the dog's abdomen was found to be distended and it had difficulty urinating. Abdominal palpation revealed a full bladder with a sense of pain, and bladder stones were suspected in this dog. After consultation with the owner, an abdominal exploratory surgery was performed.
2 Surgical method
The dog was restrained in dorsal recumbency on the operating table and given 846 general anesthesia. The surgical site was at the linea alba 3-5 cm cranial to the pubis. The surgical site was shaved and disinfected, and an incision about 6 cm long was made in the skin from the cranial border of the pubis toward the umbilicus. After ensuring hemostasis, the fascia between the sheaths of the rectus abdominis muscles along the midline was sharply separated down to the peritoneum. After incising the peritoneum, the bladder was found to be full of urine; about 200 mL of urine was drawn off with a syringe, and the bladder shrank. The bladder neck was held back with two fingers, and the bladder was carefully flipped out through the incision so that the dorsal side of the bladder faced upward. The bladder was then walled off with moistened warm saline gauze to prevent urine from flowing into the abdominal cavity. A 1 cm incision was made in an avascular area on the dorsal side of the bladder, and stones were found inside the bladder. The stones were removed with a bladder spoon, including 1 stone the size of a peanut, several the size of soybeans, and dozens the size of millet grains. At this point, an assistant inserted a sterilized urinary catheter through the urethral opening, flushing with sterile saline while inserting, repeating several times. After confirming there were no stones in the urethra or bladder, the bladder was flushed with sterile saline containing ampicillin, and then the bladder incision was closed. The bladder was sutured in 2 layers with absorbable suture material: the first layer using a spiral suture pattern, and the second layer using a continuous inverting suture pattern. After rinsing with saline, the bladder was returned to the abdominal cavity. The peritoneum was closed with silk thread using a spiral suture, the sheaths of the rectus abdominis muscles on both sides were closed with interrupted sutures, and the skin was also closed with interrupted sutures. Finally, the skin wound edges were tidied, and iodine tincture was applied to the surgical area.
3 Postoperative care
After surgery, the affected dog received an intravenous drip of 100-200 mL of 5% glucose saline. The skin incision was painted with iodine tincture 1-2 times daily, and ampicillin 0.5 g was injected intramuscularly twice a day for 5-7 consecutive days to prevent infection. The sutures were removed after 7 days, and the dog recovered.