What is Lithotripsy?
Lithotripsy is a procedure performed in dogs to treat urolithiasis-- the presence of stones in the urinary tract. Lithotripsy involves using energy to break the stones (uroliths) into small particles that can be collected or flushed from the urinary tract. The treatment is typically completed with a laser via cystoscopy, a procedure that provides access to the urinary tract with a small scope, rather than with open surgery.
Laser lithotripsy is typically recommended after other treatment methods, such as medication, diet change, and urohydropulsion have proven ineffective in removing urinary tract stones. Dogs are likely to be referred to a surgical or internal medicine veterinary specialist for laser lithotripsy treatment.
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Lithotripsy Procedure in Dogs
Laser lithotripsy is completed under general anesthesia with the use of a cystoscope.
- The patient will be evaluated to determine if he or she is a good candidate for the procedure and fit for the use of anesthesia.
- The patient is anesthetized and positioned for the procedure.
- X-rays or other imaging may be conducted to visualize uroliths.
- The cystoscope, a thin tube fitted with a camera and designed to accommodate surgical tools, is passed into the urethra.
- As stones are encountered, a laser tool is guided to make contact with the stone and energized to break up the material.
- Urolith fragments are either collected and removed or washed out the urinary tract via voiding urohydropulsion.
- The cystoscope is removed and the patient allowed to waken from anesthesia.
Efficacy of Lithotripsy in Dogs
Laser lithotripsy is very effective at destroying urinary tract stones in many dogs, particularly within the bladder and urethra. The procedure is less invasive than surgical removal of stones, and thus carries less risk of complications than open surgery,such as cystotomy. Lithotripsy is generally more effective in female dog than in males, though success rates of 80% or greater are commonly achieved with male patients.
Lithotripsy Recovery in Dogs
After the completion of a laser lithotripsy procedure, a dog may remain at the veterinary hospital overnight for observation. Since there are no surgical incisions, limited aftercare will be needed, such as the administration of antibiotics and pain medications. Small amounts of blood may be present in the urine for a few days after discharge, but the dog should experience relief from the symptoms of urolithiasis rather quickly. The veterinarian may recommend changes to diet or exercise routines following discharge and a follow-up visit may be scheduled to check progress; x-rays may be taken to check for the presence of stones in the urinary tract.
Cost of Lithotripsy in Dogs
The cost of laser lithotripsy in dogs may range from $1,300 to $2,800, depending on the size and condition of the patient and the number of stones present, which will affect anesthesia requirements and the time needed for the procedure. Local availability and the cost of living, along with the need for diagnostic tests and imaging, can affect the overall cost of lithotripsy treatment.
Dog Lithotripsy Considerations
Though laser lithotripsy is an effective method of resolving existing urinary tract stones, it will not prevent the formation of new stones. Any underlying health conditions or dietary issues must be addressed to prevent recurrence of the condition. Further, due to the nature of cystoscopy, not all dogs are good candidates for the procedure; small breed male dogs may not have a large enough urethra to accommodate the scope required to carry out lithotripsy. Additionally, the procedure may not be appropriate for dogs with a large number of stones or particularly large stones, and may not be effective for stones located higher in the urinary tract or the kidneys.
Occurrence of complications associated with the procedure is rare, but injury caused by the cystoscope or laser are possible. Risks associated with anesthesia are also present, though veterinarians minimize the likelihood of complications with a thorough preoperative evaluation and proper monitoring during the procedure.
Lithotripsy Prevention in Dogs
Dog owners can take several steps to prevent urolithiasis from developing and leading to the need for laser lithotripsy treatment. Feeding dogs an appropriate diet, promptly addressing urinary tract infections, providing a sufficient water supply, and giving adequate exercise and opportunities to empty the bladder can help promote good urinary health in dogs.