Urohydropulsion in Dogs

Urinary calculi, or stones as they are called, are not uncommon in dogs. These stones often develop in the bladder, but can also form in the urethra. This can lead to a partial or full blockage of the urinary tract. Dogs suffering from urinary stones often present with difficult urination or blood in the urine. Obstruction is extremely dangerous and should be avoided at all costs, as it can be life-threatening.

Once a dog has been diagnosed with urinary calculi, the vet may suggest treatment via strict dietary management. If this does not work or if the stones are too large, urohydropulsion preceded by a cystocentesis will be recommended. This procedure is preferred over surgery as it is less invasive to the animal. It uses catheters and positioning to flush stones out of the urethra. Any veterinarian or vet tech may perform urohydropulsion as it does not require special training or equipment.

If urolithiasis is suspected, x-rays or an ultrasound will be used to locate all stones and determine their size. The vet will likely palpate the bladder from outside the skin to see if it is enlarged. Blood work may then be run to assess if general anesthesia can be used for the process or not. The dog will be sedated using general anesthesia or topical pain relief combined with low doses of intravenous anesthesia. 

If decompressive cystocentesis is being used, it will be performed using a needle to collect and remove urine from the bladder. This releases pressure and improves the results of the urohydropulsion. Two people are required to perform this procedure, especially on large dogs. One catheter is placed into the urethral lumen and another is inserted up the urethra. 

A gloved finger must be placed into the dog's rectum to apply pressure to the urethra through the rectal wall. Once a tight fit has been made, saline solution will be flushed through the catheter. The bladder will be palpated throughout this process to ensure it does not fill too much. After the tract has been flushed, the catheters may be removed.

Urohydropulsion is a very effective way to remove small stones from the urinary tract. It is most successful in medium and large breed dogs who have stones that are 5 mm or less in diameter. The procedure can fail if pressure is not maintained throughout the process. More than one flush may be run at a time to remove as many stones as possible. Ongoing management will likely be needed to help prevent the growth of calculi in the future. Urohydropulsion is much easier on the dog than a surgical removal and is often the choice of treatment in dogs who suffer from urolithiasis chronically.

As the catheters are removed, the veterinarian will gauge how much trauma has occurred. If the removal has caused damage, a course of antibiotics will be issued to the dog. Pain relief will also be prescribed. X-rays will be taken to see if all stones have been evacuated. If any remain, the dog may be immediately transferred into surgery to remove them. If the equipment is available, a lithotripsy may be used instead to dissolve stones with a laser. If the stones have passed using urohydropulsion alone, the dog will likely be discharged on the same day of the procedure. A special diet to discourage stone formation will be started at this point if it has not already been initiated.

The cost of urohydropulsion can vary from $200 up to $750 depending if general anesthesia is used or not. Antibiotics, pain medication, and blood work also influence the overall price. If during the procedure it is determined that surgery or lithotripsy is needed, costs can jump an additional $1,000. The price of specially formulated dog food can be significantly higher than basic brands, so buying food for your dog to treat urolithiasis may be an ongoing cost that will have to be factored in.

Many dogs who are diagnosed with urinary calculi also suffer from kidney issues. This can make sedation for the procedure complicated. Your vet may have to use more than one method of sedation and carefully monitor the dog throughout the process. During the urohydropulsion, it is possible for either the bladder or the urethral lumen to rupture from being filled too much. It is also possible for an infection to develop in the urinary tract due to unsterilized instruments. Many dogs suffer from mild dysuria after the procedure, however this often goes away on its own. Over a quarter of the time, urohydropulsion does not remove all of the stones, which results in emergency surgery.

There are many different factors that contribute to stone development in the urinary tract. Genetics play a part, so it is always important to request your dog's full family health history when obtaining the animal. Certain breeds are more disposed to these issues than others. A species-appropriate diet low in carbohydrates may reduce the chance of calculi forming. Encouraging your dog to drink many times throughout the day can also help prevent urolithiasis. As soon as symptoms of a urinary tract infection present, treatment should be sought. Chronic or advanced UTIs contribute to stone formation.