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When Urinary Stones Don’t Always Need Surgery

Early detection can sometimes provide more treatment options.

This dog was brought to AVCI because of difficulty urinating and increased urinary frequency. Abdominal radiographs revealed multiple small radiopaque uroliths within the urinary bladder, confirming cystolithiasis.

Urinary stones can irritate the bladder lining and contribute to inflammation, discomfort, blood in the urine, frequent urination, straining, and passage of only small amounts of urine. Depending on their size and location, they may also migrate into the urethra and cause a potentially life-threatening urinary obstruction.

Not every bladder stone requires immediate surgical removal. Treatment depends on several factors, including:

• Suspected mineral composition
• Size, number, and location of the stones
• Presence of urinary obstruction
• Severity of clinical signs
• Urinalysis and other diagnostic findings
• The patient’s response to medical management

In this case, the stones were small, the patient remained able to urinate, and medical management was considered appropriate. Treatment included oral medications, a prescribed urinary diet, and close clinical and radiographic monitoring.

Therapeutic urinary diets are formulated to modify urine composition and may help dissolve certain types of uroliths, particularly struvite stones. However, not all stone types can be dissolved medically. Calcium oxalate and several other mineral types generally require physical removal or another interventional approach.

At the five-month radiographic recheck, the previously visible bladder stones were no longer detected. The patient remained clinically well, and surgery was avoided at that stage.

This outcome does not mean that all urinary stones should be treated without surgery. Some cases require urgent catheterization, cystotomy, or other procedures, especially when the patient is obstructed, the stones are not dissolvable, or medical treatment is unsuccessful.

Watch for repeated attempts to urinate, straining, crying during urination, blood in the urine, accidents inside the house, or passage of only a few drops. A pet that cannot pass urine requires immediate veterinary attention.

Early examination, urinalysis, diagnostic imaging, and regular rechecks can help determine the safest treatment plan.

Case handled by Dr. Vanissa M. Mengullo-Arabis.