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Miniature Schnauzer Unable to Urinate

September 4, 2011

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1 hour after urethral hydro retropulsion and cytotomy surgery, the silver and white mini schnauzer Klaus is eating!

A happy patient eats!

6-Year Schnauzer Can’t Urinate

Klaus, the six-year-old male neutered silver Miniature Schnauzer could not pee.

“Doc, I’m really worried.  He’s been dribbling urine for a few weeks.  But yesterday and today, I haven’t seen any pee. This morning, he didn’t even want to eat breakfast,” Klaus’ mom Trish looked like she was about to cry.

The sweet Schnauzer looked up at Doc, but he did not wiggle his Schnauzer stubby tail.  Klaus felt sick.

“Let’s take an X-Ray, and see if we can find the problem,” said Doc Truli.

Big Reasons for Interruption of Urine Stream in a Dog

  • Bladder Stone
  • Urethral Stone
  • Cancer
  • Infection
  • Granuloma
  • Injury and scar tissue

Klaus’ Radiograph Showed a Stone

Xray of os penis in a dog showing the round radioopaque urethral obstruction

Round Stone Blocking the Pee

This X-ray shows the problem with Klaus’ pee.  The bog white lines are the bones in his back legs.  The curving white thing is the os penis.  Dogs are among the species that have a bone in the penis.  That os (means “bone”) became very, very important in the management and cure of our furry friend Klaus.

The os surrounds the urethra (the pee tube.)  So, if there were no bone, then a stone or object could stretch the urethra mucosal lining a little and the thing would pop out and then the little guy could urinate.  This happens to blocked cats sometimes.  They strain and strain and sometimes, if the vet massages the end of the cat penis, a stone or obstruction will come out and then the urine will be released.  This will not work for a dog because of the os, or bone that restricts the stretch of the urethra.

The yellow arrow in the picture points to a round white thing just behind the os.  (Klaus’ face was to the left of the picture). The stone is bigger than the diameter of the os penis.  The location of Klaus’ obstruction, just behind the os, is a common location for urethral obstruction in a male dog.

How Can We Fix a Urethral Stone?

Klaus’ mom worried more, “How are we going to get that stone out of there?”

First, if a dog is not completely blocked, and if your veterinarian agrees, especially if the stone is in the bladder, or the dog is female, then a special calculolytic diet may be tried.  (pronounced cal-cue-low-lit-tic).  Special prescription-only diets are designed to melt the stone within two weeks.  (Note: there are NO diets at the supermarket or the pet store that may be used in this way.)

Because Klaus was totally blocked, and because the stone was in the urethra, he had no time to try any melting of the stone.

Surgery was Klaus’ best option.

Surgery for a Urethrolith

We did not cut a hole in the urethra in order to remove the stone.  Really?

Yes, really.

What Is an Urethrostomy?

Sometimes the stone is so embedded in the mucusal lining of the urethra that an urethrostomy procedure – cutting a hole in the urethra to get the stone out – is the only way to go.  This procedure may be recommended for a dog that repeatedly blocks.  -Ostomy means making a “stoma” or hole in the part of the body that preceeds the suffix.   For example, a urethrostomy is a hole in the urethra.

 -Ostomy means making a “stoma” or hole in the part of the body that precedes the suffix.   For example, a urethrostomy is a hole in the urethra.

Surgeons can design the hole to stay permanently open, thus by passing the os penis part of the urethra.  The dog would urinate out the bottom on the penis, not the end.  As you may imagine, infections and mess are side-effects of this surgery.

What Is Hydroretropulsion?

Hydroretropulsion is using water (hydro) the push (pulsion) a stone back (retro) up into the bladder.  This procedure relieves the pressure off the bladder and allows urination through the penis.  As you can imagine, it is uncomfortable, and a relaxed pain-free patient is required for the procedure.

Klaus underwent general anesthesia.  A sterile urethral catheter was placed to the point of the stone obstruction.  Doc could actually feel the hard thunk, thunk of the catheter against the mineral stone.  It did not budge.  It did not budge for an hour!  Doc Truli began to lose heart.

Maybe the stone is one of the ones that is embedded deeply in the mucosal lining.  Maybe Klaus would need a disfiguring hole in his penis just to save his life!  Doc did not give up!

All of a sudden, the stone broke free.  The water under Doc’s fingers suddenly pushed back and the stone felt like it went “pop!” and the round offending object passed under the Doc’s fingers up into the bladder.  What a relief!

Obviously, we could not just leave the stone up there; it would find its way back into the urethral and lodge at the os penis again in the near future.

Cystotomy Finds the Lith

Doc Truli switched gears and performed a cystotomy surgery.  An incision was made in the abdominal wall, very much like for a dog spay procedure.  The blader was identified and brought out of the body cavity for examination.  A hole was made into the bladder and the offending stone (“lith” is a synonym for stone) was lifted out of the body and set aside for analysis.  The neatest thing about bladder surgery is how easily the bladder wants to heal.  Everything was sewn up and Klaus woke from surgery.  That bladder was 100% within two weeks.

Klaus was placed on a special diet to prevent calcium oxalate stones in the urinary system, as the stone analysis came back as 100% calcium oxalate stone.

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