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Ask the Vet: Can I smash Shih Tzu's bladder stone using ultrasound?

By Craig Reilly

I have a five-year-old Shih Tzu, called Sammy. He's passing blood in his urine and the vet says he has a bladder stone. I really don't want him to have surgery. Is there any alternative way to remove it, as I know people can have them smashed using ultrasound?

Frank, Belfast

Bladder stones aren't that unusual in our patients. Dogs can grow many different types of bladder or kidney stone, each composed of different mineral elements, and each resulting from a different metabolic cause. Perhaps the common stone in dogs can actually be dissolved by feeding a special diet for several weeks.

Before any decisions can be made about using a dissolving diet it is absolutely crucial that a full work-up is completed to assess liver and kidney function, rule out (or characterise) a urinary tract infection, and a detailed assessment to try and determine the exact stone type. If the wrong diet were applied it could really exacerbate the problem. In people, as you say, there is a technique called lithotripsy, where ultrasound waves can be applied either direct to the stone via a camera inserted up the urethra, or perhaps transcutaneously (across the intact skin surface).

In veterinary medicine this technology is starting to become available, but even in the USA it's still only offered by a very few specialist centres. I know the Royal Veterinary College in London is investigating the purchase of a new machine, which may work in small animals, but this isn't available yet (and I suspect may be rather expensive).

Today, we still rely on surgical removal in most cases, at least until we get a stone analysed and can determine its chemical make-up, to facilitate selection of a preventative or dissolving diet or a targeted drug regime.

Most dogs sail through this procedure, especially if it is done before any urinary obstruction develops.

I would urge you to discuss your concerns fully with your vet. You need to trust him/her fully, and seeking reassurance that the very best facilities are available will allow you peace of mind.

No procedure is without risk, but modern anaesthesia and pain relief should ensure a happy outcome.

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Craig is a partner in Cedarmount Veterinary Clinic, Bangor (cedarmountvets.co.uk). Send your pet queries to tele.vet@hotmail.com. Craig can only respond to questions through this column, and these answers cannot substitute for treatment decisions based on a full history and clinical examination by your vet

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