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          Canine Bladder Stones          

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Canine Urolithiasis
Bladder Stones
What is Uriolithiasis

Canine Urolithiasis

http://www.executec.com

Urolithiasis is a disease caused by the presence and effects of uroliths (stones) or claculi or excessive amounts of crystals in the urinary tract. The disease is referred to by many names, including cystitis, urethritis, urinary calculi, bladder stones, or kidney stones. As in humans, these stones and crystals can form anywhere in the urinary tract of the dog, including the kidney, urethra, or most commonly, the bladder. These crystals or stones irritate the lining of the urinary tract, causing changes in the lining, blood in the urine, and often pain. In some cases the crystals or stones will block or partially block the flow or urine, making urination painful or impossible.

Signs of Canine Urolithiasis
A dog with urolithiasis will exhibit some or all of the following symptoms:

Frequent urination (often in unusual places)

Bloody urine

Dribbling urine

Straining

Weakness

Depression

Loss of appetite

Vomiting and pain

If your pet has any of these symptoms, you should contact your veterinarian immediately. In some cases without appropriate diagnosis and treatment, your dog could face a life threatening situation. Stones can block the urine flow, prevent elimination of poisonous wastes and cause death. It is important to know that not every dog with canine urolithiasis exhibits all of these symptoms.

Definition of Terms
Your veterinarian may use some terms in describing urolithiasis with which you are not familiar. These terms include cystitis, crystaluria, urolith, and urethral obstructions.

Cystitis is an inflammation of the urinary bladder. This condition occurs because of bacterial or possibly viral infection which results for the irritation caused by crystals and stones in the bladder. Cystitis may contribute to the formation of additional stones within the bladder.

Crystaluria denotes the presence of crystals in the urine. Crystals form when minerals bind together. The bound crystals are not as soluble as the unbound form and may result in mineral deposits, much like the deposits commonly found in a teapot or coffee maker.

When more and more of these crystals join together, they form a urinary stone or urolith. There are several different types of stones and each should be treated or prevented differently. It is important for your veterinarian to know what type of stone your dog has.

Urethral obstruction occurs when stones or an accumulation of crystals partially or completely block the tube through which urine is excreted. This is very painful and is a medical emergency.

Important Factors
There is no single cause of canine urolithiasis. Yet, there are a number of important factors.

They are:
Age: Urolithiasis may appear in your dog when it is less than two months old, but most stones occur in dogs two to ten years of age.

Sex: Urolithiasis appears to occur with equal frequency in adults of both sexes. However, because the urethra of the male is longer and narrower than the female's, urethral obstruction is more common in males.

Breed: Small breeds, including the Welsh Corgi, Miniature Schnauzer, Pug, Lhasa Apso, Pekingese and Yorkshire Terrier are more commonly affected than are large breeds. The Beagle, Dachshund, Dalmatian, Bulldog, Basset Hounds, Cairn Terrier and Scottish Terrier are also susceptible.

Confinement and Exercise: Infrequent urination, as a result of confinement, lack of regular exercise, or low water intake, contribute to the formation of crystals and uroliths.

Diet: High levels of some minerals in the diet, such as magnesium, phosphorus, and sometimes calcium, have been directly linked to canine urinary bladder stone formation. A diet with excess protein can contribute to stone formation.

In most cases, stones are made up of only one type of crystal, but on occasion, different crystals may be mixed within the same stone. Each type of stone is affected by different nutrients and characteristics of the diet. Therefore, it is important to know what type of stone your dog has.

Diagnosis of Canine Urolithiasis
If your veterinarian suspects your dog may have uroliths, he or she may perform some or all of these diagnostic tests:

Abdominal palpation, to feel stones present in the urinary bladder
Urinalysis, to determine the types of crystals present

Urine culture, with antibiotic sensitivity, to determine if bacteria are present in the urinary tract and the appropriate antibiotic with which to treat these bacteria

Radiographic examination (possibly with contrast media), to see if stones are present and their location in the urinary tract.

To evaluate how well your pet is responding to therapy, your veterinarian may periodically repeat some of these tests. Therefore, you will need to bring your pet in for rechecks as directed by your veterinarian.


Treatment/Management
If the urinary tract is blocked, your veterinarian will have to correct the blockage and empty the dog's urinary bladder. Then, your dog will be further examined to determine the stone type and appropriate therapy. Your pet may need to stay at the hospital during this process.

In the past, urinary bladder stones have been surgically removed and for some stones, surgery may be the only effective treatment. But for most stones, there is an alternative. In most cases, the stones may be dissolved by feeding a special diet with reduced amounts certain minerals and protein, or a special diet plus medication. If an infection is present, antibiotics are also necessary.

Special diets work by reducing the mineral building blocks or urinary stones in the urine. These diets affect the urine pH and increase urination to help flush the urinary tract.

To completely dissolve the stones takes 4-16 weeks, depending on the size and number of stones present. During this time it is very important that your dog consume nothing besides the prescribed medications and the prescribed diet. Otherwise, the diet will not work properly and your pet will be plagued with this condition longer than necessary. Follow your veterinarian's directions when feeding the prescribed food, whether for treatment or prevention. Although these foods may not look like your typical dog food, most dogs readily eat these diets and find them palatable. If your dog is one of the few that doesn't readily accept a new diet after two days, you may want to try the following:

Warm the canned diet to, but not above, body temperature

Hand feed the new diet for the first few days

Mix the dry diet with a little warm water and wait 10 minutes before serving

Over a 7-10 day period, mix the diet with your pet's former food, gradually increasing the proportions until only the new diet is being fed

Feed only the prescribed diet!

Do not feed meat, liver or other animal tissue, vitamin/mineral supplements, calcium supplements, breakfast cereals or vegetables.

Be patient, but firm with your dog. This is important. The success or failure of treatment depends to a large degree on strict adherence to the new diet.

If a bacterial infection is present you may need to keep your dog on antibiotics during this entire period.


Home Management
Once at home, your pet needs special attention and care. It is important that you provide free access to fresh, clean water at all times. Follow your veterinarian's instructions for card and activity if your dog's stones were removed surgically. This will include monitoring the incision and returning to your veterinarian for rechecks.

Follow instructions carefully if your dog has a prescribed medication. Antibiotics should be given for the entire period for which they are prescribed.

During and immediately following the dissolution process, your veterinarian may ask you to monitor your dog's urine pH at home or to bring a urine sample for follow-up urinalysis.

Call your veterinarian if any questions or problems arise. Watch your pet for bloody urine, straining, urinating in unusual places, excessive licking of the vaginal or penile areas, vomiting, diarrhea, lack of appetite, or depression. If any of these signs occur, please contact your veterinarian.


Diet and Prevention
Of all dogs treated for urolithiasis, 20 to 50 percent will have a recurrence of the problem and accompanying pain if preventive measures are not taken. Fortunately, just as there is a dietary alternative to surgery, certain diets can also be used to aid in the prevention of stone formation. Based on the type of stone your pet had, your veterinarian can prescribe the correct diet to aid the prevention.

"An ounce of prevention is worth a pound of cure"
Copyright © 1995-98 Branford Miniature Schnauzers
reprinted with kind permission from R Theer
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  Bladder Stones (Urinary Calculi)

By Race Foster, DVM and Marty Smith, DVM
Drs. Foster & Smith, Inc.
http://www.peteducation.com

This article will help you better understand bladder stones in dogs. If your dog or cat is showing any symptoms or signs of disease, please contact your veterinarian. We want you and your pet to be happy and healthy.

Although we often call the condition "bladder stones", its real name is urolithiasis and it refers to finding stones (or calculi) anywhere in the entire urinary tract. The urinary calculi can be found in the kidneys, ureters (tiny tubes that carry urine from the kidneys to the bladder), bladder, or urethra (the tube from the bladder to the outside of the animal). However, in the dog, they are found within the bladder itself over 85% of the time.

Signs and diagnosis of bladder stones
Dogs with bladder stones may have blood in their urine and may urinate frequently, passing only small quantities each time. Often they will strain while urinating, holding their body in the same posture for much longer than normal. However, much to the constant surprise of the veterinarian and the owner (once they have seen the x-rays), many of the affected animals show no signs at all. In our practice, bladder stones are usually diagnosed during a routine office call when the animal is brought in for yearly vaccinations or a heartworm test. There are no complaints about urinary problems. Rather, while palpating the abdomen during the physical exam, we detect the stones.

In less obvious cases, the diagnosis is made or confirmed with abdominal x-rays. Most stones are radiopaque, meaning they show up on the radiographic film as obvious white circles or shapes just as bones do. A few are radiolucent, where the x-ray beams pass right through without being affected and therefore they do not show up on the finished film. To confirm the presence of urinary calculi, we put a dye (similar to barium) in the bladder and it outlines the stones in the x-ray. With the method we see a white area (the dye) with a black hole in the centre (the stone).

As we stated, many dogs with bladder stones show no outward signs of any kind-no pain, no blood, no straining. We honestly do not understand this because in many of these animals the stones are occupying over 80% of the internal space of the bladder! However, don’t get the idea that this condition cannot be life threatening. If a stone is caught in the ureters or urethra, it can easily obstruct urine flow completely which leads to a painful death. In these situations, only emergency surgery can save the animal.

Types of bladder stones
There are several different types of bladder stones, depending on their chemical make-up. In this article we will deal with the more common struvite stones that are composed of magnesium ammonium phosphate. Others are made of calcium oxalate, calcium apatite, cystine, or ammonium urate. Each form has its own different peculiarities as to which breed is most often affected and what factors affect the formation. However, by understanding the struvite ones we will learn a lot about urolithiasis in general.

How bladder stones are formed
All bladder stones, whether they are struvite or any other type, are formed by minerals which first precipitate out in the urine as individual microscopic crystals. Over time, these crystals unite and small grains of sand are formed. Once these first grains are present, additional precipitation forms on their surface and the tiny specks are gradually built into stones that sometimes reach 3" to 4" in diameter. As a simple example, this is the same process that occurs when you put sugar into a hot cup of coffee. At first it all dissolves, but as the liquid cools its carrying capacity decreases and the sugar returns to its granular form. There is no such temperature change in the bladder but the dissolved minerals still precipitate out in the form of microscopic crystals. If this happened only rarely, no harm would be done as they would be flushed out of the body with the urine. In certain animals, however, large quantities of minerals are rapidly formed and clinical urolithiasis develops.

What causes bladder stones
The process is really quite simple, but what causes it to occur only in certain dogs, cats or humans? As we understand it today, the factors that bring it about are genetic predisposition, bacterial infections, diet, and urine pH. Any one of these could be solely responsible but it is usually a combination of any or all of them.
 Genetics: Whenever we describe any medical condition, it seems we always have to mention genetics. We sometimes worry that our readers think we are trying to place blame for all of these conditions on the shoulders of either the breeders or the dog owners. But stop and think about it for a second. Every day on radio or television, we are told of how a researcher just isolated the gene that causes Cystic Fibrosis, Parkinson’s Disease, colon cancer, etc. Genetics has the same effect in veterinary medicine as it does in human medicine. Our problem is that in animal research we are years behind in this area. We are left with trying to determine which animals show and/or carry the defective gene in question and then eliminating them from the breeding population. If diet were the sole answer, wouldn’t all dogs fed the wrong diet develop stones? Think how much easier it would be for good breeders if veterinarians could test puppies and determine which ones were carrying the gene that caused them to develop hip dysplasia. Someday we will be able to do this. But for the near future, breeders are left with the older methods of trial and error as they attempt to accentuate the good traits and eliminate or reduce the less desirable ones. It’s the same with struvite stones. The genetically controlled physiology of some animals causes them to produce within their bodies the higher levels of the substances that are precursors of the crystals. They are then excreted or formed in the urine. We have no way of testing to predetermine in which individual dog or line of dogs it will occur, but from experience we can tell you that the incidence is much higher in the Pekingese, Dachshund, Miniature Schnauzer, Dalmatian, Pug, Bulldog, Welsh Corgi, Beagle, Basset Hound, and Cocker Spaniel breeds. Once an individual animal has developed stones within the urinary tract we might recommend against breeding it. We say might because we may determine that some of the following other factors may have been predominant causes of the problem.

Bacterial Infections: Bacterial infections of the bladder (referred to as cystitis) play a large role in struvite stone information for two reasons: (1) they tend to make the urine more alkaline (with pH higher than 7.0) and (2) by-products of their metabolism actually initiate chemical reactions that cause the magnesium ammonium phosphate crystals to form. Most bacterial infections of the bladder tend to raise the pH of the urine. This is important in this specific condition as struvite crystals are more apt to remain in solution if the liquid is acidic (with a pH lower the 7.0). That is, they would continue to be dissolved in the liquid and no crystals would form.
Additionally, many of the bacteria that cause a cystitis also produce an enzyme (a compound that causes chemical reactions to occur) called urease. This enzyme starts the process be reacting with urea molecules found in the urine to form ammonia and carbon dioxide. The ammonia is slowly converted to ammonium ions while the carbon dioxide unites with other compounds, freeing up phosphates. Then, through a chain of chemical reactions that seem to feed on each other and at the same time raise the pH of the urine into the alkaline range even more, the magnesium that is normally present within the urine unites with the ammonium and phosphate to form magnesium ammonium and phosphates (struvite). If the crystals are formed rapidly and in large quantities, they will unite together to form stones. However, if only small amounts are formed over a longer period of time they would simply be flushed out in the urine without producing any problems.
Diet: Diet also plays a role in struvite formation. The urea that we mentioned above is formed when protein within the bladder is broken down by bacteria. The body's breakdown of large dietary proteins into smaller molecules also produces urea. Diets with excessively high levels of proteins simply provide the system with more urea to work with in the formation of ammonium and carbon dioxide. In truth, this may be the only factor in animals fed all-meat diets. Commercially prepared dog foods, even the highest protein varieties, would not be a factor in most animals.

Treatment
Treatment of urolithiasis allows choices for the owners and veterinarians - that is, either to treat medically or surgically. In most cases, we prefer to handle these with a combination approach. In situations where a stone has lodged in the ureters or urethra, surgery is of course mandatory. We are dealing with a life or death matter that must be resolved immediately. Urinary obstructions lead to kidney shut down and death. However, in typical cases where the stones are found only in the bladder, choices can be made.

Surgery: The surgical removal of stones within the bladder is referred to as cystotomy, meaning an opening of the bladder. This is usually a very easy procedure. Most veterinarians would agree that it requires less skill than a spay. With the dog under anaesthesia and lying on its back, an incision is made through the ventral abdominal wall in front of the pelvis. The bladder is exposed and lifted out through the incision. It is then opened, urine is collected for culture and analysis, and the stones are removed. We usually flush the bladder and urethra with sterile saline solution to wash out any small or microscopic particles. The bladder is then closed with sutures as is the abdominal wall. The patient is placed on antibiotics and sent home the following day. The stones are sent to a laboratory for analysis to determine their chemical make-up and the remainder of the therapy will vary depending on the results.

If there are stones caught in the urethra, which is especially common in male dogs, we try to back-flush them into the bladder before it is opened. If this cannot be done, an incision must be made directly through the urethral wall where the stone is located. In the rare case where stones are lodged in a urethra, an incision would have to be made at the site. Some work is being done using ultrasonic waves to destroy stones in these situations but it is not readily available for all practices. This technique is common in human medicine and may eliminate surgery.

Medical Therapy: Medical therapy can be used by itself or in conjunction with the surgery. After the diagnosis and x-rays, pre-treatment laboratory work entails culturing the urine for bacteria and a urinalysis to determine what type of crystals are present along with the pH of the urine. Armed with this knowledge, we follow the obvious path. If there is cystitis present, a culture and sensitivity is done to determine the appropriate antibacterial medications to use and then treatment is initiated. After we determine what crystals are present in the urine, we know what type of stone is probably present and we try to modify the dog’s metabolism and urine to prevent further formation. This entails altering the urine pH, increasing water consumption, inhibiting the activity of urease, and use of special foods. Urinary Acidifiers: As we said, struvite stones form in alkaline urine. In these cases we would use medications that acidify the urine hoping it will keep the magnesium ammonium phosphate crystals dissolved and prevent them from precipitating out in the urine. Examples of such medications would be ascorbic acid (Vitamin C) and dl-methionine. Some of the other less common types of stones (that we didn’t discuss) form in acidic urine, so with these we may want to make the urine more alkaline. To counter the activity of urease that is produced by the bacteria, we may also use a compound called acetohydroxamic acid. It prevents urease from breaking the urea down into ammonium and carbon dioxide molecules and this can, in some cases, greatly reduce struvite formation. Remember: Do NOT give urinary acidifiers when you are using one of the speciality diets that also acidify urine.  
 
NOTE: Do NOT use a urinary acidifier and s/d, c/d or a similar diet at the same time.

Diet Alteration:
Diet alternation may be as helpful as anything in the medical treatment of struvite urolithiasis. The S/D Diet produced by Hills can actually cause the stones even large ones- to dissolve completely. Other companies such as Purina and Waltham have also developed special diets available through your veterinarian. These diets take time, often 60 to 180 days, to work. The principle by which S/D works is that it contains lower than normal levels of large proteins, magnesium, and phosphorous. Less protein means less urea and therefore less ammonium and carbon dioxide formed by the action of urease. Remember that struvite is made up of magnesium and phosphate ions, so lower levels of these materials also decrease the quantity of crystals that can potentially be formed. Feeding S/D helps the urine become more acidic. And last but not least, Hills has slightly increases the sodium chloride (normal table salt) to increase water consumption by the animal thereby increasing a flushing action through the bladder and better keeping the crystals in solution.

However, S/D cannot be used indefinitely as a preventative because it is not considered a complete diet. Also, it is not recommended for use in patients suffering from heart failure or kidney disease because of its salt and protein levels. We have never had a problem with its use except that according to the behaviour of some dogs, the flavour must leave something to be desired. After the initial 60 to 150 day period when medical therapy is actively attempting to dissolve the stones or sand that is present in the bladder, the animal is removed from S/D and placed on a normal but low protein diet.

Long term therapy, which might continue over a period of years, would include urinary acidifiers and lightly salting the food on a daily basis.

In our practice we typically try to use the best of both worlds, combining surgery with the above medical protocol. During the surgery, it is easy to remove all the stones and materials that can be detected with the naked eye. Smaller particles may still unknowingly be left behind and serve as a nidus onto which crystals can precipitate in the formation of new stones. Therefore, wherever possible, we choose to follow surgery with some or all of the above medical treatments. The medical therapy helps to dissolve any materials left behind and alter the animal’s physiology to prevent more from being formed. This has significantly reduced the percentage of recurrence in our clinic.

There are two final points to consider. First, please remember that the above system was directed at only one of the five different types of bladder stones found in dog. Each type has its own peculiarities as to the medical portion of the treatment. Surgery will remain the same regardless of the chemical composition of the stone. And secondly, please remember the old expression used in human medicine, "Once a stone former, always a stone former!" The same is true for the canine. No matter how we treat some individuals, the problem will reoccur with time. Genetics definitely plays a role.

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What is urolithiasis?


related term: cystinuria
http://www.upei.ca/cidd
Urolithiasis is a condition in which crystals in the urine combine to form stones, also called calculi or uroliths. These can be found anywhere in the urinary tract, where they cause irritation and secondary infection. Most end up in the bladder or urethra.

Several different types have been identified, with struvite stones (magnesium ammonium phosphate) being by far the most common, except in the Dalmatian. Any breed can develop uroliths, but a genetic predispostion to producing crystals makes the development of stones more likely.

Dalmatians have a defect in the pathway that normally leads to the breakdown of urates, which are a by-product of protein digestion. This results in increased urate excretion in the urine (4 to 8 times that of other breeds), and this predisposes them to the formation of urate crystals and eventually, stones.

In some other breeds, an inherited defect in a different pathway causes excessive urinary excretion of the amino acid cystine, resulting in cystine crystals and potentially stones in the urine.

type of crystal/stone
 breeds affected
 inheritance
 treatment
 prevention
struvite (triple phosphate, MAP)
cocker spaniel, miniature schnauzer, bichon frise, seen in many other breeds as well 
  this is the most common type of stone seen, but little is known about inheritance
 dissolve medically or remove surgically feed special diet;
 acidify urine
urate
 Dalmatian, English bulldog
 autosomal recessive
 dissolve medically or remove surgically provide special diet
 (reduced purine) and, if necessary, use allopurinol; alkalinize urine
calcium oxalate
 Lhasa apso, miniature poodle, miniature schnauzer, Yorkshire terrier
 little is known
 remove surgically feed special diet;
supplement with potassium citrate
cystine
 English bulldog, dachshund, Newfoundland, Irish and Scottish terrier
 autosomal recessive in Newfoundland and suspected in Irish and Scottish terrier 
alkalinize the urine by increasing vegetable protein in the diet, +/- supplement with sodium bicarbonate.
xanthine
  Cavalier King Charles spaniel
 thought to be autosomal recessive  



For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.

How is urolithiasis inherited?
The trait for high urate excretion is autosomal recessive in the Dalmatian. The gene pair responsible is genetically linked to the gene pair responsible for the absence of white hairs in the spots, so that selection for sharply delineated black spots may have accidentally also resulted in selection for high urate excretion.

The trait that results in high cystine in the urine (called cystinuria) appears to be autosomal recessive in the Newfoundland, and in the Irish and Scottish terrier.

What does urolithiasis mean to your dog & you?
The changes in the urine are generally present from birth. However it usually takes some time for crystals to form and combine into stones that cause problems, most often between 3 and 6 years of age. The signs you will see in your dog depend on where in the urinary tract the stones end up. They collect most commonly in the bladder, in which case you may see blood in the urine, difficulty and pain in urinating, and small frequent amounts of urine. If a stone completely obstructs the urethra and thus blocks the outflow of urine (more common in male dogs, who have smaller urethras), then these signs of discomfort will be magnified and your dog may also show signs of kidney failure - vomiting,depression, loss of appetite.

How is urolithiasis diagnosed?
If your dog is showing the physical signs described above, your veterinarian will do an analysis of his/her urine (urinalysis) to look for crystals and also for a bacterial infection, which is commonly seen with this condition. Many stones can be seen with x-rays; some (especially urate uroliths) will only show up with contrast radiography.  Ultrasound can generally detect stones of all types.                   

A DNA test is available to detect cystinuria in Newfoundlands, making it possible to identify affected, carrier, and clear animals.

For the veterinarian: Types of uroliths vary in radiodensity. Calcium oxalate uroliths are usually obvious on radiography; urate uroliths may be radiolucent and therefore require contrast radiography or ultrasonography.

How is urolithiasis treated?
A combination approach is usually needed. Stones are often small and numerous. Larger ones may be removed surgically - this is preferred if your dog is in pain or the stone is blocking the ureter or a kidney. Stones may also be fragmented by laser shockwaves, so they are small enough to be passed in the urine. The medical approach is to dissolve the stones gradually by changing the pH of the urine, ie. making it more or less acidic (depending on the type of stone) through medication and changes in diet.  Special diets also result in a larger volume of more dilute urine, making it easier for a dog to pass the stones. Your veterinarian will monitor your dog's progress through periodic radiographs and analysis of the urine over the period of time the stones are dissolving (which can take some months). Some types of stones are more amenable to dissolution than others.

In all cases of urolithiasis, in addition to paying careful attention to your dog's diet, you can help to reduce the formation of stones by providing lots of fresh water and regular opportunities to urinate, so that urine doesn't accumulate in the bladder allowing time for stones to form. You can increase your dog's water consumption by feeding a canned diet with a high water content, or mixing dry food with water.

Bacterial urinary tract infections are common with urolithiasis, and should be treated promptly.

Breeding advice
Affected animals should not be bred, and it is preferable to avoid breeding their parents and siblings as well. Carriers for cystinuria can be identified in the Newfoundland breed through DNA testing.

FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.

Resources
Ackerman, L. 1999. The Genetic Connection: A Guide to Health Problems in Purebred Dogs.182-186. AAHA Press, Lakewood, Colorado.
Osborne,CA and Finco, DR. 1995. Inherited and congenital disease of the lower urinary tract. In Canine and Feline Nephrology and Urology. p. 681-692.  Williams and Wilkins, Philadelphia.
Lulich, JP, Osborne, CA, Bartges, JW, Polzin, DJ. 1995. Canine lower urinary tract disorders. In E.J. Ettinger and E.C. Feldman (eds.) Textbook of Veterinary Internal Medicine, p. 1833-1861. W.B. Saunders Co., Toronto. -  contains good protocols for management and prevention of the different types of uroliths, including stubbornly recurring ones.
Copyright © 1998 Canine Inherited Disorders Database. All rights reserved.
Revised: November 24, 2003.
This database is a joint initiative of the Sir James Dunn Animal Welfare Centre at the Atlantic Veterinary College, University of Prince Edward Island, and the Canadian Veterinary Medical Association.
reprinted with kind permission from:- Alice Crook, DVM,Coordinator, Sir James Dunn Animal Welfare Centre,
 Atlantic Veterinary College,University of Prince Edward Island, 550 University Ave.Charlottetown, PEI C1A 4P3
http://www.upei.ca/cidd
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Bladder Stones in the Dog
 Case History  Bladder Stones
 Bladder stone surgery in the dog
 Bladder Stones
Case History Stones
 Case History Stones
 Supplements
 Treats for Dogs with Bladder Stones
 
 

chloebutton talabutton  

The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.