I’ve been treating Bomag for six years or so now. He’s a huge black lab mix with a lumbering disposition and a sweet stare. He’s the kind of dog that will give you his huge paw when you need to take his blood and gaze deeply into your eyes as you lay him down to take an X-ray. In a word: lovable.
When Bomag was sick to his stomach last week I made sure to take an X-ray. Apart from the inflammation in his bowels (likely caused by one too many treats the weekend before) I found a cluster of stones nestled in his bladder.
Ouch!…That’s gotta hurt. But Bomag had never shown any classic signs of bladder discomfort. Sure enough, a urinalysis confirmed he had a raging urinary tract infection. Poor Bomag. He’s so good he never once complained. I love this dog.
Once his belly’s discomfort cleared up we decided to get in there and do something about his bladder stones. Surgery is the only answer in these cases, as stones like this will never resolve with a change in diet or antibiotic therapy. After a week of antibiotics it was time to go in and get them out.
Surgery day: I opened his belly down low next to his prepuce (the sheath inside of which dogs keep their penises neatly tucked away). I found his bladder and held it up with a neat trick involving suture material used as a suspension mechanism to hold it in place.
Bomag`s bladder was a mess. It was an unnatural, deep pink color and quite firm, to boot. Its normally thin walls were swollen to more than ten times their normal thickness while blood vessels snaked all over its surface—a sure sign that this had been going on for a long time.
I then cut into the bladder with a scalpel. Uh-oh. Did I say ten times the normal thickness? More like twenty. On the inside, the bladder was lined with deep folds of abnormal tissue; like tentacles reaching deep into the bladder to hold—you guessed it—clusters of bladder stones. Hundreds of tiny stones were caught in the grips of these undulations in the bladder wall.
This is what some of us in the business call the surgical peek and shriek. It happens when you’ve just determined you’re in over your head. What most of us do is take a deep breath and carry on. Some of us just close up and send the pet to a surgeon.
I’ve done so many of these surgeries (technical term: cystotomy) I felt I could weather the storm. I dug in and gently began dislodging the stones one by one. Flushing with saline solution aided by gentle manipulation with my fingers got the vast majority out. I’m sure I left a few tiny ones. I reasoned that these would be capable of passing through his urethra now that they had been freed of their fleshy attachments.
It took two hours of hard work.
After I was done and Bomag was recovering well, I had time to sit and think. In retrospect I surely would have sent Bomag to a board-certified veterinary surgeon. I like to think of vet surgeons as the chefs of the veterinary world. And while I consider myself an excellent cook, I’m certainly no chef. Bomag could have used Emeril today, for sure.
That evening I called my vet surgeon friend and cried on his shoulder (via telephone). As always, he was reassuring. After listening to my babble and stress-talk he assured me that even surgeons take two hours to get teeny tiny stones out. He complimented my techniques as I described them and my stick-to-it-iveness. He’s the bomb. I felt so much better. And, as he says, the proof is in the pudding. Bomag`s doing great.
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I agree with your surgeon friend. The proof is in the pudding. The dog is doing well so you did something right to make that happen.
Shannon
Shannon August 25th, 2006 10:56:00 AM
Our shih-tzu had bladder stones for years and years before we found out. She didn't display any symptoms until one day I noticed a spot of blood in her urine. We took her in to the vet assuming she had a bladder infection, and an x-ray showed that her bladder was packed to the brim with stones (an entire Ziploc Sandwich Bag full of them). I thought it was stunning that she'd probably suffered with the problem since we'd adopted her four years earlier, and perhaps even longer than that! She's been on Urocit and bottled water since her surgery (Dec. 2004), and has been doing great.
Even though the cystotomy was stressful for you, it must have been somewhat satisfying to see all that empty bladder when you were finished. Bomag must feel amazing right now :)
Leigh-Ann August 25th, 2006 02:45:00 PM
You should post a picture of the stones! Did you show the owners all that was collected?
Kelly August 25th, 2006 10:56:00 PM
Stick-to-it-iveness indeed. Good job!
jg August 25th, 2006 11:49:00 PM
The owners got a bag of stones and a bunch of pics as well as a happy Bomag. He`s doing great!
Patty
Dr. Patty Khuly August 26th, 2006 01:19:00 PM
*shudder* a bag of stones? i can only imagine what the gift giving was like. "here's your puppy! and here's what we harvested!". then again, in the grooming salon, when we have a feeling our customer is gonna throw a FIT over her badly-matted dog's complete shavedown, we're sure to save our three-6 hours worth of hard, careful work in a bag. few customers can come up with an argument when we show them the pelt (complete with all four legs and tail!) that we so diligently shaved off of their poor dog...
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