Urolithiasis (bladder stones)

Meet "Miss Scarlet the Grange Dog". She came to visit us a few weeks ago with the complaint of not feeling well and having to urinate all the time. The only problem we could find on physical exam was a small amount of malodorous vaginal discharge. Since she had never been spayed, we had to consider that she might have pyometra (infection in the uterus). Surgery to remove her uterus and ovaries was scheduled, and antibiotics and pain medicines were started. When Miss Scarlet was anesthetized we were able to palpate her abdomen a little better. While she was awake, she kept her stomach muscles so tight that we could not effectively palpate. A very hard structure was felt in the caudal abdomen (towards her tail end) -- in the area of the bladder. Since there should not be any hard objects in this area, it was likely that she had, along with the infected uterus, a stone in her bladder. The medical term for this is urolithiasis.

Surgery consisted of opening the abdomen, cutting into the bladder and removing a large "rock", flushing the bladder and urethra, and then suturing the bladder closed. Next, the uterus and ovaries were removed because of her pyometra. All went well and Miss Scarlet was returned to her owner a new "lighter" dog.

This is a picture of the freshly removed stone.

This picture shows some objects for size reference. Scarlet is a 10# mixed breed terrier. As you can imagine from the size of the stone, there wasn't much room left in the bladder for urine. This reason, combined with the irritating nature of the stone, would make it so that Miss Scarlett felt like she had to urinate all the time. Add to this the irritation and discomfort from the uterus and you can understand why she didn't feel 100%.

Here are some examples of stones we have removed from other patients. Sometimes there is just one, sometimes there are hundreds -- like small gravel. These stones are very hard. Often the stones are passed out the urethra before they get large enough to cause trouble. If they are not passed they can irritate the lining of the bladder, cause bloody urine, and make the dog feel like it has to urinate often. The stone can also temporarily (or permanently) block the passage of urine, and when this happens, it is a medical emergency. Surgery must be performed immediately to remove the stone or stones so that the dog can urinate.

Crystal formation is enhanced in urine that is alkaline (has a basic pH), and is inhibited in urine that has more acidic pH. Diet is a big contributing factor to the pH of the urine. Meat based diets tend to make more acidic urine, and plant based diets make more alkaline urine. Bacteria, which like to grow in an alkaline pH, make by-products that also contribute to crystal formation. Bladder stones in dogs are sometimes found following cases of infection in the bladder (cystitis). The inflammation and bacterial by-products form debris in the bladder which provide a starting place (or nidus) for the crystals to begin forming. Once the crystals start, they can form onto each other and build and build until they make stones. So you can see that urine pH and bacterial infection go hand in hand with urolithiasis.

Not all stones are caused from inflammation, some dogs such as Dalmatians, produce bladder stones because they cannot metabolize certain substances well. In the case of some Dalmatians, they cannot metabolize uric acid and so they make uric acid stones. This type of stone formation can be possibly corrected or prevented with special diets. Other dogs, such as Schnauzers just seem predisposed to form stones for some unknown reason.

Bladder stones can look very impressive on a radiograph as shown above. This radiograph is not from Miss Scarlett, but of a dog that had the largest stone in the above stone comparison.
Can you see the more dense central portion of the stone? This could be a different type of stone within the larger stone. It is not unusual to have multiple types of stone within the bladder at the same time. It sure looks uncomfortable to me!

A Calving Call

Last week, Dr. McGraw received a phone call from a frantic, crazy woman who said her first-time heifer was calving and that she (the heifer) had been up and down pushing for 1 1/2 hrs with nothing to show for it. So, Dr. McGraw made a quick trip home to placate the frantic, crazy woman and to check one of her (and his) cows. (Yes, the crazy woman, his wife -- a vet herself-- could have checked that heifer, but she didn't have any chains or calf-puller at her disposal, and besides that she likes to see her husband come home in the middle of the day--any excuse is a good excuse!)

"Luna" the cow had been off by herself all morning, getting up, laying down, trying to find a place to get away from all the strange pain and discomfort she had been feeling. I had been watching her carefully since this was her first time calving. I was sure she had been in active labor for 3 hrs and pushing for 1 1/2hrs, and I had not seen any evidence of the amniotic sack rupturing or any feet sticking out, I gave Dr. McGraw a call to see if he could come out and check her. She was a raised as a bottle calf so she is still very tame -- he was able to walk right up to her and check her.

The amniotic sac ruptured as he palpated and he was able to feel front feet and pull them out part way. When the sac ruptured, we could tell that the amniotic fluid was filled with {meconium} -- a sign that the calf was under stress. The calf was moving its feet though so we could tell it was still alive. Luna was trying hard to push with every contraction, but she wasn't getting very far even with help, so Dr. McGraw ran back to his truck to get the chains.

Notice the double wrap on the chains -- this helps alleviate any damage that the chains might cause on the legs when the calf is being pulled.

PULL!!!! HARD!!!! PUSH, LUNA, PUSH!!!!

No luck! Together, man and beast can only get the calf out as far as it's nose.

Time to get out the calf puller. Hang on there little calf!

A few contractions and a few ratchets on the calf puller and the calf is out. Yeah!
Ummmm.... the photographer forgot to take pictures while the calf was coming out. Sorry!

Hello little lady. So glad you could join us. Did you know that you are covered in poo?

Luna, meet your baby. Clean her up real good. This right here is the cause of all your discomfort and pain.

Enough cooing. Dr. McGraw has work to do. He checks to make sure all 4 quarters are opened up, and then he is back to the clinic. Thanks Dr. McGraw!

Within 10 minutes of being born, the calf is already trying to get up and find the milk bar. It amazes me everytime how quickly a calf goes from being in the water world of the womb to terra firma and walking on legs that have never stood before in just a matter of minutes.

Look at that calf go! Just hours later she is kicking up her heels. Would Luna have been able to have her calf on her own? Probably. Hopefully. But it would have been quite awhile later and the calf may not have faired so well had the labor gone on for much longer.

A Down Cow

Seven AM on a beautiful Saturday morning--Ring! Ring! Down cow.

Coffee and toast to go, please ma'am.

Thirty minutes later--here's the three day old calf--a beautiful Shorthorn.

And here's the poor mama. She is not in very good shape. Being that she is pastured on new grass and just calved, odds are that she has an electrolyte imbalance called "grass tetanus".

But no, instead she has a very bad case of mastitis--or infection of her mammary glands.When she weaned her last calf, some bacteria probably got into the mammary gland and sat there until she started producing milk again. Then the bacteria started growing crazy on all the fresh milk. Sometimes it hits so fast you just find a dead cow. But in this case the left hind quarter was a dead sack of pus and the cow was so toxic she couldn't get up.

The only choice is to cut our losses (excuse the pun) and cut off the dead quarter so that the pus could drain out in the hopes that the toxins produced by the bacteria and dead tissue would drain out of the body instead of being forced deeper into the cow. She would never have been able to make milk in that quarter again anyway.

She didn't actually feel a thing because the tissue was dead, and as you can see-- there was very little bleeding. The drainage on the ground is the pus that was trapped inside. You can just imagine the odors that went along with it.

I treated her with some antibiotics, pain medications, and electrolytes and left some meds for the owner to continue treatment. It took a little assistance from the tractor, pulling, pushing, rolling, and a little grunting to help her sit up. She looks better, but has a long way to go...only time will tell. The calf will get introduced to milk replacer in a bottle. It won't be as good, but it's best option.

Cow Meets Porcupine

Just when you think you've seen it all, something new comes along. That should be the mantra for Veterinary practice. We get "dog meets porcupine" all the time and the occasional "horse meets porcupine", but this is the rare "cow meets porcupine".



Two cows were brought to our large animal facilities last weekend. The first cow had quills in her muzzle and right front foot, the second cow had them in her tongue. Who licks a porcupine? A cow, I guess. I thought cows were smarter than that!





Then the second cow decided she was done with the whole thing and tried to exit--out the top of the chute! Believe it or not, she nearly made it before changing her mind and going out the front of the chute instead. Cows.