Urethrostomy in dogs | Daily News


 

Urethrostomy in dogs

The urethra is the tube that carries urine from the bladder out of the body. In the male dog, it passes along the back side of the dog and between the rear legs. Within the penis, the urethra lies within a trough of bone, the os penis, and becomes narrower. Calculi (stones) that develop within the urinary tract will often become stuck within the urethra behind this bone, blocking the urethra. The urethra can also be blocked if the bone is fractured or if the dog develops a tumor of the penis. Scar tissue can also cause partial blockage. Urinary tract calculi are the most common cause of urethral obstruction in dogs; anything that causes stone formation will increase the risk of urethral blockage.

What is an urethrostomy?

An urethrostomy is a surgical procedure to create an opening in the urethra, the tube through which urine flows from the bladder and is voided. The surgery is performed to correct a urethral obstruction, which can be caused by protein plugs, stones, trauma, or scarring. A urethral obstruction is a serious, life-threatening condition; therefore, urethtrostomies are often performed on an emergency basis.

Signs and symptoms

Clinical signs depend on the severity of the blockage. Dogs that have a partial obstruction may: urinate small amounts frequently, take a long time urinating, strain to urinate, have blood in the urine, urinate in drips instead of a strong stream, urination in inappropriate places (on the carpet or on their bedding). If the urethra is completely blocked, your dog will strain without producing any urine. It will be in pain and be lethargic, lose their appetite, and possibly start vomiting. An overly large urinary bladder will be easily felt in the back half of the belly. The urinary bladder may rupture and spill urine into the dog’s abdomen with complete obstruction. Dogs with total urethral obstruction will die within days if the obstruction is not relieved. Your pet should be seen by a veterinarian immediately if it is unable to urinate.

Diagnostics

Diagnosis of obstruction is usually based on an inability to advance a urethral catheter into the bladder. Your primary care veterinarian may feel the catheter pass over the calculi in dogs that are partially obstructed. X-rays of the dog which can be obtain by a normal veterinary clinic in Sri Lanka may show small stones within the bladder and/or urethra. Your veterinarian can inject contrast material into a urethral catheter during x-rays to see if there is any narrowing of the urethra.

Ultrasound and blood work is evaluated to determine the severity of the dog's illness. Kidney function may be temporarily damaged in dogs with urinary tract blockage. Potassium, which is normally removed from the body through the urine, can also be very high and can cause heart problems, so an electrocardiogram (ECG) is often performed. The urine will be checked for crystals, which may help to determine the type of stone present, and for evidence of infection, and may be submitted for culture. Most of the tests can be done a veterinary clinic Sri Lanka

Treatment

If the obstruction is caused by urinary tract calculi, your veterinarian will try to flush the stones back into the bladder, where they can be removed surgically, dissolved with medical management, or broken up with lithotripsy. If your dog is very sick, surgery may be delayed, and a urinary catheter left in the urinary tract to drain urine from the bladder for a day or two, until medical conditions have improved and your pet is stable for general anesthesia and surgery.

If the stones or calculi present in the urethra the vet may surgically open the urethra according to the location of the stone and remove the stones. The vet may decide to close the surgical opening in the urethra or fix artificial urethra or keep an artificial opening in the urethra.

Aftercare and Outcome

Dogs will require several weeks of restricted activity after an abdominal procedure. It will likely have to urinate more often. They may have a sense of urgency to urinate and accidents may occur. Blood tinged urine is common. Protect the site is healed to prevent licking and chewing. Your dog will likely come home with oral pain medication. If a bladder infection is present, antibiotics will be prescribed. Calculi are sent for analysis to determine whether special diets or medications are needed.

Complications of urinary obstruction include: tears in the urethra or bladder resulting in urine leakage, bladder dysfunction, incontinence, or scarring in the urethra that can cause recurrence of the obstruction. Recurrence of urethral obstruction by calculi is prevented by reducing the factors that cause stone formation. If your dog is a stone former, you will need to follow your veterinarian's diet and medication recommendations closely, and have your dog rechecked as needed to make sure crystal formation is being controlled.

(The writer is a Veterinary Surgeon and holds B.V.Sc; M.Sc Poultry Science; Master of Public Administration and Management)


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