Bladder stones (uroliths) in a cat
Berry Haven Veterinary Group Surgical Case
Shirley was presented with a history of repeat visits to their normal vet for re-occurring cystitis symptoms. She was passing blood in the urine and only passing small volumes of urine and going more often. The previous vet had not analysed any urine samples nor performed any additional testing. She had been on antibiotics and special prescription diet (Hills C/D) to make her urine acid in the hope she had struvite crystals which is one of the most common causes of cystitis in cats
We x-rayed Shirley and were surprised to see some bladder stones (uroliths). Blood tests were all normal. We placed Shirley on an IV drip and using Isoflurane gaseous anaesthesia and some sedatives, we operated on the bladder to remove the stones.
A cat catheter was passed up into the bladder to try and prevent smaller stones from traveling down the neck of the bladder and "escaping" the efforts of the surgeon trying to remove them.
After making a small incision in the bladder, we removed the stones using a small sharp-edged spoon shaped instrument (a curette). We did not apply too much pressure to the bladder walls when using the curette to avoid damaging it. The bladder as irrigated with 0.9% saline to get the smaller stones out in the neck of the bladder.
When closing the bladder, we used a Connell-Cushing closure technique which involves 2 layers of continuous inverting sutures. This results in a better seal as the bladder stretches quite a lot when filling with urine and the last thing we wanted was urine leaking into the abdomen.
The stones have gone to the USA for analysis by Professor Carl Osborne using an X-ray diffraction technique. This is a service offered by Hill's Pet Nutrition who make special diets designed to dissolve and prevent further urolith formation.
At check-up, Shirley was very comfortable and passing normal volumes of urine. Once we know the composition of the uroliths, she will be placed on the correct Hill's prescription diet to prevent them re-forming.
Feline Urological Syndrome (FUS)