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Middle aged, Female,
Squats many times a day but pees a bit

August 10, 2008

"Can you remember my Pekinese? You vaccinated her" the ice-cream vendor asked me as I treated my Veterinary Technician, Mr Saw to ice-cream. "Sorry, I cannot remember. It must be long ago."

"Yes, 5 years ago. She can't pee normally. Small stones come out from her urine when she humped on the towel." He showed me a 15-second video clip of his Pekinese in action on his mobile phone.

"How many stones?" I asked.

"After you gave me antibiotics, 2 stones came out," he said. "Altogether she passed out 15 stones. I expected her to die... cannot afford veterinary treatment. But she is still alive."

He does have an unusual sense of humour. I did give him some antibiotics free of charge when he told me about his dog having urination difficulty during my purchase of ice-cream from him.

In Singapore, there is no charitable organisation for owners whose dogs need treatment but can't afford the private veterinary fees. In the U.K, there is the People's Dispensary For Small Animals (P.D.S.A). Maybe one day.

I told the ice-cream man to bring his Pekinese for free consultation and examination. He said he would bring the dog on Monday August 11, 2008. For some unknown reasons, I saw a cluster of 5 urinary stone cases surprising appeared during the last 7 days. These are:

1. Miniature Schnauzer, Male, 4 years. Had struvite stones removed 2 months ago. Small stones in bladder. Medical dissolution in progress. No surgery this time.
Surgery to remove numerous stones were done 2 months ago in May 14, 2008.

Urethral obstruction as presenting sign due to big stone blockage. Toa Payoh Vets

1305. May 2008. Struvite stones Part 1. A kind veterinarian offers the distressed young lady an option.

2. Maltese, Male. Had green urinary stones removed from the bladder. See picture below.

Maltese, Intact Male, 5 years. Stones must be flushed out thoroughly. Toa Payoh Vets

1504. Urinary stone removal. Dorsal wall of bladder incised in this case. Money back - my dog can't pee

3. Pug, Female. Unable to get urine for checking. Chronic urinary tract infection. Possible stones?

1509. UTI - A lady was highly emotional when her pug keeps passing blood in the urine.

4. Miniature Schnauzer, Female. 7 years. Had fits. 3 years of Chinese herbs and antibiotics as recommended by a groomer. 2 large stones palpable in the bladder. Died 24 hours after consultation. Not possible to treat. Case to be written.

5. Pekinese, Female. 5 years. >17 small stones urinated out at home. Will examine on August 11, 2008.

URINARY STONE IN A SHIH TZU IN 2007
On August 9, 2008, being a National Day for Singapore, I have some free time. I decided to recall my old pictures and write in more detail a report of one older urinary stone case to educate owners of middle-aged female dogs. See below.

Shih Tzu, Female, 7 years. Large bladder stone. Toa Payoh Vets

Middle-aged and older dogs are seldom given much attention by many owners all over the world, unlike puppies. Such dogs don't live long lives if their sickness is not treated. The Shih Tzu of over 5 years in this case report was peeing a bit here and there many times a day. After many months of painful urination, the owner consulted me.

A large bladder stone was palpated. Surgery was advised after a course of antibiotics. The owner forgot about the surgery and the urination problem recurred. Surgery was inevitable to resolve the problem. But was it too late and would the old dog survive the anaesthesia and not die on the operating table or after surgery?

The owner understood the risk. The dog was alive. The pictures of the surgery are shown below.

I prefer to incise the ventral wall of the bladder and find no problem of "the heavy weight of the internal organs pressing down on the bladder" and therefore adversely affecting the healing.

Thick and reddish bladder wall of nearly 5 mm in thickness indicates that the bladder infection has gone on for many years. Some dogs die as bacterial infection spreads to the kidneys and into the blood.

8-mm thick bladder wall. Needs 2 layers 3/0 absorbable stitching to close. Toa Payoh Vets

Chronic cystitis - large bladder stone. Stitching up bladder wound with 2nd layer. Toa Payoh Vets

2nd layer of inverting suture is now placed. Forceps on the left anchors the knot of the first layer. No omental fat layer is sutured onto the suture line although some vets do it.

Dog warded 3 days for observation. Goes home.

Shih Tzu squatted, cried and passed urine every few minutes. One spherical bladder stone removed 6 days ago. Toa Payoh Vets

The 2 stones on the left were from the bladder of another female Miniature Schnauzer with dysuria.

UPDATE AS AT AUGUST 11, 2008

No complaint about difficulty in urination for the past 18 months. The owner was not interested in regular health checks and urine testing as it means more expenses.

Conclusion:

All owners need to be aware that difficulty in urination needs prompt veterinary attention if they want their animal companion to live to old age.

FOR THOSE OWNERS WHO WANT TO DO URINE OR BLOOD TESTS TO CHECK THE HEALTH OF THEIR SENIOR DOGS:
e-mail judy@toapayohvets.com
tel: 9668-6469, 6254-3326 for appointment at Toa Payoh Vets.