2007 Case. Dysuria
(difficulty in peeing)
Shih Tzu, Female, 5 years. Peeing a bit here
and there many times a day for many months
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.
After many months of painful urination, the
owner consulted me. I palpated a large bladder stone and
advised surgery after 10 days of antibiotics. The owner
forgot about the surgery and the difficulty in 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 after the surgery. 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.
submucosa of the bladder is stitched with an
inverting suture pattern.
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. No complaint about difficulty in
urination for the next 18 months.
owner was not interested in follow up health
checks and urine testing. Urinary stone (right)
is from the bladder of this Shih Tzu. The two
stones (left) are from another dog.
2010 Case. Dysuria
(difficulty in peeing)
at the end stage of urination
Feb 26, 2010. At 13
years of age, he just had dental
scaling at another vet practice.
The vet had performed 2
blood tests 3 weeks apart and this
indicated excellent health.
Then the owner consulted another
practice (Vet 1) as the dog took a
long time to pee at the end part
of urination. Vet 1 advised
owner phoned me for advice after
Vet 1 had been consulted. I had
not seen the case and I asked "Was
the dog's urine analysed?
Struvite urinary stones, if small,
may be dissolved by the
acidification of urine." The
young lady owner said, "No."
Later, she told me that Vet 1
considered urinalysis unnecessary.
I saw the case and got the owner's
permission to do a urine analysis.
The urine pH was 6.5 and there
were no crystals in the urine on
urinalysis. So, these tests
indicated that the urinary stones
might not be struvites and
therefore acidification of the
urine would not be effective. Surgical
removal, as advised by Vet 1 was
my recommendation. But will the
dog that growled at me, die on the operating table
as he was so old?