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Surgical management of pyometra and urocystoliths in a bitch.

Introduction

Urocystoliths are aggregates of solid mineral substances that may form in urinary bladder. Uroliths arising out of metabolic origin are common in male dogs (Bovee and Mc Guire, 1984). This paper reports urocystolith in a bitch.

History and Clinical Observation

A Lhasapso bitch aged about 8 years was presented with history of dullness, inappetance, vomiting and foul smelling bloody discharge from vagina. Dog was totally on a chicken based diet and drinking moderate amounts of water. On examination, rectal temperature was 103.2[degrees]F, pulse and respiration were normal. Hematological tests revealed leukocytosis with neutrophilia. Biochemical studies showed BUN and creatinine values of 84 and 2.4 mg/dl respectively. The case was tentatively diagnosed as open pyometra and surgical intervention was planned.

Treatment

Bilateral ovariohysterectomy was performed through mid ventral incision under Xylazine-Ketamine-Diazepam anesthesia as per standard protocol. While trying to evacuate the distended urinary bladder, grating sounds were observed. Suspecting cystoliths, cystotomy was performed to find, more than fifty stones of different sizes weighing about 60 grams totally (Fig. 1). All cystoliths were removed, bladder was flushed with normal saline and wound was closed with double row of Lambert's suture. Abdominal incision was closed in a routine manner. Post-operatively, the bitch was maintained on intravenous 5% Dextrose and Ringers Lactate solution. Ceftriaxone (Intacef (a)), Meloxicam (Melonex (a)) and Ranitidine (b) injections were administered for a period of 5 days in suitable doses. Later, the dog was put on pure vegetarian diet of rice and curd. Single tablet of Cystone (c) given bid orally for 2 months. The bitch responded well to treatment and recovered uneventfully.

Discussion

Stones formed in the urinary bladder of dogs secondary to urinary tract infections with urease producing organisms, dietary influences and genetics. Most commonly affected breeds are Miniature schnauzers, Miniature poodles, Shi Tzu, Cocker Spaniel and Lhasapso (Ettinger and Feldman, 2005). While calcium oxalate is the most common stone formed, struvite, urate, silicate, phosphate and cystiene stones may also form in the urinary tract (Bartges et al., 2004). Struvite cystoliths are the most common stones in bitches (Minnesota Urolith Centre, 1981).

Increased dietary protein levels lead to an increase in concentration of urea and phosphorous in urine leading to a favorable environment for stone formation. In this case, consumption of chicken based diet, intake of less amounts of water with concurrent uterine infection might have lead to urocystolith formation. Infections have some influence on formation of uroliths (Ettinger and Feldman, 2005). However, correlation between uterine infection and development of caliculi has not been established (Hesse, 1990).

Since there is no satisfactory medical dissolution protcol, urocystoliths have to be removed surgically. A chance finding and successful removal of a large solitary cystolith in a bitch while operating for pyometra has been reported by Ranganath et al. (1992). The authors have also successfully operated to remove large cystoliths from a 4 year old Pomeranian bitch.

Summary

While operating on an 8 year old Lhasapso bitch for hysterectomy suspecting pyometra, cystoliths were detected accidentally. Upon the removal cystoliths, the animal recovered uneventfully.

References

Bartges, J.W., Kirk, C. and Lane, I.F. (2004). Update: Management of calcium oxalate uroliths in dogs and cats. Vet. Clin. North Am. Small Anim. Pract. 34: 969-87.

Bovee, K.C. and Mc Guire. (1984). Qualitative and quantitative analysis of uroliths in dogs: Definitive determination of chemical type. J. Am. Vet. Med. Assocn. 185: 983-87

Ettinger, S.J. and Feldman, E.C. (2005). Text Book of Veterinary Internal Medicine, 6th edn, Elsevier Saunders, Missouri, Vol. 2, p. 1852.

Hesse, A. (1990). Canine urolithiasis: Epidemiology and analysis of urinary calculi. J. Small Anim. Pract. 31: 599-604.

Minnesota Urolith Centre (1981). www.cvm.umn.edu/depts/minnesota Urolith centre.

Ranganath, L., Jayagopala Reddy and Umesh, K.G. (1992). An unusual case of cystolith in a bitch. Indian Vet. J. 69: 550.

C.S. Arun (1), N.B. Shridhar (2) and C.N. Santhosh Kumar (3)

Department of Veterinary Pharmacology and Toxicology Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences University (KVAFSU) Hebbal Bengaluru--560024 (Karnataka)

(1.) Private Veterinary Practitioner

(2.) Associate Professor and Corresponding author.

E-mail: sridhar_vet@rediffmail.com

(3.) Ph.D. Scholar

(a)--Band of Intas Animal Health, Ahmedabad

(b)--Brand of Glaxo Smith Kline Pharmaceuticals Ltd, Mumbai

(c)--Brand of Himalaya Drug Company, Bengaluru.
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Title Annotation:Short Communication
Author:Arun, C.S.; Shridhar, N.B.; Kumar, C.N. Santhosh
Publication:Intas Polivet
Article Type:Report
Date:Jan 1, 2015
Words:714
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