# Bladderstones- Importance of Ultrasound- Please read



## godiva goddess (Nov 19, 2007)

Hello SM Family. I don't post here much anymore but I do keep in constant contact w/ most of you via Face book. Mia has been a part of SM since she came to me in 2007 and she grew up in front of you on SM.

I feel compelled to write a post now because I want to share with you and anyone who is researching on the internet about their beloved pets' bladder stone. I hope my story can help some of you and shed some light on the process. My recent experience with Mia and her "bladder stone" health scare, and how ultrasound saved Mia from a lot of unnecessary pain and the dreaded surgery.

As many of you know, about a month ago I saw that Mia was in discomfort and in pain. I thought it was constipation. I bought her to her usual vet's office the next day for a physical and there was nothing wrong w/ her. Therefore her vet suggested doing an X ray. We did that and the X ray showed what the vet thought was a "bladder stone". I attached her X ray from that session here. _You can see the "stone" in the horizontal X ray. It is on the bottom right side, underneath her spine. it is a little white dot._

I went on to ask other vets about the X ray and everyone thought it did indeed look like a stone in the bladder.

Mia went on to do a urine test for crystals to see what type of stone it can be, because a struvite stone can be dissolved w/ food while calcium oxalate can not. Needless to say, I was hoping fro struvite. Mia's urine test came back inconclusive as they couldn't see any crystals in her urine. 

I was left w/ 2 options. Either remove the "stone" or let it stay inside. Her "stone" was small so it was not a medical emergency. But, if it stayed then I was gambling w/ it moving and blocking her urethra and then it will become an emergency. After thinking about the options, I wanted to remove the stone.

So, I went to research for methods of removing the stone. I did not want to subject Mia to the traditional surgery. Her usual vet recommended I see a specialized in NYC's Animal Medical Center. I ended up bringing Mia and the specialist suggested a procedure called PCCL (*Percutaneous Cystolithotomy). It is new method in stone removal and is a minimally invasive surgery*. I was told that a small incision would be made and they would insert a "basket" to retrieve the stone. Below is taken from an article her specialist wrote.
"This procedure is performed with a small ventral midline skin incision made over the bladder apex until 1 finger is inside the abdomen for bladder identification. A trocar is advanced into the bladder lumen and a rigid cystoscope is advanced through the trocar into the urinary bladder for stone removal with an Endoscopic stone basket. The entire mucosal surface of the bladder and entire urethra are visualized and stones stuck inside the urethra can be removed as well, without the need for urethrotomy. During this procedure the bladder can be explored carefully for polyps or masses and removed with the laser or biopsied if necessary. Once the scope and trocar are removed the incision is closed." http://www.dcavm.org/09oct.html

PCCL was going to cost 4 times more than the traditional method of surgery but I wanted this for Mia as it was minimally invasive. 

On the day of the surgery, her doctor ran the last set of X ray and still saw the "stone." She gave me a call and said she was going to proceed. I said OK and I asked her to give me the stone post surgery. She asked why and I said I wanted to see it and send it to the lab for biopsy. She said fine. I then asked her to run an ultrasound of Mia to see if there were anything else wrong, just to be safe. 

Around noon, her doctor called me to tell me that she ran the ultrasound and there was no stone in her bladder. There was nothing in her bladder, nothing in her stomach, intestines, etc. *In short, NOTHING was wrong w/ her.* I was shocked. *I asked what that "stone" was and she said it is probably the suture from Mia's spay 4 yrs ago that has mineralized. *That this "stone" sits on top of her bladder, not inside, and it is benign.

*Surgery was called off at the 11th hour. Thanks to ultrasound.*

My valuable lesson I want to share w/ you all is that please do not trust X rays alone. Mia has had at least 3 sets of X rays done and all showed the "stone". 1) *Please ask for an ultrasound in conjunction w/ the X ray before you make any medical decisions for your pet. 2) Also, ask for the stone if you do decide to go with surgery. It is also important to know what type of stone it really is to tailor a diet to prevent it from recurring.*

On a related note, my personal opinion is that ALL vets should suggest to do an ultrasound prior to operating on a dog. None of the vets I saw suggested that prior to operation. I had to ask for it bc I was a worry wart and wanted to make sure everything else was OK. I thank my lucky stars that I did ask for it. I only wish that all vets would be proactive about offering it to help confirm the existence of the stone prior to surgery. Her doctor did tell me that she had a case of operating on a dog, then found nothing. Only to realize that there were no stones but a mineralization outside the bladder like my Mia. How tragic was that?? I wouldn't want to see any dog to be subjected to surgery for no reason.

Kisses to all the fluffs ((HUGS)))


Mia's Mommy.


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## Maidto2Maltese (Oct 19, 2004)

Wonderful news on your little girl!!

I too want to state the importance of ultrasound...but for a much more dire reason. My Missy had a recurring UTI,( not terribly uncommon in a diabetic pooch) and  the second antibiotic 'fixed' but she still had blood in her urine. Vet said it could be caused by stone/crystals and not all will necessarily show on an X-ray and also said could show a reason for the bleed so suggested ultrasound. ( I guess even a cyst could be a bleeder) 

The ultrasound showed a tumor NOT a stone or cyst! Since this type of cancer is rare in a pooch ( Only abt 1-2% of dog cancers are this transitional cell carcinoma.) and usually no symptoms until the 'beast' is well established and it's a very aggressive type. had we not done the ultrasound Missy's cancer would have gone undetected! As it was it was found before it had gone thru the wall and no metastasis. 

Yes, we had to have a portion of her bladder removed but she did beautifully thru the surgery and recoped in record time....even her little bladder was quick to 'stretch ' a bit to get her back to her normal hold-time.

It's rare for a pooch with this cancer to have more than 90-180 days!! ( likely due to delay in the dx!) My Missy was at 1 year and 9 months post dx and the cancer was still not a problem...it was not the cause of us having to say good-bye.

I take this opportunity to advise everyone that has a pooch with recurring UTIs to have ultrasound and God-willing the TCC can be ruled out BUT if your baby falls into the narrow 'slit' then time is of the essence and it could save your baby's life! UTIs often accompany this cancer so when antibiotics appear to fix everything... the beast silently grows and spreads!


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## pammy4501 (Aug 8, 2007)

Excellent thread Alice! I have really started re-thinking the usefullness of repeated X-Rays for dogs when there isn't a clear reason for illness. I too have been offered radiographs when the vet wasn't certain what was going on with my dog. In human medicine there is a new push to reduce the amount of radiation that people recieve over their lifetimes. There are something called ALARA guidelines now (As Low As Reasonably Achieveable). And there are also reccomendations to cease using X-Ray entirely in some situations. I'm sure you have all experience situation such as a knee injury that will be X-Rayed but will also need an MRI. The MRI is the difinitive study, so skip the X-Ray. We have also stopped doing before and after studies with contrast media. Now we just do the after study. X-Rays are good for seeing bony injuries and some soft tissue thing, like a bowel obstruction, but MRI and Ultrasound are much better for soft tissue diagnosis. The other really good lesson here, is always question your Vet. Not because you don't trust them, but because sometimes it gets them thinking outside of the box. Ask questions about which test is the best diagnostic indicator of a problem, and then just go for that test. Ask what will you learn from this test. Is it to just rule something out? Maybe you really don't need to do that. Vets and MD's like tests. Thats how there were trained. More tests is better. Turn over every stone (no pun intended). But that isn't always necessary or even good for you dog. Good owners question. Good job Alice, and so happy that Mia is on the mend!!


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## hoaloha (Jan 27, 2012)

Thank you so much for sharing your and little Mia's experience! It really goes to show how educating oneself is SO important. I am actually shocked that a surgeon would do a surgery based on a dog without a history of stones, a negative UA and plain-film xray!!! I don't know it's true for dogs, but in humans (kids), the most sensitive test for renal/bladder stones is actually non-contrast helical CT scan. Ultrasound is a good test and better than a plain film, but ultrasound does have it's limitations (as they can miss small <1mm stones and ureteral stones). CT scan, of course, has it's drawbacks due to radiation but is still the most sensitive test.

I am REALLY glad you did your research and felt comfortable enough asking for further work-up before that procedure went through! Open communication with any healthcare provider (vet, human doc, etc...) is key! As Pam mentioned, asking questions is so very important and helpful  I wouldn't ask for every test to be run as it may not be indicated, but it's definitely good to ask why a test is being run or not run.

Hope Mia continues to do well  She is SO cute!


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## Maidto2Maltese (Oct 19, 2004)

Dr. Stone ( was head of Urology at NCU Vet school) asked me if she could have a photo of Missy and use her as an example of 'real-life-case' to her students of how early detection is so very important and recurrent UTIs must be checked. 

She said many vets tend to not go to the ultrasound 'quickly' for fear owners will think they are 'padding the bill' so to speak, especially since the 'odds' are low TCC is involved. However with this type cancer it's exactly what needs to be done.

I do think many owners, however IF EXPLAINED TO THEM that yes the odds are no cancer involved but how important it is to KNOW would agree to get it ruled out.


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## michellerobison (Dec 17, 2009)

My Rosie had a bladder stone, the size of her bladder. It must have been there since she was a pup and it slowly grew until it filled the bladder. She never had any symptoms or pain, nothing ever showed in any tests. Never had an x-ray since she never showed any cause to have one.. It wasn't until she suddenly passed at age 10 that I found she had it. It was found during autopsy. She was fine one day and gone the next. If only they'd found it,she might have had a couple more years. Vet said it was the biggest one he'd seen for a dog her size.


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## pammy4501 (Aug 8, 2007)

Maidto2Maltese said:


> *Dr. Stone* ( was head of Urology at NCU Vet school) asked me if she could have a photo of Missy and use her as an example of 'real-life-case' to her students of how early detection is so very important and recurrent UTIs must be checked.
> 
> She said many vets tend to not go to the ultrasound 'quickly' for fear owners will think they are 'padding the bill' so to speak, especially since the 'odds' are low TCC is involved. However with this type cancer it's exactly what needs to be done.
> 
> I do think many owners, however IF EXPLAINED TO THEM that yes the odds are no cancer involved but how important it is to KNOW would agree to get it ruled out.


Seriously?? A urologist named Dr. Stone? :HistericalSmiley: :HistericalSmiley: :HistericalSmiley: Too funny!!!


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## revakb2 (Sep 8, 2006)

Thank you ladies for sharing this information.


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## Lacie's Mom (Oct 11, 2006)

Alice -- I had seen you post on FB and was soooooooooooo happy that Mia didn't have to undergo surgery.

Thanks for sharing your story here. Hopefully it will save others from having an unnecessary operation performed.

Hugs to you -- I miss seeing you on SM.


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## donnad (Aug 22, 2006)

I am happy that Mia is ok and did not require surgery. Thank you for sharing this information.


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## Maidto2Maltese (Oct 19, 2004)

pammy4501 said:


> Seriously?? A urologist named Dr. Stone? :HistericalSmiley: :HistericalSmiley: :HistericalSmiley: Too funny!!!


 
LOL...Yes!! :HistericalSmiley:...and... 
Hubby used to have a chiropractor named Dr. Trauma! :HistericalSmiley:


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## zooeysmom (Aug 1, 2011)

Thank you so much for sharing this information, Alice--very informative. 

Also, thank you also to Pam and Marisa for further education on the topic  

Michelle, I'm so sorry about Rosie


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## mom2bijou (Oct 19, 2006)

Al.....I tried to follow this story the best I could on FB. I have to apologize for not reaching out to you and checking on Mia during this process. She is my Dog God Daughter afterall. I have been so consumed w/pregnancy and renovations that it's consuming me. So my deepest apologies!!!

AMEN! I am so happy Mia is ok. You are such a great Mommy to the girls and they are so lucky to have you. This is a great lesson for all of us. Thank you so much for sharing it and I just know it will help other fluff babies down the road. 

XO!


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## aprilb (Jul 9, 2010)

Thank you so much for posting this important info! I'm so glad your baby did not have to get that surgery..oh my! Very good advice!:wub::wub:


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