Uroliths_Male_ToaPayohVets.htm
is the webpage documenting the Maltese's bladder operation to remove numerous green stones.Clinical Case Study: Toa Payoh Vets
BLADDER STONE REMOVAL SURGERY ON AUGUST 5, 2008
1. General anaesthesia. IV drips.
2. Skin incision cranial to prepuce
3. Linea alba incised
4. Bladder hooked out or use forceps. Bladder was empty.
5. Ventral surface of the bladder was incised, between large blood vessels seen on the bladder wall.
Maltese, Intact Male, 5 years. Stones must be flushed out thoroughly. Toa Payoh Vets
Cystotomy. Surgical approach in this case was via the dorsal wall of the bladder as contrasted to the ventral approach in the Miniature Schnauzer case of the young lady.
Both approaches are acceptable. The ventral approach is easier, in my opinion. Some vets believe that there will be less pressure on the bladder if the dorsal approach is used.
Maltese, Intact Male, 5 years. Incision to access the bladder. Toa Payoh Vets
6. Forceps to pick out as many stones as possible, esp. large ones.
7. Insert catheter into urethra to bladder.
8. Flush 20 ml of Hartmann's solution via catheter into bladder. More stones are flushed out. Repeat.
9. Clamp incision with forceps and flush Hartmann's solution to distend bladder.
10. Release forceps to let stones flush out. Numerous sandy ones. Repeat.
11.Insert catheter via bladder to urethra and flush stones along the length of the urethra out. Numerous small sandy ones.
12. 2 layers of inverting stitches 3/0 dissolvable. Not to stitch into mucosa.
Mucosa looks white. Bladder wall is thickened.
13. Flush 10 ml of Hartmann's solution into bladder via catheter. No leakage seen as bladder distends. Repeat.
14. Close skin.
15. Collar. No need catheter.
Dog is active and normal as at August 9, 2008. Any person interested in adopting him, please e-mail
judy@toapayohvets.com
UPDATE AS AT AUGUST 9, 2008 (National Day, Singapore)
The urinary stones in this Maltese were removed by cystotomy.
However, there is no guarantee that he will not get a similar problem another time. X-rays after the surgical removal of stones and every 3-6 months are ideal. 2-weekly urine tests for the next 3 months are recommended to check for bacterial infection and crystal formation.
Absence of crystals in the urine or X-rays do not mean that the dog has no stones (>100 numerous green ones)
Friday Sep 12, 2008
http://www.toapayohvets.com/surgery/20080815Maltese_
Uroliths_Male_ToaPayohVets.htm
is the webpage documenting the Maltese's bladder operation to remove numerous green stones. He was adopted by a dog lover who has a female Maltese some 2 weeks ago.
On Wednesday Sep 10, 2008, the Maltese had a seizure for around 3-5 minutes and was brought to the Surgery in the evening. He was warded for the next 36 hours and had no seizure. He was extremely energetic.
The cause of seizures are not easy to say. He did have a seizure prior to his urethral obstruction according to the son of the patriarch who did not want him. Therefore this is his second seizure.
"Could he be having too much sex?" the new owner surprised me with his observation that the Maltese had been trying to mate the female Maltese. Both were sniffing each other for the past few days but she did not permit him to mount her.
"The female is not receptive for the first 7-10 days of estrus," I said. "So the male must be exhausted. Did he eat?"
I asked because this dog may have hypoglyceamia or low blood sugar if he does not eat twice a day. Some small breeds like the chihuahuas do suffer from such a condition.
"The female ate his food in the evening, as he did not eat it. He was not interested in his food." The male Maltese may be getting seizure soon and did not have the appetite.
As the cause of seizures are unknown in most cases, it is hard to treat. The Maltese had no seizures for the past 36 hours and went home.
"What should I do if he has a seizure again?" the new owner asked. "The dog keeps banging his head on the floor."
"For dogs with seizure, try to prevent the dog from injuring himself. For the small breed, it is possible to wrap him in a blanket and protect his head from injury. The owner is give a diazepam tube to stop the fits is used to pump the drug into his rectum.
In this Maltese, I suspect that extreme pain as in urethral obstruction earlier or exhaustion as in recent seizure could be the triggering factor. He had been warded in the Surgery for a few weeks till he was adopted 2 weeks ago. He never had fits. Neither did he have the sexual tensions too.
This dog needs to be monitored. As far as more X-rays and urinalysis to monitor the recurrence of bladder stones, many Singapore dog owners are not willing to spend money and time to do the monitoring.
The cost of living for the ordinary people in Singapore goes up every year. So veterinary advices are frequently ignored.
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