Dog Bladder Stones
In Detail
Contents -
Incidence of Acute Retention
Factors Associated with Urinary Stone Formation
General Considerations
Diet to Discourage the Formation of Bladder Stones
Physical Factors to Discourage Crystals and Stones
Personal Observation
Checking and Monitoring for Bladder Stones
Hannah's Medical Record
Final Observation
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Incidence of Acute Retention - notes from handwritten observation.
WARNING - the account of Hannah's acute retention can be upsetting to read but a retention is very rare in a bitch. Competent Vets are well aware of the possibility of a retention in a male, so take action well before it becomes serious.
Hannah, over a period of a number of years, developed a need to urinate often.
24 Jan 2000 Hannah has been developing the need to go out to urinate during the night. Tonight she went out approximately five time. Each time she strains to urinate.
25 Jan 2000 Hannah has not passed any urine today. Made an appointment with the PDSA for 9.15 am tomorrow. However she became very distressed in the evening, running up and down the hall. As she still had not passed urine by 10.30 pm I was very alarmed and made several emergency calls to the PDSA. The vet on call diagnosed cystitis over the phone and then refused further contact. Hannah had a very bad night in considerable pain. She passed no urine.
26 Jan 2000 Hannah is dull, has difficulty in moving, and is apathetic. She has a very distended swollen stomach extremely tender to touch. No eating or drinking. No bowl or bladder movement. At 9.15 am at PDSA a young Irish male, very confident, diagnose cystitis. Gave me a course of penicillin. This was in spite of my stating very clearly and several times that the first and major symptom was ‘an urgent desire to urinate, but is unable to do so, and has not urinated for over 36 hours! ’
During the day Hannah seems ok, but uncomfortable. No eating or drinking, no urine or bowl movement. Very subdued. Hannah strains at regular intervals, much as she did when she was in labour. By late afternoon she is dulled and apathetic and appears to be semi-comatose. She is very inactive.
Approx 6.00 pm Hannah urinates in a flood on the bed. Quantity approx at least 2/3 pint. Carried out to garden where she urinates again twice, excreting lesser volume each time. The urine is heavy blood stained, thick, and foul smelling. Hannah is in a state of collapse and exhausted. I cleaned up and put her to rest and sleep. The first urination on the bed contained a pea sized stone.
The pea sized stone
Approx 9.00 pm made an emergency call to PDSA. Received an aggressive response. Gave little useful advice, no re-assurance. Extremely unhelpful. Accused me of abusing the emergency call facility.
27 Jan 2000 Hannah exhausted, slept and rested all day. No eating or drinking. I syringed water and penicillin into her mouth. Is able to urinate with discomfort. All previous symptoms gone. Evening - eating and drinking.
28 Jan 2000 Hannah back to normal but is very tired and nervous. Based on my agricultural apprenticeship and medical experience in NHS hospitals as a student medic, I suspected an acute retention of urine caused by bladder stones.
9.10 am Second opinion, consultation with Best Friends, Christchurch. A spun urine sample found significant crystals, which indicates a tendency to form bladder stones. Urine had a pH of approximately 6.5 (only very slightly acid) and also contained blood and protein. Difficulty in establishing presents of stones. Recommended an x-ray (£60), an operation (£200), and a special diet (£5 per week). Advised that once stones were formed there would be a tendency to form them on a life long basis. Also advised that this was a potentially serious chronic condition that veterinary science had no assured cure for.
Options - x-ray is unnecessary, assume further stones. Put onto special diet to remove and prevent stones. If any further difficulty in urinating, have operation to remove obstruction.
Further Observations
30 Jan 2000 8.00 pm. Hannah urinating frequently. She seems unable to empty bladder in one go. Looks anxious and wants reassurance. Each urination is of small quantity; approximately a dessert spoonful, although she remains in position for a time with no flow. Behaviour around home is fearful. Urine is clear, not concentrated, and inoffensive. Hannah does not strain to urinate and her bladder region is concave, and feels empty.
31 Jan 2000 10.00 pm. Hannah urinated small amount, seemed fearful of urinating. Urine is clear, not concentrated and inoffensive. Her bladder region is convex, and feels full.
10.15 pm. Put Hannah out into garden, no attempt to urinate. Bladder region seems full.
1 Feb 2000 7.00 am. Hannah keen to go out, urinated approximately 5 ml, straw coloured with a hint of brown. Inoffensive.
Urinating regularly and often, seems normal.
Early am. Having difficulty in urinating. Passes small quantities.
9.00 pm. Appears anxious, passed very small quantity after straining with bright red blood. Makes repeated attempts to urinate with a few drops at a time. Her stomach is swollen.
10.30 pm. Ring PDSA emergency number. The female who answered insisted that it was cystitis. Stated that it was not possible for a female to have a retention. Accused me of abusing the emergency call system. Made no inquiries as to the present state of Hannah or her symptoms.
12.00 pm. Further urinations. Hannah settled down to sleep peacefully.
2 Feb 2000 Hannah back to normal.
Possible passing of second minor stone ?
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28 March 2000 mid-day, straining to pass urine, which contains red blood and particles.
1.00 pm free flow.
29 March 2000 Four night urinations, bright red blood in early morning and mid-day.
4.00 pm, small quantity, no blood.
30 March 2000 am, small quantity of old blood (brownish ting) in urine. Passes freely.
pm, urine almost clear.
31 March 2000 am. Up several times during night. Seems ok. Clear.
Possible passing of third minor stone?
2000
5 April - Blood in urine, bright red at end of flow with fleshy bits.
6 April - Blood, brownish, free flow, signs of cystitis.
7 April - Blood, brownish, free flow, signs of cystitis.
8 April - Urine clear, no signs of cystitis.
9 April - Clear, frequently urinates when out, lively and well.
10 April - As for the 9th.
11 April - As for the 9th.
12 April - As for the 9th.
Possible passing of fourth minor stone?
16 May 2000 Hannah spayed at Spring Corner Veterinary Centre, Bournemouth. Asked to have urinary bladder checked and any stones removed. A walnut sized bladder stone with a number of smaller stones found and removed. Vet identified these as Calcium Oxalate, by far the most common, and advised that this could have caused a retention but it was a very unusual occurrence in a female. Advised that a tendency to form bladder stones would result in further stones. Suggested a special commercial diet, but warned that they were not always successful.
One of the Smaller Calcium Oxalate Stones
Warned that stones causes a great deal of chronic problems; chronic cystitis, and in males excruciating pain when passing stones, resulting in emotional and psychiatric problems for both the pet and owners, and a ruined pet.
There is also the danger of an acute retention which can be fatal.
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Research Sources
The main sources of my information were my own life experiences, inc. higher education in Applied Physics, an agricultural apprenticeship, working for over two years as a student in NHS hospitals, a year in the British Army Veterinary Corp; helpful vets and nurses, employment as a Senior Technical Author; and the time, due to early retirement, to research the Internet. The last was absolutely invaluable.
Factors Associated with Urinary Stone Formation
Factor’s in fattening cattle and sheep in the US and Canada are;
high grain rations with limited ‘greens’ and hence little vitamin C.
high grain rations causing a relatively bland alkaline gut and bladder.
oestrogen additives.
increased salt (sodium chloride) increasing mineral content of urine.
magnesium supplements increasing mineral content of urine.
Acidity
For the natural prevention and/or removal of stone formation it appears that an acidic urine is required to keep minerals dissolved. An unknown acidity (pH level) is required for this. The above factors would reduce the acidity and increase the mineral content of the urine.
Note, as the acidity of the urine is not constant, it is difficult to place a value on this.
The pH is the measure of the acidity or basicity of a solution. It is measure on a scale from -5 to 14, with 7 being considered neutral. 7 to -5 is increasingly acid, 7 to 14 is increasingly alkaline (base)
Hence -
The pH Scale. Note, 7 is considered neutral.
-5 -4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
-1 Hydrochloric acid 7 neutral 13 bleach
2 gastric acid 7.4 blood
3.5 orange juice 10 hand soap
Hannah’s urinal pH was measured at 6.5 on the 28 Jan 2000 when she had developed a walnut sized stone plus a number of smaller ones. This was not a precise measurement.
General Considerations
Hannah was fed mainly on the popular dry processed diets. They appear to consist of the remains of animals that are unfit for human consumption with a high percentage of cereal. As the human digestion is considerably more versatile than the canine this seemed to be unwise. I ate some of Hannah’s food and it was disgusting. It adversely effected my digestion and explained Hannah’s foul and unhealthy faeces.
Furthermore these diets contain no Vitamin C. It was noted that Hannah ate green plants, keenly, indicating a possible lack of vitamin C, or an unknown element x.
It seemed sensible to abandon the processed foods and use a natural diet of raw and lightly cooked meat, offal, and hard biscuits, with fish.
Army dogs were fasted once a week to rest the digestion system. Certain human cultures also regularly fast. Given that thru-out our evolution hunger (and starvation) have been part of our lives, perhaps our bodies need regular fasts for rest and health; in sensible moderation that is ! i.e. Sunday - late breakfast and very light tea as a rest day.
Reduce oestrogen hormone levels by spaying. Oestrogen additives were factors associated with urinary calculi formation.
A urine acidifying substance - calcium sulphate, 0.5% has been used in diets, but was not too successful.
Source of above information - Internet search for ‘urinary bladder stones‘.
Processed Foods
Hannah was fed on dried processed foods for all the first six years of life. These foods are dried and cannot contain any Vitamin C; do many dogs suffer from mild but chronic scurvy. It would explain the poor gums and teeth of Suzy, our pet miniature Yorkshire terrier.
Processed foods are produced by commercial companies with little or no regulation. It can be doubted if the specifications on the bags are an accurate description of the contents of the bag.
The possible constituents of processed foods are as follows;
Chicken. This could be chickens rejected for human consumption. It does not taste or smell like chicken. The 'chicken' to me tastes and smells bad; of rotten skin and feathers. I assume that it is obtained from redundant battery chickens, many of very poor health or dead, with a significant quantity of bone and excreta. I ate some and it made me ill. It could be thought that the calcium content would be high and could lead to an increased likelihood of bladder stones.
Fish. This, to me, tastes and smells of fish heads, tails, and bones; and rotten ones at that. Again this could be thought to contain a high level of calcium.
Beef. This, to me, tastes and smells appalling. Hannah would not eat it. As above.
The dried factor; the processed dried food is usually fed dry as it is easier and many dogs refuse it when fed wet - is the smell and taste too bad. The dry diet can result in a chronically dehydrated dog and a reduced urine flow. This would lead to a concentration of mineral rich urine which is prone to stone formation.
Diet to Discourage the Formation of Bladder Stones
All figures are approximations.
A typical diet as based on commercial scientific research is as follows:
20% protein
20% fat
47% carbohydrates
3% fibre
10% water
plus assorted vitamins and minerals
plus urine acidifying substances such as calcium sulphate 0.5%.
Source; commercial scientific research internet sites
Daily Food for Hannah
This was provided for Hannah by the following foods:
45% cheap non-lean mince, raw and low temperature cooking to preserve the vitamin C. This gives the 20% protein and 20% fat. Plus a pinch of salt added to the mince to increase urinary flow.
50% hard plain biscuits, to give 47% carbohydrates and 3% fibre.
5% eggs, cheese, milk, fish, and bland healthy off-the-plate tit bits (non-spicy).
Semi-fast on Sunday to rest the digestion system - one very light meal such as scrambled eggs or poached fish (for both pet and owner!).
Source: based on the Royal Army Veterinary Corp, British Army, diet for dogs, 1961.
The inclusion of two tots (approximately 20 ml of Cranberry Juice per day, especially after meals, to be highly recommended for a clean mouth and urinary tract ( for both pet and owner! )
For the natural prevention and/or removal of stone formation it appears that an acidic urine is required to keep the minerals of possible stones in solution, and so prevent the build up of stones. A pH of approximately --x-- is required for this. The above diet would increase the acidity and decrease the mineral content of the urine.
Alternative Foods
protein - lean meat
Plain red or white meat (the muscle) does not provide a number of requirements including calcium and vitamin A. When raw it does contain vitamin C, but this is destroyed by cooking. The lack of calcium gives a very adverse calcium phosphorus ratio.
Lean meat is also deficient in fat; and fat soluble vitamins.
Carbohydrates - potatoes
35% of potatoes are grown for livestock feed.
Potatoes consist of 79% water!
18% carbohydrates
2% protein (in the skin)
1% ash
0.4% fibre
They are rich in vitamin C, which is destroyed by cooking, and high in the minerals of magnesium, phosphorus, and potassium.
The high water content would encourage a high urinary flow, but the minerals are not desirable.
Magnesium Supplements
In Britain, 1981, an increased incidence of urinary retention and death occurred in male calves and lambs after being fed a high level of magnesium supplement. The cause was stones formed from crystals of magnesium ammonium phosphates. Consequently the magnesium supplements given were reduced and the incidents of retention returned to normal.
Physical Factors to Discourage Crystals and Stones
Volume - a constant state of a high level of body fluids (inhydration) to provide a large volume of urine flow and hence a low concentration of minerals. This can be encouraged by permanent sources of readily available clean fresh water. This includes in the home, the garden, and the car; especially the car. A non-spill car water bowl can be brought from large pet shop. This has a concave water surge director lid.
Hannah always had water available, and even her walks usually had a water source included, especially in winter with the abundance of puddles around.
Flow rate - a rapid movement of urine through the urinary tract to reduce the time available for the precipitation of minerals out of solution into crystals. This can be encouraged by a mild natural diuretic such as salt, in small quantities, such as a pinch per day - approximately 21 grains per stone weight of pet per day of table salt.
Ideally a ‘dog flap’ should be fitted in the garden door so the retention of urine is reduced to a minimum. No dog should be kept in a flat; a garden is essential.
Hannah was not only allowed out on demand, she was, on occasion, ‘put out’ to ‘spend a penny‘. This included first thing in the morning, last thing at night, and at regular intervals during the day. i.e. “Come on Hannah, go out and spend a penny. What’s the matter? It’s raining? Go on ! you’re a Cairn terrier, Cairns laugh at the rain, and storms, and snow and ice - get your furry butt out there !
A rapid movement of urine also helps to reduce general urinary tract infections, as anyone who has been troubled by cystitis knows only too well!
Personal Observations
Dogs have evolved over many generations to feed and live off the carcases of other animals. This includes the whole of the body, such as the internal organs (offal), the meat, the fat, the tendons, the bones, the skin, etc. etc.
In order to process the raw or slightly decayed protein rich food a dog is able to produce very high concentrates of hydrochloric acid in the stomach. This may be necessary to insure a dog’s urine is acidic to the level where kidney and bladder crystals and stones are prevented. An acidity level of --x-- seems to be required. Hannah’s urine pH was occasionally checked over the eight years when no further stones formed but as it varied and the check was not precise no records were kept. It was definitely acid.
Thus perhaps the feeding of raw or lightly cooked non-lean mince is an important part of a healthy dog’s diet. The cheaper non-lean mince should contain a range of the body elements, including fat and offal.
Fresh raw mince contains vitamin C, which is sufficient for a dog’s needs. Many commercial processed diets are completely lacking in this.
Hannah absolutely loved raw mince and enjoyed two meals of this per week plus a light snack every breakfast. I found that it was necessary to add water to keep her mouth clean. I lightly boiled it for four days a week, with a pinch of salt as a diuretic to increase urinary flow. As she became older and found the raw mince difficult to digest, as indicated by her stools, I reduced and then stopped the meals of raw mince, but continued the breakfast snacks.
A dog’s digestive system is not nearly as versatile as a human’s and the plain diet described above is suitable on a long term basis.
Checking and Monitoring for Bladder Stones
It is difficult to diagnose the presences of stones for certainty; other than by an exploratory operation, which is a bit drastic.
However there are four checks that can be made -
1 Palpating (feeling) the abdomen. This can detect the possible presence of developed and large stones, but small ones can be missed.
2 X-rays can show stones, but are not always able to do so.
3 Scans are clearer, and easier, but again can miss stones.
4 Urine samples - these can be tested for mineral crystals and acidity (ph).
Mineral crystals. Any Vet should have the facility for spinning a urine sample and checking for the presences of crystals. The presences of abundant crystals will indicate the possibility of stone formation. Just a few should not be a problem. As this check can be done by a nurse it should not be expensive.
Acidity. This can be checked by the Vets. I tried to do it myself using litmus paper and a garden soil tester but neither was accurate enough. The usual type of stone is calcium and it seems that a definitely acid urine is required to keep the mineral in solution and prevent the formation of both crystals and stones (the crystals tend to build up into stones) As the urine concentration and acidity varies over the day a precise figure is difficult to establish. It would have to be an average.
Getting a sample - this can be fun ! Most Vet’s will give a sterile container for this for free, and after the first few difficult collections your surprised pet will get use to your odd and mystifying behaviour and not move off at the crucial moment of catchment. Eventually you will become skilled at catching the golden stream of urine in the container without spilling a drop. As a challenge, I found it great fun !
The spun urine check can be used regularly to monitor for crystal’s presence (and hence possible stone formation) and so to check the effectiveness of any diet changes you try. This is what I did with Hannah. Note; it is best to have the tests done by a Vet who does not have any interest in selling any particular brand of diet to avoid any conflict of interests, and preferably has an interest in the subject of bladder stones.
Source of information - my own Vet’s advice.
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Hannah's Medical Record
After her two litters, occasional bouts of cystitis noted. Not serious.
24 Jan 2000 Commencement of Hannah's bladder stones problems.
16 Sep 2005 Spring Corner Veterinary Centre, Bournemouth. X-ray and ultrasonic scan bladder. No evidence of stones. No evidence of cystitis.
13 Jan 2006 Spring Corner Veterinary Centre, Bournemouth. Left eye chronic conjunctivitis
12 Mar 2007 Spring Corner Veterinary Centre, Bournemouth. Growths on head - warts, removed. Dental w/2 extractions (incisors) Overnight stay.
Autumn and winter 2007 Hannah increasingly inactive, growing infirmed. Health fair, good appetite.
Winter 2008 Hannah unable to rest, appears in discomfort, appetite declining. Unable to walk far. Unable to run.
13 Feb 2008 Spring Corner Veterinary Centre, Bournemouth. Dental check and clean. Urine check, ALP 178+ (15 to 60) urea 25+ (1.7 to 7.4) creat 275+ (30 to 170) - suggests kidneys deterioration due to age.
27 Feb 2008 2.30 am, two fits with violent convulsions, Hannah disorientated and distressed, in state of collapse.
Ensbury Park vets. Approximately 3.00 am euthanasia by injection at Ensbury Park vets - on emergency call.
Autopsy at Spring Corner Veterinary Centre, Bournemouth - no crystals or stones found in bladder or kidneys.
28 Feb 2008 Heathlands Pet Crematorium - individual cremation. Ashes scattered on Southbourne Cliffs opposite Seaward Avenue, Bournemouth, Dorset.
Final Observation
Hannah remained completely clear of stones after the removal of her existing ones in May 2000 for the rest of her life. She deceased at the age of 13 years and 7 months; her breed life time is regarded as from 12 to 14 years.
Personal Note
She was much loved, and sorely missed.
I found these to be informative and helpful links -
note; I cannot judge on the usefulness of any of the products advertised in the linked sites.
If you would like to query anything in this article then please email me on
degray1982@gmail.com