Help Needed! Kidney Stones - Stent

[SamiSalo]

Dollys Owner is right. You ALWAYS have to know what kind of stones/crystals they are. Have they taken an urine sample? If there is a stone the most likely also is crystals so they can be tested. They just can not say by just ultra sound that they can not be solved. He can have cystine or urate stones, very common in bulldogs. It can be calsium oxalate or struvite or even xanthine, calcium phosphate or silica. Some can be solved and others not.

He’s been given IV fluids for 2 days. I believe they compared the ultrasound taken on the first day (Sunday) & today (Tuesday). Based on that, they feel they can’t dissolve the stone.

Culture has been sent off. Results not back yet.

You’re saying it’s too soon to decide on surgery? How many more days should they keep giving him fluids?


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[SamiSalo]

Dollys Owner is right. You ALWAYS have to know what kind of stones/crystals they are. Have they taken an urine sample? If there is a stone the most likely also is crystals so they can be tested. They just can not say by just ultra sound that they can not be solved. He can have cystine or urate stones, very common in bulldogs. It can be calsium oxalate or struvite or even xanthine, calcium phosphate or silica. Some can be solved and others not.

Just remembered something else they said. The stone’s core could be one material & the outer another. So no foolproof way of knowing what it’s made of. So they compared scans to see if it got smaller. I think that was the logic. For sure I’ll mention your point tomorrow. Thx


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[Dollys Owner]

Depending on type of stone they may be able to dissolve it over a few weeks ( assuming it's too large to pass now ) if it's only a partial obstruction. But if the kidney gets really enlarged from backflow it's more of an emergency and then you can't wait for that.

 

[Cbrugs]

I agree with the others that the most important thing at this point would be to identify what kind of stones. Hard to say what kind of treatment should be done without knowing the type of stone.

 

[SamiSalo]

Really important to know what kind of stones they are in terms of long term treatment. If the stone has completely blocked the ureter and it's too big to pass with a bolus of iv fluid then it's a medical emergency and there is no choice but to remove it with catheter assisted retrieval or cystoscopy or other methods including lithotropsy. If the stone can't be pulverized with lithotropsy or pulled out, then a stent is better than surgically removing it since it will help the ureter open wide enough for the stone to pass.Later on ( let's say in a few weeks ) after the stone has passed then the stent will be removed. Let us know what kind of stone it was so we can advise on a long term treatment since you don't want the stones to recur. Your dog will probably also need some antibiotics for the procedure, or longer if he also has a urinary tract infection .

Confirmed, the stone is in a ureter, about halfway down. So grabbing it or breaking it up (lithotripsy) isn't an option (without invasive surgery). Apparently using a stent to let it pass through isn't an option because in males, the ureter is small & it could take awhile. Salo many not have that kind of time. Someone did say there's liquid building in the kidney. They describe it as a substantial blockage so they feel surgery is necessary. They will remove the stone.

If the ureter sustained damage, they will install a stent. Concern, Salo has a history of UTIs & we don't want bacteria attaching to the stent. If there's no damage, no stent. Concern here, scar tissue from the incision will narrow the Ureter, increasing the chances of more stones/blockages. Surgeon will see & decide during the surgery. Their preference is no stent only because of his UTI history.

Stone will be removed & identified. Salo has smaller stones in his kidney. They're not concerned. They're assuming all his stones are the same so once they identify it, they can prescribe the proper treatment. We've known for.... 2 years now he has kidney disease.

 

[2BullyMama]

Confirmed, the stone is in a ureter, about halfway down. So grabbing it or breaking it up (lithotripsy) isn't an option (without invasive surgery). Apparently using a stent to let it pass through isn't an option because in males, the ureter is small & it could take awhile. Salo many not have that kind of time. Someone did say there's liquid building in the kidney. They describe it as a substantial blockage so they feel surgery is necessary. They will remove the stone.

If the ureter sustained damage, they will install a stent. Concern, Salo has a history of UTIs & we don't want bacteria attaching to the stent. If there's no damage, no stent. Concern here, scar tissue from the incision will narrow the Ureter, increasing the chances of more stones/blockages. Surgeon will see & decide during the surgery. Their preference is no stent only because of his UTI history.

Stone will be removed & identified. Salo has smaller stones in his kidney. They're not concerned. They're assuming all his stones are the same so once they identify it, they can prescribe the proper treatment. We've known for.... 2 years now he has kidney disease.

Sending healing thoughts and prayers.... keep us posted


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[Dollys Owner]

Hope he's ok, keep us in the loop as we're all concerned !!

 

[SamiSalo]

Hope he's ok, keep us in the loop as we're all concerned !!

Surgery was a success, couldn't have gone any better. Ureter was in good shape - stone didn't cause any damage because the stone was nice/smooth. So stent was NOT installed. Urine poured out of the kidney as soon as they removed the block. They think the blockage was recent.

Now just have to see how the incision heals... And check for leaks...

 

[Dollys Owner]

Surgery was a success, couldn't have gone any better. Ureter was in good shape - stone didn't cause any damage because the stone was nice/smooth. So stent was NOT installed. Urine poured out of the kidney as soon as they removed the block. They think the blockage was recent.

Now just have to see how the incision heals... And check for leaks...

Great news ! Let us know what kind of stone it was.

 

[2BullyMama]

Surgery was a success, couldn't have gone any better. Ureter was in good shape - stone didn't cause any damage because the stone was nice/smooth. So stent was NOT installed. Urine poured out of the kidney as soon as they removed the block. They think the blockage was recent.

Now just have to see how the incision heals... And check for leaks...

Great news!!


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[SamiSalo]

Great news!!


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They’re keeping him for another day. To take another blood test to compare. To aid in treatment recommendations. Kidney enzyme before surgery was 320. Today, 250.

Before surgery, culture was negative & urinalysis before, no crystals.


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[Dollys Owner]

They’re keeping him for another day. To take another blood test to compare. To aid in treatment recommendations. Kidney enzyme before surgery was 320. Today, 250.

Before surgery, culture was negative & urinalysis before, no crystals.


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Glad to hear he's on the mend ! It's good they are keeping him another day as they probably have him on an intravenous saline drip to hydrate his kidneys, and possibly a catheter to help him urinate. Sometimes it takes a few days for the inflammation to go down so you can urinate without a catheter ( in humans ). Sometimes humans get send home with the catheter and a home care nurse takes it out in about 5-7 days.

 

[SamiSalo]

Glad to hear he's on the mend ! It's good they are keeping him another day as they probably have him on an intravenous saline drip to hydrate his kidneys, and possibly a catheter to help him urinate. Sometimes it takes a few days for the inflammation to go down so you can urinate without a catheter ( in humans ). Sometimes humans get send home with the catheter and a home care nurse takes it out in about 5-7 days.

He’s home now. Creatinine level didn’t change. Another blood test in 2 weeks to check it again - they don’t expect it to drop much. I’ll get a treatment plan & their life expectancy prediction at that time. Stone analysis due back in weeks.

Not looking forward to that conversation...


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[Dollys Owner]

He’s home now. Creatinine level didn’t change. Another blood test in 2 weeks to check it again - they don’t expect it to drop much. I’ll get a treatment plan & their life expectancy prediction at that time. Stone analysis due back in weeks.

Not looking forward to that conversation...


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At least he's home and with his family that he loves. Try giving him as much fluid as you possibly can with lots of opportunities to go outside and pee. I would give him wet dog food- eg. add water to his raw dog food to make it soupy in texture. The creatinine which measures his kidney function should gradually get better.

 

[SamiSalo]

At least he's home and with his family that he loves. Try giving him as much fluid as you possibly can with lots of opportunities to go outside and pee. I would give him wet dog food- eg. add water to his raw dog food to make it soupy in texture. The creatinine which measures his kidney function should gradually get better.

Will do. Planned on cooking his food for a couple of days before going back to raw. Adding water, good idea.

That’s good to know - that the creatinine can still improve. Thx


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