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Date:   08 February, 2012  

Focus:
 Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Recurrent urolithiasis - Calcium phosphate urinary stones
Why urinary stones present again after surgery 12 months ago?
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
08 February, 2012  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129

urinary stones recur again one year after surgery by Vet 1. Why? toapayohvets, singaporeIn my review of this recurrent urolithiasis, for the benefit of dog owners, the vet did not perform a stone analysis in the first cystotomy done 12 months ago. This was  probably due to the owner's  instructions to reduce costs. In the recurrent case, operated by at Toa Payoh Vets by Dr Vanessa,  I insisted on a stone analysis. The results were as follows as this ought to be done to know the type of stones present and hence a preventive program using prescription diet or other ways to manage and prevent recurrence.
 

12.1.12 At Vet 1
after midnight emergency

 
urinary stones recur again one year after surgery by Vet 1. Why? toapayohvets, singapore Shih Tzu, Male, 8 years old

 
 
BLOOD TEST URINE TEST X-RAY
WBC high 24.48 (5.5 -17)
Neutrophils 82%, L=3.6%, Mono = 12.9%
Absolute High for Neutrophils, Monocytes, Basophils, Platelets, BUN, ALKP.
Dysuria urine pH = 7.2, USG 1.015 urinary stones recur again one year after surgery by Vet 1. Why? toapayohvets, singapore

3.1.12 at Toa Payoh Vets

SURGERY URINE TEST STONE ANALYSIS: Calcium Phosphate.
urinary stones recur again one year after surgery by Vet 1. Why? toapayohvets, singapore
 
Urine pH 7.0, USG 1.012
Protein 2+, Blood 4+, WBC 468 RBC 25, Bacteria 3+, Crystals Nil.
urinary stones recur again one year after surgery by Vet 1. Why? toapayohvets, singapore
Do proper planning before surgery to save on manpower time and resources and to reduce length of anaesthesia, ensuring better survival outcome for old dogs. No crystals in the urine do not mean no urinary stones inside the bladder or kidneys Negative for oxalate, urate, magnesium, cystine, ammonia, bicarbonate.

In conclusion, most Singaporean pet owners don't bother with prescription diets, monthly urine tests and 3-monthly X-ray to detect small urinary stones which can be flushed out using urohydropropulsion and thereby saving on surgery and higher costs. However, it is THE DUTY of the veterinary surgeon to record in the case sheet that such advices have had been offered to the owner to prevent misunderstanding when there is a recurrence.

Younger Singaporeans may be much more sophisticated and educated and may understand the need for such preventive tests. But many Singaporeans are time-pressed. Till the dog can't pee or pass blood and then they may consult the vet.  I hope this review will provide some information to owners who wants more information on prevention as I do know of some owners who would just euthanase the dog when there is a recurrence.

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toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
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Clinical Research
 

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All rights reserved. Revised: February 08, 2012

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