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Team work makes the dream work
November 26, 2024
Dougal presented inappetent, unsettled and not himself. On clinical exam a very large bladder was found suggesting that he had become ‘blocked’ which is a life-threatening emergency. Dougal was admitted immediately and radiographs revealed that he had stones (aka uroliths) in his urethra and bladder. Uroliths in male dogs are especially risky because they have a narrow urethra (the tube via which urine exits the bladder) and a bone within the penis known as the os penis – this can cause uroliths to get stuck.
Dougal had a procedure to unblock the bladder and then surgery to remove the stones, known as a cystotomy. The uroliths were sent to Minnesota Urolith Centre to determine their mineral composition. Dougal’s uroliths were comprised of ammonium urate which only occurs in ~5% of cases and are usually the result of one of two main underlying causes – genetics or abnormalities with the liver vessels.
A bile acid stimulation (BAS) test was performed to test liver function, and the result suggested an abnormality in his liver. Dougal was then referred to the internal medicine specialists at Auckland Referral Centre (ARC) where he underwent a CT scan which identified a liver shunt – this is an abnormal vessel causing blood to bypass the liver. The liver is very important for detoxification of the blood; because toxins were not being eliminated appropriately this lead to a build-up of ammonia and consequently the uroliths. Other clinical signs include stunted growth, gastrointestinal signs and in worst cases seizures.
The specialist soft tissue surgeons at ARC then performed an intricate surgery to tie-off the abnormal vessel. We recently repeated the BAS test which showed that Dougal’s liver is now functioning normally. Dougal has been a star patient and loves coming to the practice and getting lots of attention from our wonderful staff.
We would like to take this opportunity to thank the amazing team at Auckland Referral Centre for their assistance and support with this case; and also to thank Dougal’s owners for entrusting us with his care.
