Rock On: Bomag`s Bladder Stone Surgery
I’ve been treating Bomag for six years or so now. He’s a huge black lab mix with a lumbering disposition and a sweet stare. He’s the kind of dog that will give you his huge paw when you need to take his blood and gaze deeply into your eyes as you lay him down to take an X-ray. In a word: lovable.
When Bomag was sick to his stomach last week I made sure to take an X-ray. Apart from the inflammation in his bowels (likely caused by one too many treats the weekend before) I found a cluster of stones nestled in his bladder.
Ouch!…That’s gotta hurt. But Bomag had never shown any classic signs of bladder discomfort. Sure enough, a urinalysis confirmed he had a raging urinary tract infection. Poor Bomag. He’s so good he never once complained. I love this dog.
Once his belly’s discomfort cleared up we decided to get in there and do something about his bladder stones. Surgery is the only answer in these cases, as stones like this will never resolve with a change in diet or antibiotic therapy. After a week of antibiotics it was time to go in and get them out.
Surgery day: I opened his belly down low next to his prepuce (the sheath inside of which dogs keep their penises neatly tucked away). I found his bladder and held it up with a neat trick involving suture material used as a suspension mechanism to hold it in place.
Bomag`s bladder was a mess. It was an unnatural, deep pink color and quite firm, to boot. Its normally thin walls were swollen to more than ten times their normal thickness while blood vessels snaked all over its surface—a sure sign that this had been going on for a long time.
I then cut into the bladder with a scalpel. Uh-oh. Did I say ten times the normal thickness? More like twenty. On the inside, the bladder was lined with deep folds of abnormal tissue; like tentacles reaching deep into the bladder to hold—you guessed it—clusters of bladder stones. Hundreds of tiny stones were caught in the grips of these undulations in the bladder wall.
This is what some of us in the business call the surgical peek and shriek. It happens when you’ve just determined you’re in over your head. What most of us do is take a deep breath and carry on. Some of us just close up and send the pet to a surgeon.
I’ve done so many of these surgeries (technical term: cystotomy) I felt I could weather the storm. I dug in and gently began dislodging the stones one by one. Flushing with saline solution aided by gentle manipulation with my fingers got the vast majority out. I’m sure I left a few tiny ones. I reasoned that these would be capable of passing through his urethra now that they had been freed of their fleshy attachments.
It took two hours of hard work.
After I was done and Bomag was recovering well, I had time to sit and think. In retrospect I surely would have sent Bomag to a board-certified veterinary surgeon. I like to think of vet surgeons as the chefs of the veterinary world. And while I consider myself an excellent cook, I’m certainly no chef. Bomag could have used Emeril today, for sure.
That evening I called my vet surgeon friend and cried on his shoulder (via telephone). As always, he was reassuring. After listening to my babble and stress-talk he assured me that even surgeons take two hours to get teeny tiny stones out. He complimented my techniques as I described them and my stick-to-it-iveness. He’s the bomb. I felt so much better. And, as he says, the proof is in the pudding. Bomag`s doing great.