Urolithiasis is a common clinical problem in small animal veterinary patients. See how a minimally invasive technique helped
a Bichon frise.
Initial findings
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Signalment: 3-year-old spayed female Bichon frise
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Presenting complaint: Recurrent urinary tract infections and intermittent hematuria
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Pertinent history: Two years of recurrent intermittent dysuria, hematuria and pollakiuria with three documented urinary tract infections consisting
of Staphylococcus species
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Previous diagnostic tests performed
—Urinalysis: Urine specific gravity = 1.021; pH = 8; too numerous to count cocci bacteria/hpf; 10 to 20 WBC/hpf; 5 to 10 RBC/hpf; protein
3+
—Urine culture:
Staphylococcus intermedius > 100,000 colonies
—CBC: All results normal
—Serum chemistry profile: Blood urea nitrogen = 38 mg/dl; creatinine = 2.1 mg/dl (slightly elevated)
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Previous medications: Amoxicillin trihydrate-clavulanate potassium (15 mg/kg orally b.i.d. for 14 days), four different treatments periods
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Progression: Each course of antibiotics improved the dysuria and hematuria. These signs recurred within one to four weeks after discontinuation
of antibiotics.
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Physical examination findings: Bright, alert, good body condition; lightly hooded vulva
Problem list
- Recurrent urinary tract infections
- IRIS stage 2 chronic kidney disease (elevated creatinine concentration with low specific gravity)
Differential diagnoses
- Pyelonephritis
- Possible urolithiasis (suspected struvite)
Further diagnostics tests
Figure 1: A radiograph of a female dog with bilateral large staghorn nephroliths.
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Abdominal radiography: See Figure 1
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Abdominal ultrasonography: Large nephrolith in each kidney measuring 3.5 cm on the left and 2.8 cm on the right; small bladder stones (< 2 mm)
Diagnosis
- Bilateral staghorn nephrolithasis: suspected struvite stones
- Cystolithiasis
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