What To Do About Bladder Stones if Your Dog Is Struggling to Pee

Urination is usually an easy fact of life for dogs. Bladder stones in dogs, though, can make urination a painful experience. The stones can even prevent urination altogether, creating a medical emergency.

If you've ever had bladder stones, you can imagine how uncomfortable they are for dogs. Bladder stones need to be promptly diagnosed and treated so that affected dogs can go back to urinating comfortably.

What Are Bladder Stones?

Bladder stones, also called uroliths or cystic calculi, are mineral formations in the bladder and resemble rocks. They can be as small as grains of sand or as big as gravel (in some, even cases bigger!).

Dogs can develop many different types of bladder stones; these are categorized by their mineral composition. The most common types are struvite (magnesium ammonium phosphate), calcium oxalate, and urate. Less common types of bladder stones in dogs include cystine, xanthine, silica, and calcium phosphate.

Struvite stones are the most common overall and tend to occur more frequently in female dogs. Calcium oxalate stones are more common in male dogs. Certain dog breeds are more prone to bladder stones. For example, urate stones are especially common in Dalmatians. The following dog breeds may have a greater risk of developing bladder stones:

• Miniature schnauzer
• Shih tzu
• Bichon frise
• Lhasa apso
• Yorkshire terrier

An affected dog's bladder may contain numerous small stones or multiple large stones. Sometimes, smaller stones can get stuck in the urethra (the long tube carrying urine out of the body). This scenario, called a urinary obstruction, is a medical emergency.

Bladder stones can occur at any age and grow quickly or slowly.

What Causes Bladder Stones?

Bladder stone formation is complex. A theory called the Precipitation Crystallization theory helps explain some of the process:

When the urine contains an excess of certain minerals, such as magnesium, the minerals can no longer dissolve in the urine and separate out, forming crystals. These crystals rub against and irritate the bladder lining, creating mucus. The mucus and crystals clump together and eventually form bladder stones.

Several risk factors can trigger bladder stone formation:

• Bladder disease, including urinary tract infections (UTI)
• Urine acidity level ("pH") that's too high or low
• Excessive dietary minerals
• Abnormal metabolism
• Reduced water intake
• Genetics
• Medications
• Systemic disease, including kidney disease and diabetes

Signs and Symptoms of Bladder Stones in Dogs

The most common signs of bladder stones in dogs are hematuria (blood in the urine) and stranguria (straining to urinate). Other symptoms include pollakiuria (frequent urination), genital licking, abdominal pain, and urinary accidents.

Urinating only in little squirts or not all is a medical emergency! When a dog can't urinate, toxins that would normally get flushed out in the urine accumulate in the body, making dogs very ill. The following signs may indicate a urinary obstruction:

• Urinating small amounts frequently
• Straining to urinate with little or no urine coming out
• It takes a long time for your dog to urinate
• Blood in the urine
• Urine is dripping out (instead of coming out as a stream)
• Lethargy
• Vomiting
• Pain or vocalization while urinating

Signs of bladder stones and urinary obstructions may resemble those of other urinary tract conditions. If your dog has any of these signs, immediately make an appointment with your veterinarian.

Diagnosing Bladder Stones in Dogs

To diagnose bladder stones, your veterinarian will first perform a physical exam, paying close attention to your dog's abdomen. Large stones may be felt with the fingers when your veterinarian gently touches your dog's bladder.

Imaging tests, including abdominal X-rays and ultrasounds, will help your veterinarian see the stones. Some stones can be easily seen with a plain X-ray. If the stones are translucent, your veterinarian may use radiographic contrast material or do an ultrasound to see the bladder stones.

Basic laboratory tests, including bloodwork, urinalysis, and urine culture, will assess your dog's overall health. These tests may reveal an underlying cause of the stones, such as diabetes or UTI.

How to Treat Bladder Stones in Dogs

The three main treatment options for bladder stones in dogs are surgery, urohydropropulsion, and dietary dissolution. Type of stone, location of stone (bladder, urethra), and overall health will determine which treatment a dog needs.

Antibiotics are prescribed if there's an underlying UTI.

Surgery

Surgery is the quickest, most effective treatment for bladder stones in dogs. It is recommended for dogs with numerous bladder stones. Emergency surgery is required if a dog can't urinate because of the stones.

The surgical procedure is called a cystotomy. This is where a veterinarian opens the bladder and manually removes the stones. A urethrotomy (incision into the urethra) may be needed to remove stones in the urethra. Your veterinarian will typically try to flush or push any stones that are blocking the urethra back into the bladder. The stones that are removed are analyzed to identify their type. Dogs often recover within a few days.

Surgery may not be appropriate for older dogs or dogs with health conditions that make anesthesia risky.

Urohydropropulsion

Urohydropropulsion is a non-surgical treatment in which a catheter is passed into the bladder and the stones are flushed out and analyzed. Dogs are anesthetized or sedated for this procedure. The stones must be of a certain size for this procedure to be performed successfully.

Dietary Dissolution

Dietary dissolution involves feeding a special diet that will slowly dissolve the stones. This is a good option for dogs with struvite stones. This is not suitable for all types of stones, but a diet change may be recommended in dogs that cannot undergo surgery.

Dietary dissolution has a few disadvantages. Stones typically start dissolving within a few weeks, but they may still obstruct the urethra before they can dissolve. In addition, dietary dissolution diets are formulated specifically to dissolve stones and may not meet all of your dog's nutritional needs during treatment. This is not a concern for short-term treatment, but these diets are not recommended for long-term use.

Can You Prevent Bladder Stones in Dogs?

Bladder stones are not always preventable. However, some prevention strategies can reduce the risk of stone formation:

• Provide unlimited fresh water. Adequate hydration is key to diluting the urine and promoting urination. You can also add some water to dry food.
• Feed a nutritionally balanced diet. Talk with your veterinarian to ensure that your dog's diet isn't too high in nutrients that could lead to bladder stone formation. Also, do not give your dog supplements without your veterinarian's approval.
• Consider feeding your dog wet food. Wet food has lots of moisture and helps dilute the urine.
• Treat underlying diseases.

Additional preventive measures, including regular monitoring of the urine and imaging of the bladder, are needed to prevent a recurrence. If your dog has had bladder stones or is a breed at higher risk, your veterinarian will advise how frequently your dog will need this monitoring.

Bladder stones are uncomfortable and painful for dogs and can become an emergency if they prevent urination. If your dog shows any signs of bladder stones, schedule an appointment with your veterinarian without delay.