Diagnostic tests are needed to identify urolithiasis as the cause of your pet's symptoms and to exclude other disease processes. Your veterinarian may recommend: Complete medical history and physical examination, including palpation of the abdomen. Bladder stones can be difficult to palpate due to the tendency of many pets to tense their abdomen when the veterinarian attempts to palpate them. The medical history may include questions about the pet's urine stream, the frequency of urination, presence of blood in the urine, change in water consumption, changes in appetite, weight loss and history of previous illness or infection.
Urinalysis to evaluate urine concentration, acidity or alkalinity (called pH), presence of red blood cells, white blood cells, bacteria and crystals
Abdominal X-rays to identify stones that are dense enough to be visualized
Other diagnostic tests that may be completed include:
Urine culture and sensitivity to identify bacterial urinary tract infection
Serum biochemistry tests to assess kidney function
Complete blood count to evaluate for infection
Abdominal ultrasound to evaluate for obstruction of the urinary tract by stones
Contrast dye X-ray studies to visualize some stones not visualized on plain X-rays
Stone analysis to identify the mineral composition of the stones and guide your veterinarian in treating urolithiasis
Treatments for urolithiasis may include one or more of the following:
Treatment of bacterial urinary tract infection with antibiotics
Removal of stones surgically or by dietary intervention. There are advantages and disadvantages to both methods. Surgery is invasive but usually insures removal of all stones and allows for mineral analysis of the stones. Dissolution of stones by dietary methods is not invasive but does not allow mineral analysis of the stones and requires your veterinarian to make an educated guess about the type of stone present. Some stones can be dissolved by dietary means and others cannot. Whether or not to attempt dietary dissolution will depend on your pet's general health, the type of stone suspected, the location and number of stones and other factors that your veterinarian will discuss with you. In many instances, surgery is the most direct way to remove stones and submit them for analysis.
At home, be sure to administer any medications prescribed by your veterinarian. Give antibiotics according to the schedule prescribed. It's important to allow your pet free access to fresh clean water.
Follow-up with your veterinarian for physical examinations and urinalysis as directed. Urine culture should be repeated 5 to 7 days after completion of antibiotic treatment to ensure eradication of infection. If your pet has a poor response to treatment, further workup may be required to search for underlying disease processes.
Stone analysis will guide your veterinarian's treatment plan:
Struvite stones: antibiotics to treat bacterial infection
Oxalate stones: thiazide diuretics and potassium citrate
Urate stones: allopurinol
Cystine stones: penicillamine or 2-mercaptopropionyl glycine (2-MPG or Thiola)
Most stones are difficult to prevent. Providing your pet with frequent opportunities to urinate and an ample supply of fresh clean water may help.
Prompt treatment of urinary tract infections can help reduce the potential for certain stone formation.