I still remember those words from the vet, "Truffle needs surgery." I had taken her to the vet for what I thought was a hairball blockage and left scheduling a surgery to remove bladder stones. I'd heard of stones, but had no idea what they were or how to treat them.
What Are Bladder Stones?
Bladder Stones (uroliths or cystic calculi) are rock-like deposits of minerals, crystals, or organic material that develops in the urinary bladder. Bladder stones may be a large, single stone or a collection of stones that range in size from sand-like grains to gravel. The stones may be a mixture of both large and small stones.
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Bladder stones removed from Truffle |
Dr. Richard Goldstein, DVM (Cornell Feline Health Center) says "minerals are present naturally in a cat's body and stones form when the minerals exceed a certain threshold of concentration in the urinary system. When the concentration goes over that threshold, they start to form crystals, and the crystals accumulate and may grow into stone." Dr. Goldstein explains that they don't know why this process takes place, but veterinarians have found that stones tend to occur frequently in domesticated cats, especially those that are not very active, don't take in enough fluids, and don't urinate enough. There is some belief in the veterinary community that stress in the environment could cause bladder stones.
There are two types of bladder stones: Calcium Oxalate and Struvite.
Calcium Oxalate stones (Minnesota Urolith Center) are the most common and difficult stone to prevent because the factors that are responsible for its formation are not completely understood. It's accepted that crystal growth and possibly initial crystal formation may be a reflection of urine supersaturation with calcium and oxalate. Cats who are fed a low-sodium or low-potassium diet or a diet formulated to maximize urine acidity are at increased risk for developing calcium oxalate stones. Some believe that neutered male Burmese, Persian, and Himalayan cats may be genetically predisposed to developing calcium oxalate stones.
Struvite stones tend to form in sterile urine. The formation of struvite urolith formation in sterile urine is poorly understood; however, dietary and metabolic factors that result in alkaline urine and increased concentrations of magnesium, ammonium, and phosphate in the urine have been implicated (Grauer, 2019). Diets that are high in magnesium, phosphorus, calcium, sodium, chloride, and fiber, with moderate protein content have been associated with an increased risk to develop struvite stones. Struvite stones may be twice as likely to develop if urine pH is consistently elevated (6.5-6.9 versus 6.0-6.2).
How Are Bladder Stones Diagnosed
The most common symptoms of bladder stones are blood in the urine (hematuria) and straining to urinate (dysuria). Hematuria occurs because the stones rub against the bladder wall, irritating and damaging the tissues and causing bleeding. Dysuria may occur because of inflammation and swelling of the bladder walls or the urethra, from muscle spasms or due to a physical obstruction to urine flow caused by the presence of stones. Other possible symptoms may be frequent urination, genital licking, chronic urinary tract infections, urine spraying, and urinating in unusual places. Sometimes, cats exhibit no symptoms of bladder stones.
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Dr. Boyette palpates Brulee's abdomen during an examination |
If bladder stones are large enough, your veterinarian may be able to feel them through the cat's abdominal wall. However, most veterinarians tend to use radiographs (x-rays), ultrasound, urinalysis, and urine culture to diagnose bladder stones and help determine the underlying cause. If a cat is brought into the veterinary hospital who is experiencing abdominal pain or has recurrent episodes of hematura or straining, a veterinarian usually performs diagnostic imaging testing to help determine the cause.
Treatment
There are multiple treatments if a veterinarian suspects stones in the bladder, however, the fastest solution is to perform a cystotomy and urolithotomy, or surgically open the bladder and remove the stones, especially if a diagnostic imaging test determined there are larger stones. The surgery is a routine procedure for removing stones and most cats make a speedy post-operative recovery. Stones are removed from the bladder and sent off for analysis to determine which type of stones were in the bladder to better determine appropriate treatment to prevent future stones.
A second option some veterinarians may use is to try to dissolve stones with special prescription diets. If you have a cat who has health issues which may cause complications for surgery, this is an option the veterinarian may try first. The disadvantages of treating the stones with a special diet are it's not successful for all types of stones, it's slow, and not all cats will eat the special diet.
Other less popular treatments are using a flushing procedure where the bladder is filled to induce urination, lithotripsy (breakdown of stones with shock waves), and waiting for the cat to naturally pass the stones.
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Having plenty of water available |
Prevention
After the stones have been removed and sent off for analysis, you'll have a better idea of how to treat your feline to help avoid future stones in the bladder.
You should have always have plenty of water available for your cat to drink, especially if she's had a history of bladder stones. It's not only important to have plenty of fresh water available, but you need to monitor your cat to make sure she is drinking the water. Some veterinarians prefer cats stay on a prescription diet, depending on the type of bladder stones that were present. Even if your cat is on a special diet, at least 50% should be wet food. High moisture foods are more effective because increased water consumption is associated with decreased urine concentrations of calculogenic minerals. It's important to help your cat exercise on a regular basis to help keep her system healthy. Keeping the litter box clean will encourage your cat to urinate more frequently. Since stress may be a contributing factor for bladder stones, it's important to keep your cat's environment as stress-free as possible.
Your vet may recommend a urinalysis (pH should be maintained between 6.5-8.0 and specific gravity should be less than 1.030) and urine culture several times throughout the year to test for crystals and/or infection. Some vets may perform an ultrasound or other type of medical imaging during annual wellness checkups.
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Mom Paula and Truffle at follow-up visit to vet |
Personal Experience
Truffle was taken to the veterinarian because I noticed she was going to the litter box more frequently than usual and I noticed some loose stools. I thought she may be fighting a hairball because both cats had excessive shedding that month. However, one night, I noticed Truffle going back and forth to the box every few minutes and I saw nothing in her box and I saw some blood on her back end. I rushed her back to the veterinarian the next day and x-rays were taken. As I said at the beginning of the post, the "young" vet came into the room very excited, saying, "we know what the problem is AND Truffle needs surgery." The surgery was schedule for the first part of the next week.
I also try to keep my home as stress-free as possible for the health of both of my cats. I keep Feliway or Comfort-Zone diffusers plugged into my home at all times. When I need to travel overnight, I have a pet sitter come into my home and she is one that both girls like and are comfortable being around. Truffle no longer hides with the new pet sitter and she eats the entire time I'm gone.
This will be a life-time commitment for me to monitor Truffle through her diet, water availability and consumption, and regular wellness checkups with the veterinarian.
That sounds awful! We are glad ya got the surgery for them.
ReplyDeleteI (Iza) will probly not have that. I drink a LOT of water. I LIKE the stuff. But I'll have ta keep my eyes on Ayla and Marley. I almost NEVER see them drinking water.
Thanks for the info on that problem...
Truffle is lucky to have you looking after her.Brulee too.
ReplyDeleteIt shows the importance of observing your pets and Vet visits.
Purrs,Georgia and Julie
Gosh, I know how painful kidney and bladder stones are for humans; poor kitties are so tiny! I count peeballs every morning when I scoop the litter boxes, because Chuck had a couple of UTI's over the years, before I knew what they were. We are the best advocates for our cats; keeping them healthy is paramount!
ReplyDeleteYou have a great vet who knows exactly what he is doing which I am sure relieves the stress for you and am happy you found the perfect feeding solution for Truffles.
ReplyDeleteVery informative post. My Sammy had surgery to remove calcium stones. He is on Hill
ReplyDeletes C/D canned and dry food so it won't happen again. Luckily, he did not get blocked.
That was really an interesting post Paula and we're so happy your sweet girl is still doing great.
ReplyDeleteI'm glad to read that Truffle's surgery and continued care afterwards was successful! It's always so scary when our little ones need surgery.
ReplyDeleteScary stuff surgery and I am so glad she has come through. I forget that cats can get stones like people can so your post is a tiely reminder!
ReplyDeleteI remember Truffle having to go through the bladder stone surgery! I'm glad she came through it and you know to monitor it and take preventative measures.
ReplyDeleteOuuuch, poor Truffle. I'm glad you got it diagnosed and treated.
ReplyDeleteWow. I had never heard of cats getting bladder stones. Very informative post. I didn't know there were different types of stones and that their diet had to be monitored. Truffle's lucky to have you take such good care of her.
ReplyDeleteI didn't realize that there were different types of bladder stones. I remember reading about Truffle's bladder stones. I'm glad that she is doing well and can enjoy some of her favorite food now.
ReplyDeleteOh my doodness, poor kitteh! I hope Truffle is feeling better.
ReplyDeleteI can't even imagine ... but I'm glad you finally shared your and Truffle's story. This was all pretty much new to me.
ReplyDeleteI'm so glad Truffle came through everything and is doing better now!
ReplyDeleteBecause you are such an observant Mom, Truffle was able to get relief from the stones. But we know how worried you must have been when she was in surgery. Mom and Dad had a Samoyed doggy that started having piddles on the floor; he wasn't able to get to the back door fast enough before they happened. He had never had accidents before that in all his years. It was discovered through tests that he had gotten crystals. With medication they did go away.
ReplyDelete