THE LAST STONE

Kelly and I were finishing a cystotomy. This is a surgery in which the urinary bladder is opened to remove urinary stones. I must have removed 99 stones. The dog was only three years old, and she had impressively made more stones than I had ever seen at once.

After stone removal surgery, we always take an x-ray to assure all the stones have been removed. Almost a formality. I always fret a bit though between the surgery room and the x-ray table.

The x-ray appeared on the screen, and one lone stone remained in the trigone of the bladder. I was mortified. This happens in a reported 20% of stone removal surgeries in which x-rays are taken afterwards, but it had never happened to ME.

Back to surgery we went, Kelly reminding me, as she often does, to BREATHE. I sure love that friend. As basic as it sounds, I was NOT breathing, and needed to in order to complete surgery.

We reopened the surgery site, I removed the stone with a hemostat and returned to take another x-ray. The stone was out, and I was glad I had returned for the one last stone. 

Luke 15

or something

URINARY STONES

For those of you with a weak stomach or no interest in the ins and outs of surgery...or both...skip this post!

Those of you who like the weird and the gross, read on.

One of the coolest surgeries we do is stone removal surgery from the urinary bladder.

Stones can be quite pretty. These look like roses to me.

We take stones out for two reasons - they hurt and they can obstruct the urinary system, especially in males.

Before surgery, we do a physical exam and blood work. When we have patients undergoing anesthesia, we - of course - want it to be as safe as possible.

The day of surgery, the pet is fasted. He or she is sedated and anesthetized. An IV catheter is in and anesthesia monitoring equipment is hooked up. 

The pet is placed on their back on the surgery table in the surgery room. Lights are aimed at their belly.

Warning! Here is the gross/cool part...An incision is made into the abdomen and the urinary bladder. The stones are scooped out - I am not making this up - with a tiny measuring spoon. We have three. They say "smidge," "sprinkle" and "pinch." I use the "smidge" spoon, the smallest one.

The bladder incision and the abdominal wall incision are sewn back up and x-rays are taken to make sure all of the stones are out. The stones are sent to a lab for analysis. 

And the pet lives happily ever after, hopefully forever stone free.