Surgical Treatment Options

URETHROTOMY VS. URETHROSTOMY
"Urethrotomy" is simply the creation of an opening at the base of the os penis
cranial to the scrotum which allows the dog to urinate and pass small stones and crystals. As the urethra passes through the os penis its diameter decreases greatly thereby creating the perfect lodging point for many small stones. The key about a urethrotomy is that it is not a permanent opening. The opening is allowed to close up and heal in, much like a simple laceration. The goal is that by the time the opening heals, the stones will have passed and corrective measures to prevent reformation of uroliths will be in place (ie diet, water, +/- medications). I have performed this procedure in many breeds, even one of my own pet Dalmatians.

A "urethrostomy" on the other hand, is the creation of a permanent opening. It
can be done in the same area as the urethrotomy, but most often is done along with a neuter and removal of the scrotum to create an opening much like that of a bitch.

In both types of surgery, there is A LOT of bleeding every time the dog urinates for up to 2 weeks, usually 5-7 days though. This is because of the tremendous amount of vasculature in the area combined with the pressure of urinating and contraction of the urethral smooth muscle. It can look like a slaughterhouse floor, but truly the dogs do fine and they do recover nicely. Remember, corrective and preventive measures are just as important as the surgery for overall health of the bladder.

Carroll H. Weiss
Study Group on Urinary Stones
Research Committee
Dalmatian Club of America
carroll@suntech.net

WHAT IS A "URETHROSTOMY?"
This surgery is performed on stone-forming dogs who repetitively obstruct. A urethrostomy is NOT the usual bladder surgery whereby the dog's urinary bladder is surgically opened and stones removed from it. "Urethrostomy" is an artificial opening surgically created at an anatomic area *BEFORE* the "os penis" area within the penis (where most male stone-forming Dals obstruct). It generally is done as *A LAST RESORT* and must be carefully evaluated because:

(1) it is a very delicate operation and the surgeon should be experienced and knowledgeable in the surgical procedure;

(2) it is a very bloody operation and, postoperatively, the dog heals very slowly;

(3) it is generally done at the base of the scrotal sacs and - even there - if a large enough stone subsequently forms, that size stone can obstruct BEFORE it reaches the urethrostomy. Therefore a urethrostomy by no means is a panacea nor removes the daily caution of observing the male dog to monitor if they are urinating normally or have obstructed. It is important that the decision for a urethrostomy should be finalized after a consultation with one of the three stone-forming veterinary specialists in the U.S..

(4) once performed, the Dal may be prone to more-frequent-than-normal urinary infections.

(5) a urethrostomy does not affect the underlying stone-forming of the dog. It merely (if successful and well done) minimizes or prevents urinary obstruction by stones continuing to be formed and expelled.

Wherever possible, an unavoidable urethrostomy should be performed by a "Board-Certified" veterinary surgeon and one who is experienced in this surgical procedure. We also suggest that the general anesthetic be "ISOFLURANE" which has demonstrated significantly fewer anesthetic deaths than its predecessor anesthetics.

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