Efficacy and Safety of Laser Lithotripsy to Manage Urocystoliths and Urethroliths in Dogs: 100 Consecutive Cases
We hypothesized that laser lithotripsy was an effective and safe method for removal of canine uroliths. To test this hypothesis we prospectively studied 100 dogs with naturally occurring urocystoliths and/or urethroliths.
Lithotripsy was performed during anesthesia with a holmium-YAG laser via cystoscopy. Basket retrieval and voiding urohydropropulsion were used to remove urolith fragments. Post-procedural contrast cystography was used to assess efficacy and safety. Urine samples for analysis and culture were collected before and three times after urolith removal from the first 40 dogs.
Complete urolith removal was achieved in 82% of dogs; 52/66 with urocystoliths, 17/17 with urethroliths, and 13/17 with urocystoliths and urethroliths. Incomplete urolith removal was detected in 18 cases; 9 dogs had uroliths >3 mm in diameter; 9 dogs had uroliths <3 mm. Multivariate analysis revealed that gender (female) was the most significant predictor for success.
Two dogs developed post-procedural urinary tract obstruction. Hematuria (>5RBC's/hpf) was detected in 53% on day 0, 84% on day 1, 13% on day 4, and 3% on day 11. Leukocyturia (>5WBC's/hpf) was detected in 13% on day 0, 47% on day 1, 0% on day 4, and 3% on day 11. Clients perceived that their dog exhibited urinary discomfort (>10 on a 0 to 100 scale) in 62% on day 0, 60% on day 1, 38% on day 4, and 3% on day 11.
Although associated with immediate and reversible hematuria and noninfectious inflammation, lithotripsy is a safe and effective method of managing urocystoliths and urethroliths in dogs.