Surgically Assisted Nephrolithotomy

What to do with complicated kidney stones in dogs? Laser them out!

Kiki is a beautiful four-year-old female spayed Japanese Chin who was kindly rescued with pre-existing kidney issues and an abnormal eye. Kiki repeatedly saw Dr. Erinne Branter, head of our interventional radiology department, for kidney stones and kidney disease. The kidney stones were not able to be medically dissolved and as a result, Kiki kept having painful urinary tract infections.

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Often, kidney stones can be left alone if they are not causing any issues, but Kiki had developed stones causing obstructions to her kidneys by blocking the ureter, the tube that brings urine to the bladder from the kidney.

Dr. Branter discussed options to remove the kidney stone with Kiki’s owners—shockwave lithotripsy from outside the body, lasering the stone in the kidney in a minimally invasive way, or a surgery where the kidney is cut open to remove the stone.

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Kiki’s owners opted to remove the stone with a nephrolithotomy, a minimally-invasive procedure to remove stones from the kidney by using a small catheter through a small incision, and then place a ureteral stent. This made sure the kidney had very little damage and that all the stones were able to be removed. We used a combination of minimally invasive approaches to the kidney to reduce damage to kidney tissue. We then used an endoscope and a laser to break up the stone and make stone fragments that were small enough to be removed without damaging the kidneys.

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This entire process is called a nephrolithotomy (kidney stone removal) and is the standard of care for humans with complicated kidney stones. Although few have been done in veterinary medicine, Kiki was able to go through the procedure without any issues and is recovering very well with no negative changes in her kidney values or function. We are thrilled to report that little Kiki is now stone free! Many pet owners do not know that their pets can suffer from many of the same illnesses that humans do. Unfortunately, pets suffering from illness can also experience the same pain and discomfort as we do, though they may be better at hiding it.

If you suspect your pet is experiencing urinary issues, contact your primary veterinarian right away.

Key words for pet owners:

  • Kidney stones- A hard mass formed in the kidneys
  • Lithotripsy- A treatment, typically using ultrasound shock waves, by which a kidney stone or other calculus is broken into small particles that can be passed out by the body
  • Nephrolithotomy- A minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin
  • Stone retrieval- A process in which a doctor retrieves and removes stones from within the body
  • Ureteral stent- A thin, flexible tube threaded into the ureter
  • Ureteral stones- Stones that form within the ureter
  • Urinary obstruction- An obstruction that occurs within the urinary tract. Obstructions in the urinary tract cause distension of the walls of the bladder, ureter, or renal pelvis, depending on the location of the obstruction
  • Urinary stones- Stones that form within the urinary tract
  • Urinary tract infection- An infection in any part of the urinary system, the kidneys, bladder, or urethra
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