Have you recently found out your dog needs a urethrostomy? Are you wondering what this is and what does it involve? Don’t be alarmed by the unpronounceable title of this surgery, this article will reveal all!
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Let’s dive into a bit of background info first and foremost. Your dog’s urinary system plays an important role in keeping their body healthy. Think of it as part of a complex waste disposal system that filters out the bad stuff their body doesn’t need.
When you see them squatting down or cocking their leg to pass urine, they are ridding their body of waste products that can do some serious harm if they are left to build up. The urine that they pass out is a waste product made by the kidneys. This travels down two thin tubes called the ureters that lead into the bladder. The bladder stores the urine until it gets full, then it leaves the bladder and your dog through another tube called the urethra. Sometimes, there are things that can go wrong with your dog’s plumbing system. If the urethra becomes blocked the waste products have no escape route and start to build up. This is a medical emergency.
Luckily, there is a surgical procedure called a Urethrostomy that can fix this problem. Read on to discover what it is, when it is indicated, and why we do it.
What is canine Urethrostomy?
A Urethrostomy is a surgical procedure where your vet creates a new opening in the urethra. The urethra is the tube that carries urine from the bladder to the outside of your dog’s body. The function of the new opening is usually to bypass an obstruction in the urethra so that urine can pass out of your dog freely.
The new hole can be made in a couple of different locations depending on where the blockage is. It is usually made over the scrotum in male dogs.
The operation is done under a general anaesthetic. Your vet will make an incision in the skin over the area the new opening will be. They will then dissect the urethra and open it up. The edges of the urethra will then be sutured to the skin to create a permanent opening for the urine to flow out of.
After the surgery, your dog will be uncomfortable for a good few weeks. They need to be monitored closely and will need lots of TLC. Your vet will administer pain medication for your dog and they will give you some to take home with you. Your vet will normally fit a buster collar (cone) onto your dog to prevent them from licking and chewing the surgical site.
The surgical site will take a good few weeks to heal fully. It is very important that you keep the area as clean and dry as possible during this time. Your vet will discuss in detail how to monitor for any complications.
When is Urethrostomy needed for a dog?
A urethrostomy is a major surgery, and the decision to perform one is not taken lightly. It is considered to be a ‘salvage procedure’ which means it is often done as a last resort, typically performed when other treatment options have not been successful. If there is a severe blockage or repeated problems with your dog that are causing them a lot of distress, your vet will have a frank chat with you about performing the surgery. They will take into account the general health status of your dog and any concurrent health issues as not all dogs are good surgical candidates.
A urethrostomy can be performed in several different locations. In male dogs, a scrotal urethrostomy is the most common location. This is because the urethra has a wide diameter here compared to other locations. This reduces the risk of postoperative complications such as stricture, or narrowing, formation where narrowing occurs.
Why is dog Urethrostomy performed?
One of the more common reasons for performing a urethrostomy is recurring urinary tract stones (also known as urolithiasis).
If a bladder stone is small enough, it can pass from the bladder down into the urethra. Often in male dogs, the stone will become lodged in the urethra near the bone of the penis. Your vet may be able to flush the stone back up into the bladder, but often this is not possible as they are too big or have caused too much trauma. If a stone gets stuck in the urethra, this can cause a great deal of pain, and the toxic substances that build up in the body will build up very quickly and cause serious issues. Bladder stones are a common issue in male dogs as the opening of the urethra can be extremely narrow.
Other indications for urethrostomy may also include:
- An injury or trauma to the urethra could mean part of the urethra needs to be removed (or amputated) meaning a new hole needs to be made to allow the urine to be released.
- Sometimes tumours can grow that block the urethra. Cancer of the penis is one cause.
- Another less common condition that may require a urethrostomy is a urethral stricture. This is where scarring causes narrowing of the urethra, making passing urine very difficult.
Signs your Dog may have a Urethral Obstruction
- Straining to urinate
- Not passing any urine at all
- Passing urine little and often
- Blood present in the urine
- More sleepy and lethargic than usual
- Signs of pain when urinary like crying /whipping around
- Licking their bottom/genitals
Advantages of performing Urethrostomy in dogs
- It provides a permanent solution
If a bladder stone is flushed back into the bladder or removed, this will provide temporary relief but it is very likely that stones will occur and /or get stuck again. If a urethrostomy is performed, the stone will not become stuck in the wider opening that has been created.
- It reduces the number of surgeries for the dog
If a dog is prone to developing bladder stones or has a very narrow urethra, they may require repeated surgeries to remove the stone. This sort of surgery is very invasive and the bladder can reduce in size and be covered by scar tissue over time. If a new opening is made in the urethra, this will mean that there is no need to keep opening up the bladder inside your dog’s abdomen.
- Reduce pain and discomfort and improve quality of life
If your dog has a new, unobstructed pathway for urination, this will significantly improve their quality of life and reduce pain and discomfort from having repeated issues with blockages.
Potential Complications Associated with Urethrostomy in dogs
All surgical procedures have potential complications. There are some specific ones that are associated with urethrostomy. It is important to remember that the overall risk involved for a healthy dog is low.
Bleeding
The urethra has a really good blood supply. After the operation, there can be quite a lot of blood oozing out still. This can be difficult to manage. Bear in mind excessive bleeding is always a cause for concern, so if you notice blood, contact your vet to have them check it out asap.
Infection
While the surgical site is healing, it is easy for an infection to develop. It is important to maintain good hygiene at the site to prevent infections occurring. Dogs are also prone to urinary tract infections. If you see any signs of a urinary infection, such as pain when passing wee, going more frequently, or blood in the urine, contact your vet immediately.
Stricture
Narrowing of the urethrostomy site, also called a stricture, can sometimes occur. This is less common with the modern techniques when a scrotal urethrostomy has been performed, but it can still happen.
Wound dehiscence
This is just a fancy way of saying the wound is breaking down. This can happen in some cases, especially if the dog is allowed to rub or lick the surgical site which is why it is very important to put a buster collar on your dog.
Conclusion
Urethrostomy surgery is an extremely useful procedure for dogs suffering from urethral obstruction. While the surgery itself is complex, it offers a permanent solution to a potentially life-threatening condition. The prognosis is generally very good – depending on the reason for the surgery (for example cancer compared to a bladder stone)
Dogs usually recover well as long as the surgical site is kept clean and the dog is not allowed to rub or lick the area.
If you have any concerns about your dog’s urinary health, book an appointment with your vet as soon as possible. Early diagnosis and intervention may help prevent the need for surgery altogether.
Sources and further reading
- Perineal urethrostomy in male dogs – Technique description, short- and long-term results – PMC
- Scrotal Urethrostomy and the Stone Cycle – DVM360
- Urethrostomy – an overview – ScienceDirect Topics
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