[Dailydrool] Cystine Stones

[Karen Markisenis]

Ron and I are devastated.  Last July, just prior to his 2nd birthday,  Cadbury had emergency surgery to remove many stones from his bladder.  (In fact he had 2 emergency surgeries as the skin gave way at the internal suture site and the vet needed to repair the area with a second surgery within 10 days.)  

Analysis of the stones showed that Cadbury develops a less common/rare type of stone - cystine.  He has been on a special diet ever since (Royal Canin Low Purine; no other food at all)  Potassium citrate is added to each meal to alkalize his urine even more. 

Cadbury was born with cystinuria, an inherited metabolic disorder. His kidneys are unable to filter excess cystine (which happens to be a beneficial amino acid) before it passes into the urine.  When cystine passes into the urine, it can form crystals.  They cannot be dissolved with diet or supplements.  

Today's ultrasound showed that stones have once again formed.  (We are assuming they are cystine, but won't know for certain until they are removed & sent out to a lab.) My vet was off today, but the vet who performed the test called her with the results.  She recommended surgery.  We have an appointment with our vet tomorrow and at that time we will discuss the ultrasound in detail as well as our options.  We do not want to put our little boy through another painful surgery.  It's not about the money -  it's about the pain Cadbury will suffer (and the "pain" we will suffer watching him go through it all again).  

There are some options (that were discussed last year).  Two prescription drugs are sometimes used (Cuprimine & Thiola), but both have severe side effects and one is extremely expensive, costing about $400 per month for a dog Cadbury's size.  A more extreme procedure would to perform a scrotal urethrostomy.  (Redirecting Cadbury's urethra away from his penis to an opening in front of the scrotum.)  This would create a larger opening from which the urine and any small stones can pass.  Such surgery would reduce the risk of further blockage.  As with any surgery, there are risks.  And, because this area is rich in blood vessels, there is risk for significant bleeding.

A lot of my knowledge is a year old.  I may learn of more tomorrow when I speak with my vet. 

I am writing to you because I am hoping you will be able to bring forward more information to help us decide upon a course of action.  If you have had any experience with this condition, please share what worked; didn't work.  Please pass this on to all of your friends that have dogs.  Perhaps one of them might  have additional insight into this condition.

Thanks so very much.  And if you are so inclined, please pray for our little boy (and those who love him).

Karen