This was an insane case that took everyone in the clinic on a roller coaster ride!
"Sunny" was a 5 year old female spayed Beagle. The owners called, concerned, a few hours before close because the dog was straining to urinate and didn’t seem to be producing anything for the past day. They lived over 100 miles away but promised they could be there before we closed. We asked if they wouldn’t rather take her to a clinic in their rural town but they said they trusted us and would rather she come see us.
They made the three hour drive and arrived 45 minutes before close. I was hoping that she would just have a UTI, since complete urinary blockages are very rare in females. But she sat there on the exam table wagging her tail and then trying and trying to urinate, and not producing a single drop.
I took the first x-ray and groaned. Her bladder is HUGE. There are also a cluster of stones in the bladder, which at first distracted me from the real problem — the stone in her urethra, visible behind the pelvic bone. It was huge as well.
With a sinking heart I told the owners that she had a complete obstruction. The owners looked to each other in tears. They had significant financial constraints. I told them that a surgery tonight to remove the blockage would likely be $2000-$3000 at an emergency hospital. They could also try to have her catheterized so that the stone could possibly be pushed back into the bladder (where it would be unlikely to fall into the urethra again), but with anesthesia and hospitalization that would still cost $1000 and might not work anyway, it’s very difficult to catheterize female dogs.
The owners wanted me to try calling a few e-clinics to see if anyone thought they would be up to catheterization. I tried the two local clinics but no one there felt confident in their female dog catheter skills. I called one further away and they thought they could do it, but the $1000 price tag was still the owner’s whole paycheck.
The owners were crying as they told me they would have to put her to sleep, since they couldn’t afford either procedure and knew they did not want her to die at home from an obstructed bladder, which is a terrible death; toxins fill the bloodstream and the bladder begins to die or can even burst. I told them we would have the tech go over the estimate, and gave the dog a huge handful of treats, which she ate with joy, wagging her tail.
Agonizing I went into the back, wiping the tears from my eyes. It was horrible! She was only 5! What bad luck it was to get blocked as a female dog (whose short wide urethras usually protect them). I felt sick but at the same time knew that I did not want her to just die at home. I knew I couldn’t catheterize her (I couldn’t even do it in a cadaver at school, let alone in a life or death situation) and was just feeling awful about my inability to help. Death seemed so wrong and yet was better here than slowly dying at home.
While the technician was going over the estimate for euthanasia I suddenly heard a call for me. “Doctor!!!” I hurried down the hall and there was a most beautiful sight — the Beagle wagging her tail, standing proudly next to a huge puddle of urine and the HUGE stone in the picture. SHE DID IT! SHE PASSED THE STONE!
We snapped one more x-ray and voila! The small stones are still there, but the bladder was tiny! One owner ran at me with her arms wide in a huge hug when I showed her the x-ray. Every tech and receptionist was sooooo relieved, we all left with the hugest smile on our faces when we sent them home with food to dissolve struvite stones and antibiotics. YAY.
If there had been any less delay in any of those scenarios — they hadn’t made the drive, they hadn’t had me call around — we could have had them sign those papers sooner and she wouldn’t be here. It really felt like a veterinary miracle!!!