Stone Removal Now Safer, More Efficient
***This article first appeared in the Fall 2024 issue of the CCAH Update newsletter.***
Historically, veterinary surgeons rarely removed kidney stones in dogs, largely due to procedure risks. In humans, these stones are commonly removed through advanced minimally invasive techniques. Those procedures are now available to veterinary patients at UC Davis, thanks to an anonymous gift to the Center for Companion Animal Health.
The generous gift, earmarked specifically for large breed canine equipment, allowed the CCAH to purchase a Boston Scientific Swiss LithoClast® Trilogy Lithotripter. In addition to kidney stones, this equipment can remove bladder stones in large dogs.
Urolithiasis, or stones in the urinary tract, occur commonly in dogs and can lead to life-threatening consequences if not treated or removed. Smaller stones in the lower urinary tract can be removed using laser lithotripsy, which breaks up the stones so that fragments can be removed minimally invasively. However, this technique does not work effectively on larger stones in the upper urinary tract (kidneys) or for a large number of bladder stones.
In the past, invasive surgical removal of larger stones by opening a dog’s kidney was the accepted treatment protocol but was associated with high morbidity rates. Given this, even when stones caused significant problems, such as urine flow obstruction or chronic infections, it was very rare to remove the stones. This new device can be inserted minimally invasively through the skin (percutaneous) and into the kidney where stones can be broken up into small pieces using a combination of ultrasonic (mechanical vibrations) and ballistic (jackhammering inflexible stones) energy. The lithotripter can then suction up the stone fragments to remove them from the patient.
Following the procedure, a small stent is placed into the urinary tract to prevent stone fragments from blocking the ureter (tube that carries urine from the kidney to the ureter). When the procedure goes smoothly, this minimally invasive technique often allows the patient to return home the following day.
Dr. Carrie Palm and a team of surgical and internal medicine specialists recently performed the first known minimally invasive percutaneous kidney stone removal in Ella, a 7-year-old female spayed Briard using the new equipment. After a successful procedure in a large canine patient, the team has also removed kidney stones in two smaller dogs with a modified percutaneous technique. Palm has now presented her finding at a scientific meeting to introduce the technique beyond UC Davis.
“We are so thankful to have the generous support of compassionate donors that allow us to provide relief for our patients in a safe, efficient manner,” Palm said.
With support of the UC Davis School of Medicine Urology Service, the school is uniquely positioned to lead research efforts with this equipment to further advance veterinary medicine. In addition to the huge benefit to patient care, this device has tremendous research potential, including projects focusing on minimally invasive treatment of different stone types in multiple anatomical locations and in numerous species.
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