Ashley Has Bladder Stones

[Centerline]

Ashley has bladder stones. She is about to turn 8 years old. She's going in for a cystotomy on the 31st. I'm nervous because of her age. And she is absolutely terrified of the trip to the vet. She will have to stay there overnight on the 30th, surgery on the 31st and observation. I can pick her up on the 1st. Aside from being a smidge overweight, her health is good. She's as everywhere all at once as she ever was. Does anyone have any experience with bladder stone surgery?

[Centerline]

Here's a screenshot of her x-ray. She has one big one and a dozen or so little ones.

[Charley Chuckles]

Just want you to know I'll be sending many prayers for her and you 🙏🙏🙏
I've only know of a squirrel that had crystals but no surgery was done.

[SamtheSquirrel2018]

Ashley has bladder stones. She is about to turn 8 years old. She's going in for a cystotomy on the 31st. I'm nervous because of her age. And she is absolutely terrified of the trip to the vet. She will have to stay there overnight on the 30th, surgery on the 31st and observation. I can pick her up on the 1st. Aside from being a smidge overweight, her health is good. She's as everywhere all at once as she ever was. Does anyone have any experience with bladder stone surgery?

Hi Centerline:
What has been going on with Ashley that prompted you to take her to the Vet (such as blood in the urine, distended [swollen] abdomen, obvious pain or discomfort, decreased appetite)? Is this the only x-ray film? The reason I am asking is that this is only a lateral (from the side) view. This certainly appears to be bladder stones but the definitive location can only be ascertained with x-ray films from at least 2 different directions. Ideally, another film would have been taken in the ventrodorsal or dorsoventral directions (this is top to bottom or bottom to top and either would pass through the same region and structures; just in opposite directions) as this would help determine if what appears to be bladder stones are actually in the center of the abdomen which would be consistent with bladder stones as the bladder is normally located in in the centerline of the abdomen in the pelvic region but if the "stones" were off to one side or the other, the densities seen may be in the skin or muscle in another organ rather than the bladder.

Is your Vet experienced with Squirrels or small rodents such as rats and has your Vet performed similar procedures in the past as he has recommended for Ashley? Are you able to get a second opinion from another experienced Vet?

If you are ultimately opting for having the procedure preformed and Ashley is terrified of the trip to the Vet, I would suggest discussing this with your Vet and maybe he will prescribe something that may help calm Ashley for the trip and being at the Vet's office. A suggestion might be for Gabapentin. I would suggest that you NOT give any medication to Ashley without your Vet's approval (assuming that the procedure will be done as scheduled) because your Vet will be giving Ashley anesthesia and all additional medications should be known and approved before anesthesia or other planned medications are utilized by your Vet.

Regards,
SamtheSquirel

[Centerline]

Hello Samthesquirrel,

Ashley is fine. No pain or issues. I just took her for her yearly check-up. We've been watching the large stone (too big to pass) for a few years now. But all those little ones have shown up this year. They could be passed but she's not passing them. So we're going to get them removed so that we don't end up with a blocked urethra emergency. We did do two x-rays. I'll attach those. The vet is a good one. They are in Raleigh, NC and they are the only option in this state. I'm not worried about that. It's just her age that I worry about and the trauma of it. I will ask the vet about something calming to give her.

Thanks!

[CritterMom]

Dr. Dan?

[Centerline]

Yes. It is Dr. Dan's place. But Dr. Sara will be the surgeon on our day.

[SamtheSquirrel2018]

Hello Samthesquirrel,

Ashley is fine. No pain or issues. I just took her for her yearly check-up. We've been watching the large stone (too big to pass) for a few years now. But all those little ones have shown up this year. They could be passed but she's not passing them. So we're going to get them removed so that we don't end up with a blocked urethra emergency. We did do two x-rays. I'll attach those. The vet is a good one. They are in Raleigh, NC and they are the only option in this state. I'm not worried about that. It's just her age that I worry about and the trauma of it. I will ask the vet about something calming to give her.

Thanks!

Thanks for your response! I made the assumption that this condition was recently discovered and that surgery was a "knee-jerk" response by a Vet who had just met Ashley. Obviously that is not the case, and thankfully so! Ashley is not really a geriatric Squirrel and it sounds as if she has no medical problems. The following is only my opinion but state it anyway. While there are always risks associated with surgery, the fact that Ashley is, overall, quite healthy and "only" 8 years old, I don't believe her age will significantly increase risk! As long as the your Vet is experienced in this particular surgery, and is experienced in administering anesthesia and providing perioperative and post-operative care and monitoring, the risks are as low as they can be under the circumstances!

I hope all goes well for Ashley! My thoughts are with you and for you; Little Squirrel!

Regards,
SamtheSquirrel

[Centerline]

Samthesquirrel,

No worries. I appreciate you looking out for us. I feel better now. I'll be sure to post how everything went.
I will also make sure to get a chemical analysis of the stones so we can maybe change up Ashley's diet to prevent more stones.

Thanks,
Centerline & Ashley

[Centerline]

Ashley had her surgery this morning. The doctors started with an x-ray to see if the stones were still there. They were so they proceeded with the cystotomy. Not a single stone was in her bladder. Some looking around revealed that she had calcifications on her uterus that were showing in the x-rays all along. They called me immediately with the findings and the options. I chose for Ashley to have a hysterectomy. They removed all her girl parts except some of her cervical area which they explained to me is so close to the ureters in rodents that it's best to leave some. Unfortunately, there's some calcification in the part they had to leave. Her parts removed are going to the lab for analysis. Hopefully there's no cancer and we can formulate a diet to reduce or rid this calcification problem. Ashley is home now. She got her antibiotic dose, pain medicine dose, and some water and went to bed. I'll post tomorrow on how she's doing.

[SamtheSquirrel2018]

Ashley had her surgery this morning. The doctors started with an x-ray to see if the stones were still there. They were so they proceeded with the cystotomy. Not a single stone was in her bladder. Some looking around revealed that she had calcifications on her uterus that were showing in the x-rays all along. They called me immediately with the findings and the options. I chose for Ashley to have a hysterectomy. They removed all her girl parts except some of her cervical area which they explained to me is so close to the ureters in rodents that it's best to leave some. Unfortunately, there's some calcification in the part they had to leave. Her parts removed are going to the lab for analysis. Hopefully there's no cancer and we can formulate a diet to reduce or rid this calcification problem. Ashley is home now. She got her antibiotic dose, pain medicine dose, and some water and went to bed. I'll post tomorrow on how she's doing.

Hi Centerline:
What has been going on with Ashley that prompted you to take her to the Vet (such as blood in the urine, distended [swollen] abdomen, obvious pain or discomfort, decreased appetite)? Is this the only x-ray film? The reason I am asking is that this is only a lateral (from the side) view. This certainly appears to be bladder stones but the definitive location can only be ascertained with x-ray films from at least 2 different directions. Ideally, another film would have been taken in the ventrodorsal or dorsoventral directions (this is top to bottom or bottom to top and either would pass through the same region and structures; just in opposite directions) as this would help determine if what appears to be bladder stones are actually in the center of the abdomen which would be consistent with bladder stones as the bladder is normally located in in the centerline of the abdomen in the pelvic region but if the "stones" were off to one side or the other, the densities seen may be in the skin or muscle (or) in another organ rather than the bladder.
Regards,
SamtheSquirel

Hi Centerline:
I'm glad that Ashley is home and tucked in! I'm at work so I'm obviously not sleeping tonight and looked in on TSB during a free moment and saw you post. To be honest, I am now having some very significant guilt feelings about not continuing to push for a definitive diagnosis and even a second opinion as I had concerns about Ashley having absolute NO symptoms from these "bladder stone" and because the findings on the x-ray studies may not have been consistently correlated with Ashley's working diagnosis or maybe even at odds with it and in fact, we now know that in Ashley's case, they definitely NOT! When you responded by posting; "we've been watching the large stone (too big to pass) for a few years now," I just assumed that all possibly pertinent data had been correlated over this very extensive period of time and the diagnosis had been rendered definitive.

That's why I didn't want to be a distractor or worse yet, an irritant to you; and I never posted more in that line of commentary and never to post a very important characteristic of stones within the bladder that, again; I assumed your Vet understood, but here it is now although unfortunately to late to have possibly resulted in a "hold" on the surgery to reassess Ashley's diagnosis---Bladder Stones are essentially floating within the bladder so when the bladder fills with urine (as it is designed to hold the urine until a safe time and place permits peeing) the stones change position within the bladder and in relation to each other with the Ashley's positioning and movements! That would never happen, of course, with calcification of a fixed organ such as the uterus and the "stones" would remain in their same relative positions during the entire two years they were monitored!

This is why I feel so guilty about this and that is with two years or more of imaging and reviewing the "stones," there would have been no significant and random movement of the densities in the uterus as there would be if they were in the bladder and this would have, in itself, ruled out stones within the bladder. I'm very sorry I dropped this but at the time it seemed nonsensical for me to continue to push for a definitive diagnosis as it appeared that one had been made over a 2 year of monitoring Ashley and sequential x-ray studies.

Please give little Ashley my best wishes!

Again, I apologize and best regards,
SamtheSquirrel

[Centerline]

Thanks Samthesquirrel. Yes, I'm feeling a little surprised too. But it is what it is now. We got that mess removed. Ashley is taking water but has yet to eat anything. She picks up a Henry block like sheets going to take a bite but she just puts it back down. She's still a little off balance too. She is back in bed now. Will advise.

[Centerline]

Ashley is doing well. She is eating. She took water and lots of it Thursday night but not so much since then. I give her 2mL of water right after her meds while I've got her in the burrito just in case.
She does urinate and the initial expected blood has gone away. She has not pooped yet that I have seen. She's still a little uncoordinated but getting better. So far so good.

[Diggie's Friend]

Did the surgeon have the stones analyzed for type?

Since bladder stones typically made up of either, "Calcium oxalate', 'Struvite', or, 'Calcium phosphate'...with each form having specific causes; the determination of the form of the stone(s) can help to determine the cause. With this knowledge, corrective changes to the diet, like adding probiotics with prebiotics which degrades oxalates and counters bad bacteria forms in the gut; and/or simply adjusting the diet by increasing or lowering the amount and type of acidic or alkaline foods to support a healthy, "slightly acidic' mean urine pH found for squirrels species. Both of these steps lend to the increase the availability of calcium from the diet to the bones, thus lowering the loss of calcium into the urine, that reduces accumulation of calcium and other mineral crystals in the bladder, which in turn helps to prevent the abrading of the lining of the bladder by mineral crystals that cause inflammation leading to bladder infection.

[Centerline]

Diggie's Friend,

We had an incorrect diagnosis. She didn't have bladder stones. She had calcifications on her uterus. The tissue removed has been sent to a lab for investigation.
We are definitely going to examine and modify her diet.

Thanks,
Ashley & Centerline

[Diggie's Friend]

Did they spay her in the process?

[Centerline]

Yes. She was spayed. The lab results came back today and the tissue removed is not cancerous. So that's good.