Ruby Moraga – a 9-year-old, female, spayed Bull Terrier – was presented to CARE Animal Emergency Services with the complaint of excessive abdominal pain. There was concern for constipation due to signs of straining and posturing. She is on daily regimen of thyroid supplement, but is an otherwise healthy dog.

On physical examination, Ruby was displaying very marked signs of abdominal discomfort. Her heart rate was elevated and she was found to be dehydrated. Once in the examination room, Ruby urinated a large amount of bloody urine. Abdominal radiographs demonstrated loss of serosal detail (or clarity) of abdominal organs.

There was also evidence of bladder stones. Based on Ruby’s clinical signs, hospitalization was recommended for rehydration, pain management, antibiotic therapy, and abdominal ultrasound. Abdominal ultrasound demonstrated fluid in the abdomen as well as an abnormal area near the bladder. Ruby was scheduled for exploratory surgery that afternoon.

During Ruby’s surgery it was determined that she had suffered a ruptured bladder and small amount of urine was beginning to leak out and into the abdominal cavity causing irritation to the other abdominal organs. There was evidence of bladder stones in the bladder as well. A small area of the bladder was deemed to be inflamed and unlikely to heal, so it was removed along with the bladder stones. Ruby’s abdomen was flushed with a warm saline solution prior to completing the surgery. Ruby recovered well, but was hospitalized for 2 days for post- operative monitoring, antibiotics, and pain management.

Bladder disease in dogs is a common finding that can be caused by infection, drug therapy, reproductive tract infections, preexisting diseases, and stones. Therapy for bladder disease is dependent upon the underlying cause. In Ruby’s case, her clinical signs were caused by stones that likely caused trauma to the bladder wall and/or prevented full emptying of the bladder which led to increased filling, pressure, and eventually a tear in the bladder wall. Analysis of the stones determined that they were Struvite in nature. One reason that these types of stones occur is as a result of a bacteria that produces an enzyme that causes the urine to become too alkaline. Long-term prevention of reoccurring stones will be through a prescription diet that will control the pH of the urine.

Ruby was discharged to her owners feeling much better. She has continued to heal well.