Urolithiasis in dogs: how does it manifest and can it be cured?

• abdominal palpation and rectal examination if urethral obstruction is suspected;
• diagnostic imaging;
• ultrasonography;
• simple radiography;
• radiography with contrast (positive contrast studies, antegrade pyelography);
• computed tomography;
• cystoscopy.

Diagnostic Imaging

Ultrasonography can detect small uroliths of any radiopacity. In addition, the operator and patient avoid exposure to ionizing radiation. However, compared with plain radiography, ultrasound is more time consuming and makes it difficult to detect stones in the ureter, pelvis and distal urethra. When diagnosing nephroliths and ureteroliths, ultrasound helps to identify pyeloectasia, ureterectasia and its severity, which is very important for developing a treatment plan.

Figure 3. A large calculus with uneven edges in the bladder cavity, giving a clear echoacoustic shadow. Ultrasound signs of acute cystitis

Figure 4. Appearance of the stone, which was visualized by ultrasound in Figure 3 after removal. The stone is represented according to spectrometric analysis by calcium oxalate monohydrate 60%, brushite 30% and struvite 10%

Figure 5. Ultrasonogram of two large stones with smooth edges in the bladder cavity, which give an echoacoustic shadow. The presence of suspension in the cavity of the bladder. Upon further examination, struvite-type urolithiasis was diagnosed against the background of a urinary tract infection in a female dog.

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Plain radiographs should be part of the routine examination of patients with urolithiasis. When installing, it should be taken into account that the entire urinary system should be clearly visualized in the picture. Plain abdominal radiographs should include both lateral and ventrodorsal views, and sometimes oblique views when interpretation difficulties exist.

Only certain uroliths will be radiopaque (eg, struvite, calcium oxalate, calcium phosphate). Small stones, 1–3 mm in size, may be poorly visualized on a native x-ray. Positive contrast studies are important for detecting stones that are radiolucent.

Figure 6. X-ray of a male Yorkshire Terrier. Lateral projection. A radiopaque calculus with uneven edges is visualized in the projection of the bladder

The number and size of stones will be important when choosing the most appropriate method for stone extraction or removal. If you need to find out the size of the stone, then a more accurate diagnosis is an x-ray than an ultrasound.

Uroliths on radiographs may be missed for a variety of reasons, including:

• overexposure of radiographs;
• patient positioning error;
• parts of the urinary tract are closed by the pelvis;
• air in the lumen of the bladder or abdominal cavity after cystotomy or other reasons.

Analysis of urine

All dogs with urolithiasis should undergo a clinical urine test, including urine specific gravity and pH, with sediment microscopy required. Urine pH and crystalluria may indicate the most likely mineral composition of the outer layer of urolith, but is not 100% sensitive or specific in diagnosing stone type.

Figure 7. Microscopy of urine sediment revealed large amounts of struvite

Figure 8. Microscopy of urine sediment revealed calcium oxalates in large quantities

The most accurate diagnosis for determining the type of stone is a spectrometric study. The method allows the determination of both organic and inorganic compounds, as well as different crystalline phases of the same compound.

Any stone must be examined. This will allow you to make a correct diagnosis and make it possible to prevent the occurrence of new ones in the future.

Urine culture should be performed on dogs if:

• clinical signs of urinary tract infection. We remember that any calculus can be its source;
• suspicion of struvite urolithiasis due to infection. Then urine culture will help dissolve this calculus, that is, remove the cause.

Urolithiasis in dogs and its varieties

If the specific gravity or pH of urine deviates from the norm, then over time, stones, or urinary calculi, will form in the dog's bladder. They are dense formations that prevent the free movement and exit of urine. Due to stagnation, the number and frequency of urination is reduced, and the accumulated urine poisons the body and causes inflammation. Based on the severity of symptoms, ICD is divided into 4 types.

Asymptomatic

This species is distinguished by the absence of external signs. The pet does not show concern and behaves as usual. Pathological changes can be seen during a blood test. In case of illness, the pH shifts to an acidic or alkaline environment. Specific types of stones can be detected on ultrasound and x-rays.

Lightweight

The mild form is accompanied by frequent and painful urination. The animal constantly licks itself, asks for a walk more often than usual, whines during bowel movements and spends more time on it. Droplets of blood remain on the genitals of a urinating dog.

Due to the inflammatory process, the likelihood of a secondary infection increases. It can be easily detected by a sudden rise in temperature.

Heavy

The pet becomes apathetic, refuses to eat, but drinks often. Control over urination is lost: a well-mannered dog begins to leave small puddles or droplets of urine throughout the house. At the moment of defecation, he stops raising his paw and takes a pose characteristic of bitches. Splashes of blood are clearly visible. In the absence of medication, there is a rise in temperature, repeated vomiting and convulsions.

By palpating the abdomen, the veterinarian detects a tight bladder. It's stretched out and crowded.

Life-threatening

When urination completely disappears (anuria), there is a danger of bladder rupture. Poisoned by toxic substances, the body loses its last strength. Body temperature drops below a critical level. The animal may become comatose. When the walls of the bladder are damaged, its contents spill into the abdominal cavity, leading to death from poisoning.

Main symptoms

The most common signs of the disease include the following:

1. Frequent urination. The dog not only begins to ask to go out very often, but can also “make a puddle,” even if this is an adult animal and nothing like this has ever been noticed before.
2. Pain during urine excretion. The dog squeals and whines while urinating, after which it takes a long time to come to his senses, does not want to play, run, tries to lie down and even hide away from people.
3. The appearance of traces of blood, sand or pus in the urine if the disease is accompanied by an acute inflammatory process.
4. Obstruction of the urinary tract, which can lead to intoxication and kidney failure.
5. Signs of hepatic encephalopathy in dogs with portacaval shunts.
6. The animal reacts painfully to touching the kidney part of the back and the lower half of the abdomen. In an acute condition, it can growl and can even bite the owner if he accidentally causes pain.

If the stones are in the kidneys or at the top of the ureters without blocking them, they can go undetected for a long time. The disease does not show itself in any way, and at this time chronic renal failure develops in dogs.

Types of formations

Stones in dogs can be soluble or insoluble. The second group includes the most dangerous formations - oxalates. In most cases they have to be removed surgically. They are formed in an acidic environment and are most often diagnosed in males over 6 years of age. Those at risk include lap dogs, pugs, shih tzus and affenpinschers.

More gentle treatment is provided when soluble stones are identified, including:

1. Urats

   . It occurs in young (1-3.5 years) representatives of large breeds: shepherd dogs, terriers, wolfhounds, Dalmatians.

2. Struvite

   . Characteristic of female poodles, Pekingese, dachshunds and terriers 3-5 years old.

3. Cystines

   . The rarest species, typical for male Chihuahuas, dachshunds and English bulldogs under 5 years of age.

In addition to the listed varieties, there are also mixed forms, suggesting the presence of several types of stones at the same time. The most vulnerable breed is Yorkshire terriers. Urolithiasis in these dogs develops in all of the listed forms, including mixed.

The role of bacterial infections

Bacterial infections of the bladder (that is, cystitis) play an important role in the formation of uroliths , and there are several explanations for this. Firstly, such diseases lead to an increase in the pH level and its movement into the alkaline zone. This can already cause excessive precipitation of salts called struvite when the animal consumes food with a low pH level. Normally, urine should have a neutral reaction, when the likelihood of developing a chemical reaction is reduced to zero.

But the presence of bacteria is dangerous not only for this. In particular, waste products of microorganisms themselves can precipitate, stimulating the development of uroliths. In addition, some bacteria synthesize an enzyme called urease. This compound, without going into the intricacies of organic chemistry, simply splits urine into its constituent components. Ammonia slowly turns into ammonium ions, while carbon dioxide combines with other components to form phosphates. Then, thanks to a chain of chemical reactions, magnesium, which is always present in the urine, combines with ammonium and phosphates. This is exactly how the same struvites are formed, which we already wrote about above.

Remember! The inflammatory reaction, which appears due to the action of pathogenic microflora, contributes to a sharp increase in the volume of mucous secretion. And, as we already know, it is an important “building” element of stones in the genitourinary system of an animal.

Causes of the disease

The risk group includes middle-aged and elderly pets, as well as most small breeds. The causes of urolithiasis in dogs are divided into:

1. External

   . Insufficient water, excess proteins and carbohydrates lead to the deposition of stones. Stagnant processes are explained by rare walks, excess weight and low activity. All this prevents timely emptying and increases the concentration of urine, causing the deposition of salts.

2. Domestic

   . These include infections of the genitourinary system, changes in the acid-base balance, diseases of the digestive system of a chronic nature and congenital pathologies that affect metabolism and digestion. There is also a relationship with genetic predisposition.

The type of stones directly depends on the diet. An abundance of meat dishes shifts the pH to an acidic environment, and an excess of cereals and vegetables - to an alkaline one.

The main types of kidney stones in carnivores

Each type has a typical shape, which makes it possible to determine the nature of the stone already at the stage of ultrasound examination. There are many special cases, but mainly these are the following chemical groups:

Struvite and cystine may also appear. The secondary binder is cholesterol and other polyunsaturated fatty inclusions. Therefore, we can conclude that fatty foods contribute to the formation of stones. This occurs when there is insufficient breakdown of fats in the digestive tract and consumption of too hot food. In a melted state, they enter the urine, reaching the kidneys, where they settle on the surface of the calculus, compacting it. There is no relationship between breed, gender and age.

Symptoms: how does ICD manifest?

The severity of symptoms depends on the form of the disease and the type of stones. Severe pain and the presence of blood are typical for formations with a rough surface and sharp edges.

It is almost impossible to suspect the presence of stones at an early stage without laboratory diagnostics. If your pet does not relieve itself in the litter box, then you are unlikely to detect changes in the amount and density of urine. That is why it is important to regularly take urine and blood tests for preventive purposes.

Over time, signs of urolithiasis in dogs become more obvious. The resulting violations are accompanied by:

• lethargy, apathy and loss of appetite;
• restlessness and frequent licking of the genitals;
• frequent urination in small portions;
• whining or shaking during bowel movements;
• bloating and abdominal pain;
• change in urine color to dark brown or pinkish;
• increased temperature;
• vomiting and convulsions.

If your pet asks to go to the toilet more often than usual, sits in an unusual position, or pees in the wrong place, make an appointment at the veterinary clinic. The sooner you seek help, the less likely you are to develop complications.

Diagnostics

If you suspect urolithiasis, you must undergo a number of mandatory tests. These include ultrasound of the urinary system. An ultrasound will show the presence of uroliths, their size and exact location. It will show the structural component of the kidneys, the presence of an acute or chronic inflammatory process in them. A general urine test is also very revealing. It can show urine density, pH, the presence of blood and inflammatory cells, microflora, as well as the smallest uroliths that can pass through the urethra. If microflora is present, urine culture with titration for antibacterial drugs may be indicated. Sometimes an X-ray examination is required; it will show the location of radiopaque uroliths, this can be especially useful to exclude blockage of the urethra in male dogs. General clinical and biochemical blood tests will help exclude acute inflammatory processes and acute kidney damage.

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Rarer studies include urography or cystography with a contrast agent, computed tomography.

Establishing diagnosis

If copious amounts of blood are discharged or anuria occurs, go to the veterinary clinic without an appointment. Due to the high probability of death, doctors at a 24-hour facility are required to provide emergency care at any time of the day.

To make a diagnosis, urine and blood tests are taken from the four-legged patient. Due to stagnation of fluid, urine is collected directly on the spot by puncturing the bladder. The type of stones is determined by ultrasound and x-ray. A blood culture test is also performed to exclude or confirm the presence of a secondary infection.

Predisposing factors and pathogenesis of the disease

It all starts with a sharp change in the pH level of urine and the level of its saturation with soluble (relatively) salts of magnesium, calcium, phosphorus, etc. In the case when both of these factors act simultaneously, deposition of a crystalline precipitate begins. It is important to note here that this process is not a chain reaction. If at this moment the diet and feeding conditions are normalized, the dog stops taking any medications (tetracycline, for example, can provoke urolithiasis), then the development of the pathology stops. In many cases, a small amount of the resulting sand is simply excreted into the external environment in the urine.

Treatment methods

Further therapy depends on the form of the disease and the type of stones. Sometimes a simple change in diet is enough to help your pet recover, and sometimes the only solution is emergency surgery.

Despite the variability of possible solutions, in all cases the primary task is to remove accumulated urine by cleansing the urinary ducts. On average, the process of destruction of urinary stones is 1-4 months.

Catheterization

In case of anuria, the animal is given a catheter to drain urine and wash the ducts. The procedure is performed under general anesthesia. Catheterization allows you to create back pressure inside the urethra, which helps push the formed stones back into the bladder, bypassing the operation.

Also, insertion of a catheter may be necessary if renal failure is detected. In this case, the four-legged patient needs blood purification. For this purpose, hemodialysis is performed.

Removing Stones

If catheterization and drug therapy do not give the desired effect, then the outflow of urine is quickly restored. For this purpose, several operation options are used:

1. Cystostomy

   . The surgeon cuts the bladder at the site where the stones are deposited and removes them out. Before the stitches heal, the pet urinates through the catheter. The disadvantage of this operation is the high probability of narrowing of the ducts and their re-clogging.

2. Urethrostomy

   . This operation involves widening the natural opening in the urethra. To prevent its overgrowth, mandatory castration is recommended for all male dogs.

3. Retrograde urohydropulsion

   . The stones are pushed back into the bladder, where they are removed using a cystostomy.

Some formations are amenable to pulsed magnetic therapy. This procedure is based on a low-frequency magnetic field that breaks stones into smaller pieces. In this case, they leave the body on their own.

Drug therapy

If a secondary infection or inflammatory process is detected, the pet is prescribed antibiotics. Together with them, it is recommended to take hepatoprotectors, probiotics and immunomodulators. These drugs help relieve the load on the liver, normalize intestinal function and restore the body's defenses.

For severe pain, antispasmodics and painkillers are prescribed: Papaverine, Baralgin and No-Shpu. For acute pain, novocaine blockade is recommended.

Urine concentration is reduced with diuretics. They increase its rate of formation, stimulating the removal of stones and preventing the deposition of new ones. It is also recommended to use herbal infusions and mineral water.

Specialized feed as a preventive measure

We won’t engage in direct advertising, but some well-known global brands actually produce food for dogs that, according to their beliefs, can fight kidney stones or at least prevent their formation. The composition includes special complex organic acids that gradually destroy these mineral nodules. This method of control and prevention has opponents and supporters. This is due to the following reasons:

• While the stone lies in its seat, it does not break into fragments. If its danger is small, then you should not disturb the position and structure. Otherwise, the fragments will then cause unbearable pain to the animal.
• The acidic environment that breaks down such hard material can greatly affect the overall function of the kidney, as well as corrode blood vessels. And this can lead to more severe health problems.
• There may be an indirect effect on other functions of the dog’s body. Clinical studies, constantly advertised by manufacturers, are quite short-term in nature, usually no more than six months. It will be very difficult to prove something later. The owner accepts everything at his own responsibility.

Complications and prognosis

The neglected process is fraught with the development of chronic inflammation, the growth of connective tissue (adhesions) and rupture of the bladder. Stretched walls of the urethra and bladder provoke the development of urethritis, kidney pathologies and cystitis.

It is important to understand that after the animal has recovered, a relapse is possible. Because of this, the owner’s main task is to follow preventive recommendations that stop new attacks.

About the predisposition of animals

It is officially believed that predisposition, as such, does not exist. Urolithiasis can be detected in dogs of any gender, age, or breed. And it’s true: unlike cats, the Himalayan and Burmese breeds of which are noticeably more likely to suffer from stones in the urinary system, no such picture was found in any of the dog varieties.

But still males, and especially old ones, get sick more often . In addition, in males, the disease in many cases is noticeably more severe. This is due to anatomical features: in females, small stones and sand often come out through the urethra on their own, but in males, due to the presence of an S-shaped bend of the penis, this “garbage” almost always gets stuck in the lumen of the organ. This leads to blockage of the urethra, dysuria (no urine is released), and severe intoxication. Death is possible either due to severe uremia, or due to internal bleeding resulting from rupture of the walls of the organ. By the way, even the natural passage of stones from the bladder is fraught with such consequences: along the way, they damage the mucous membranes and tear blood vessels.

Diet for ICD

Regardless of the chosen therapy, a diet is always prescribed for urolithiasis in dogs. It is selected individually, taking into account the type of formations identified and helps normalize the pH level, relieving the load on the kidneys. To remove cystine and urate stones, urine is alkalized, and to remove struvite stones, it is oxidized.

In the diet, reduce the amount of foods rich in proteins or carbohydrates. Calcium and phosphorus are partially removed from minerals. The main thing here is not to overdo it, since the lack of these substances is no less dangerous. That is why the nutrition plan is approved by the veterinarian.

For those who do not eat “natural” food, it is recommended to purchase medicinal food. It is also selected individually depending on the type of stones. Food for urolithiasis in dogs contains one of the following designations on the packaging:

• s/o – for struvite and oxalates;
• u/c – for urates and cystines.

To check the effectiveness of treatment, a repeat urine test is required. Due to a sharp change in pH, cases of the disappearance of found stones and the formation of completely opposite ones are acceptable. The problem is solved by replacing the food again and reducing the time until the next test. After normalizing the pH, the dog is returned to its usual diet.

What to do at home

Treatment of urolithiasis is long and quite complex. If an animal is scheduled for surgery, it will be under observation in the clinic for the first time. When the veterinarians are sure that everything is fine with the dog, she will be released home. At home, the animal is provided with complete rest, warmth, proper nutrition, following a special diet prescribed by a veterinarian for a specific type of stone.

If there is an inflammatory process or in the postoperative period, the dog is prescribed a course of antibiotic therapy. Treatment of the disease is long-term, up to several months, and in case of chronic urolithiasis with kidney damage - lifelong.

After bougienage, ultrasonic crushing of stones or surgery, the animal must be regularly brought for checks to the veterinary clinic in order to ensure positive results of treatment and prevent relapse of the disease.

At home, the most important thing for a dog is diet and sufficient, but not excessive, clean drinking water, as well as protection from hypothermia and infections.

If struvite is present, diets restricting protein, calcium, magnesium and phosphorus are used. With urates, the amount of proteins and purines in food is reduced. Cystine stones also reduce the volume of proteins. Oxalate stones require the elimination of hypercalcemia if the veterinarian has concluded that such a problem exists.

Therapeutic measures

If there is an obstruction, the veterinarian will remove the rotting urine using a catheter inserted into the urethra. Then the doctor will prescribe medications that eliminate the consequences of blockage of the ducts - antispasm, hemostatic, anti-inflammatory, painkillers. A course of furagin (human medicine) in combination with cantarene (veterinary homeopathy) quickly relieves symptoms. However, treatment should only be prescribed by a veterinarian, and the owner must follow the recommendations exactly!

When the acute condition is overcome, the doctor will prescribe long-term therapy. The choice of drugs depends on the type of stones. The goal is to dissolve the stones and gently remove them, preventing the formation of new stones (or sand). The doctor will definitely tell you what to feed the dog: if the environment is alkaline, it needs to be slightly acidified, and vice versa. Usually, veterinarians recommend switching to medicated food, strictly balanced for a specific type of KSD. Such diets are available from Eukanuba, Royal canin, Hills, and Purina. In addition, at first you will have to have your urine tested once a month, and with significant improvement - once every six months. This is necessary in order to stop the complication in time: KSD is a chronic disease, and a single attack indicates that it is necessary to support the dog throughout its life (read further).

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The nearest metro stations and service areas in Moscow: Otradnoye, Bibirevo, Yuzhnoye Medvedkovo, Sviblovo, Babushkinskaya, Medvedkovo metro station, Botanical Garden metro station, Vladykino metro station, Altufyevo metro station.

In cases where therapeutic treatment is not able to help the animal, surgical operations are applicable. Of course, every veterinarian tries to resort to them only in extreme cases, but sometimes situations are forced. Our veterinary clinics are equipped with modern specialized equipment necessary for emergency operations. Deciding whether to perform surgical interventions such as stone removal surgery in dogs

, operations on the genitourinary system of varying degrees of complexity are performed by a veterinary surgeon after a thorough study of laboratory tests.
You were looking for information about surgical operations for animals at the address of the Southern Administrative District
. We can suggest you visit one of the Exulap or ZOODoctor veterinary clinics, where you will receive the best treatment.

Price list for the provision of paid veterinary services (Veterinary Clinic “Aesculapius”, “Zoodoktor”)

• Therapy

  Name of service			Price, rubles
  Initial appointment\consultation (1 animal)			650
  Repeated examination/consultation			450
  Consultation on test results			300
  Consultation without an animal			500
  Applying for an international passport			150
  Examination\consultation with a cardiologist		Primary	1000
  		Repeated	700
  Examination\consultation with a dermatologist		Primary	1500
  		Repeated	1000
  Examination\consultation with an endocrinologist		Primary	1500
  		Repeated	1000
  Examination/consultation with an oncologist		Primary	1000
  		Repeated	700
  Examination\consultation with an ornithologist		Primary	1000
  		Repeated	700
  Examination\consultation with an ophthalmologist		Primary	2000
  		Repeated	1000
  Ultrasound of the abdominal cavity with a written report (review)			1200
  Ultrasound of the abdominal cavity with a written report (1 system)			800
  Ultrasound diagnosis of pregnancy			600
  Ultrasound screening			700
  Glucosemetry			300
  Daily glucose monitoring (24 hours)			1500
  Taking blood samples			300
  Collection of scraping/smear/wash			300
  Needle biopsy			300
  Punch - biopsy			750
  Otodectosis test			300
  LD – diagnostics			200
  Diagnostic laparocentesis			500
  Laparocentesis with removal of ascites fluid			1500
  Cystocentesis (diagnostic/urine aspiration)			500
  Diagnostic thoracentesis			700
  Thoracentesis with aspiration of fluid/air from the chest cavity (excluding medications)			1500
  Fixing the animal			450
  Obstetrics in a clinic 1 hour (excluding medications)			850
  Oral administration of drugs			200
  Treatment of the oral cavity with topical preparations (excluding drugs)			120
  Rectal/vaginal administration of drugs			220
  Injections	subcutaneous		80
  	intramuscular		80
  	intravenous (if a catheter is available)		80
  	intravenous (without IV catheter)		250
  Subcutaneous infusion			300
  Intravenous infusion up to 1.5 hours			600
  Intravenous infusion over 1.5 hours			1000
  Infusion therapy for more than 6 hours			1500
  Blood transfusion (2-4 hours)			1500
  Blood transfusion over 4 hours			2500
  External treatment against ectoparasites			50
  Intravenous catheter placement	puppies < 1 kg, kittens		600
  	cats		550
  	dogs		550
  Removing the IV catheter			150
  Central catheter placement			950
  Bladder catheterization (excluding urethral catheter)	cats with urethral obstruction category 1		700
  	cats with urethral obstruction category 2		1200
  	cats with atony		500
  	cats		1200
  	males with obstruction category 1		700
  	males with obstruction category 2		1200
  	bitches		1000
  Tonometry			350
  Bladder lavage with a catheter			400
  Probing of the stomach			1500
  Cleansing enema category 1			1000
  Cleansing enema category 2			2000
  Aspiration of hematomas, seromas			550
  Postoperative suture treatment	up to 2 cm (excluding consumables)		150
  	up to 2 cm (including medications)		250
  	from 10 to 30 cm 350 (excluding consumables)		350
  	from 10 to 30 cm 350 (including consumables)		450
  	more than 30 cm (excluding medications)		500
  Removing stitches	up to 2 cm (including medications)		300
  	from 2 to 10cm (including medications)		350
  	from 10 to 30 cm (including medications)		450
  	from 30 to 50cm (including medications)		650
  	more than 50 cm (excluding medications)		850
  Treatment of superficial wounds			350
  Washing the abscess cavity			350
  Sanitation of drainages			350
  Applying a bandage			250
  Sanitation of abdominal drainages			500
  Cleaning the external auditory canal (2nd hearing)	1 category		700
  	2 categories		800
  Rinsing the external auditory canal (one/two)			900/1300
  Sanitation of paraanal glands			550
  Washing the cavity of the paraanal glands			700
  Lavage of the preputial sac			500
  Nail trimming			450
  Beak Trimming			300
  Tick ​​removal (1 pc.) (without consultation)			100
  Trimming tangles	1 category		400
  	2nd category		600
  	3 category		1100
  Hygienic cat grooming	with sedation package No. 1		3500
  	with sedation package No. 2		3500
  	without sedation		2200
  Oxygen therapy – hour			250
  Hospital	1 category (24 hours\12 hours)		1500\750
  	Category 2 (24 hours\12 hours)		2500\1250
  	Category 3 (24 hours\12 hours)		3500\1750
  Euthanasia (excluding medications)	Cat		1550
  	Dog		2750
  	Rodents		1000
  	Birds		1000

• Dermatology

  Name of service	Price, rubles
  Deep scraping examination/trichoscopy	400
  Wet paper test	100
  Cytological examination of a fingerprint smear	500
  Cytological examination of smear tape test	500
  Otoscopy	300
  Sowing for dermatophytes (Sabouraud medium, brush)	800

• Oncology

  Name of service	Price, rubles
  Chemotherapy bolus	1500
  Chemotherapy infusion	2000

• Surgery

  Explanations	Name of service			Price, rubles
  Fixed cost with anesthesia benefits	Castration of a clinically healthy cat			2800
  Fixed cost with anesthesia benefits	Castration of a clinically healthy cat			4500
  Fixed cost with anesthesia benefits	Ferret castration			2500
  Fixed cost with anesthesia benefits	Ferret castration with gland removal			4500
  Fixed cost with anesthesia benefits	Castration of a female ferret			4300
  Fixed cost with anesthesia benefits	Castration of a female ferret with removal of glands			5850
  Fixed cost with anesthesia benefits	Castration of a male dog		up to 5 kg	5500
  Fixed cost with anesthesia benefits			from 5 to 10 kg	8000
  Fixed cost with anesthesia benefits			from 10 to 20 kg	10000
  Fixed cost with anesthesia benefits			over 20 kg	12000
  Fixed cost with anesthesia benefits	Castration of a bitch		up to 5 kg	8000
  Fixed cost with anesthesia benefits			from 5 to 10 kg	10000
  Fixed cost with anesthesia benefits			from 10 to 20 kg	13000
  Fixed cost with anesthesia benefits			over 20 kg	15000
  Fixed cost	Drainage, opening of abscess, cyst			650
  Fixed cost	Primary surgical treatment of the wound		1 category	950
  			2nd category	1550
  			3 category	2500
  Cystotomy, urotrostomy	MVS category I		up to 5 kg	6000
  			from 5 kg to 10 kg	7000
  			from 10 kg to 20 kg	8000
  			over 20 kg	9000
  Resection of the bladder wall (uncomplicated) without reimplantation of the ureters, resection of single polyps, uncomplicated nephrectomy, cystopexy, complicated urethrostomy, complicated cystotomy, etc.	MVS II category		up to 5 kg	7500
  			from 5 kg to 10 kg	8500
  			from 10 to 20 kg	9500
  			over 20 kg	10500
  Large-scale resection of the bladder wall, reimplantation of the ureters, resection of multiple polyps, urethotomy, complicated nephrectomy, ureter surgery, bladder rupture, etc.	MVS category III		up to 5 kg	11000
  			from 5 kg to 10 kg	12000
  			from 10 to 20 kg	13000
  			over 20 kg	14000
  Simple enterotomies and gastrotomies, colonopexy, etc.	Gastrointestinal tract I category		up to 5 kg	7000
  			from 5 kg to 10 kg	8000
  			from 10 to 20 kg	9000
  			over 20 kg	10000
  Enterotomy at several levels, biopsy at several levels, resection of the small intestine, suturing of the diverticulum, gastropexy, etc.	Gastrointestinal tract II category		up to 5 kg	9000
  			from 5 kg to 10 kg	10000
  			from 10 kg to 20 kg	11000
  			over 20 kg	12000
  Enterotomy with resection at several levels, gastric volvulus, removal of the gallbladder, stenting of the common bile duct, cholecysto-duodenostomy, resection of the liver lobes	Gastrointestinal tract III category		up to 5 kg	13000
  			from 5 kg to 10 kg	14000
  			from 10 to 20 kg	15000
  			over 20 kg	17000
  Cryptorchid subcutaneously	Reproductive system with pathologies category I		up to 5 kg	6000
  			from 5 kg to 10 kg	7000
  			from 10 to 20 kg	8000
  			over 20 kg	9000
  Cavity: uncomplicated pyometra, castration of cavitary males (cavitary cryptorchid), ungerminated cysts/formations, episiotomy, cesarean section	Reproductive system with pathologies category II		up to 5 kg	8000
  			from 5 kg to 10 kg	9000
  			from 10 to 20 kg	10000
  			over 20 kg	11000
  Complicated pyometras, space-occupying lesions, uterine rupture	Reproductive system with pathologies category III		up to 5 kg	12000
  			from 5 kg to 10 kg	13000
  			from 10 to 20 kg	14000
  			over 20 kg	15000
  Non-humane operations on puppies (cupping, amputation of dewclaws) / surgery without medical indications / umbilical / inguinal hernias, uncomplicated	Reconstructive plastic surgery category I		up to 5 kg	4000
  			from 5 kg to 10 kg	5000
  			from 10 to 20 kg	6000
  			over 20 kg	7000
  Umbilical hernias, inguinal hernia with a large volume of the hernial sac, not strangulated, surgical correction of the BCS	Reconstructive plastic surgery category II		up to 5 kg	6000
  			from 5 kg to 10 kg	7000
  			from 10 to 20 kg	8000
  			over 20 kg	10000
  Perineal hernia, resection of the auditory canal, skin plastic surgery, surgical correction of BCD	Reconstructive plastic surgery category III		up to 5 kg	12000
  			from 5 kg to 10 kg	14000
  			from 10 to 20 kg	16000
  			over 20 kg	18000
  Simple n/a	Oncological surgery category I		up to 5 kg	2500
  			from 5 kg to 10 kg	3000
  			from 10 to 20 kg	3500
  			over 20 kg	4000
  Regional mastectomy, musculocutaneous space-occupying lesions without invasion	Oncological surgery category II		up to 5 kg	6000
  			from 5 kg to 10 kg	8000
  			from 10 to 20 kg	10000
  			over 20 kg	12000
  Unilateral mastectomy (unilateral), complicated space-occupying lesions	Oncological surgery category III		up to 5 kg	8000
  			from 5 kg to 10 kg	10000
  			from 10 to 20 kg	12000
  			over 20 kg	14000
  Diagnostic abdominal operations	Diagnostic surgery		up to 5 kg	6000
  			from 5 kg to 10 kg	7000
  			from 10 to 20 kg	8000
  			over 20 kg	9000
  Installation of chest drains, temporary tracheostomy	Thoracic surgery category I		up to 5 kg	3500
  			from 5 kg to 10 kg	4500
  			from 10 to 20	5500
  			over 20 kg	6500
  Permanent tracheostomy, suturing of the pectoral muscles, diagnostic thoracotomy	Thoracic surgery category II		up to 5 kg	7000
  			from 5 kg to 10 kg	8000
  			from 10 kg to 20 kg	9000
  			over 20 kg	10000
  Diaphragmatic hernia, traumatic and non-traumatic, surgical removal of a foreign body from the esophagus, resection of the lung lobes	Thoracic surgery category III		up to 5 kg	15000
  			from 5 kg to 10 kg	17000
  			from 10 to 20 kg	19000
  			over 20 kg	23000

• Dentistry

  Name of service			Price, rubles
  Mechanical tooth cleaning	The price is for 1 tooth excluding medications		100
  Removal of a tooth	Milk fang	1 category	450
  	Milk fang	2nd category	750
  	Permanent fang	1 category	550
  	Permanent fang	2nd category	950
  	Baby tooth	1 category	350
  	Baby tooth	2nd category	450
  	Permanent tooth	1 category	450
  	Permanent tooth	2nd category	700
  Sanitation of the oral cavity with removal of non-viable teeth (fixed cost)	cat		3750
  Sanitation of the oral cavity with removal of non-viable teeth (fixed cost)	Dog up to 5 kg		4850
  	Dog from 5 to 10 kg		5100
  	Dog from 10 to 20 kg		5650
  	Dog over 20 kg		6150

• Anesthesia

  Explanations	Name of service		Price, rubles
  Planned operations on clinically healthy animals	Anesthesia without OIA of risk category I, lasting no more than 30 minutes	up to 5 kg	3500
  		from 5 to 10 kg	3800
  		from 10 to 20 kg	4200
  		over 20 kg	4500
  Planned surgeries for uncomplicated pathologies Animals are clinically healthy, but older than 8 years of age with possible chronic pathologies, operations lasting more than 40 minutes Read also:  Treatment of dog hair loss near the tail with growing inflammation	Anesthesia without OIA of risk category II	up to 5 kg	5000
  		from 5 to 10 kg	5300
  		from 10 to 20 kg	5600
  		over 20 kg	5900
  Emergency surgery Severe unstable patients	Anesthesia without OIA of risk category III, emergency surgery, severely unstable patients	up to 5 kg	6500
  		from 5 to 10 kg	6800
  		from 10 to 20 kg	7100
  		over 20 kg	7400
  Sedation without anesthetic			1500
  Application anesthesia (fixed cost)			400
  Infiltration anesthesia (fixed cost)		650

• Vaccination

  Name of service	Price, rubles
  EURICAN DHPPI + L	1050
  EURICAN DHPPI + L + RABISIN	1100
  EURICAN DHPPI + RL	1100
  NOBIVAC DHPPI	900
  NOBIVAC L	700
  NOBIVAC R	750
  NOBIVAC RL	850
  NOBIVAC R+L	850
  NOBIVAC DHPPI + L	1050
  NOBIVAC DHPPI + R + L	1100
  NOBIVAC DHPPI + RL	1100
  NOBIVACTRICAT	1150
  NOBIVAC TRICAT + R	1200
  VANGARD 7	1050
  VANGARD 5+	1100
  DEFENSOR 3	750
  VANGARD 7 + DEFENSOR 3	1150
  VANGARD 5+ + DEFENSOR 3	1200
  VANGARD 7 + NOBIVAC R	1150
  VANGARD 5+ +NOBIVAC R	1200
  VANGARD 7 + RABISIN	1150
  VANGARD 5+ + RABISIN	1200
  RABISIN	750
  PUREVAX RCP CHL	1300
  PUREVAX RCP CHL + RABISIN	1450
  PUREVAX RCP CHL + NOBIVAC R	1450
  PUREVAX RCP CHL + DEFENSOR	1450
  PUREVAX RCP	1150
  PUREVAX RCP+R	1200

• Ratologist's appointment

  Name of service		Price, rubles
  Initial appointment	small rodents (hamster, mice)	700
  	rabbits, guinea pigs, ferrets	1000
  Repeated appointment	small rodents (hamster, mice)	400
  	rabbits, guinea pigs, ferrets	600
  Consultation on analysis/x-ray diagnostics		300
  Collection of scraping/smear/wash		150
  Taking a blood test		350
  LD diagnostics		200
  Otoscopy		200
  Injections		80
  Placement of an IV catheter		600
  Washing the abscess cavity		350
  IV infusion		600-1000
  Rinsing the nasolacrimal duct		600
  Rabbit castration	Male (fixed price)	3200
  	Female (fixed price)	4300
  Intradermal suture		1000
  Rhinotomy		4000
  Suprelorin	Chemical castration	500
  Removing stitches		300
  Rinsing the nasolacrimal duct		600
  Reduction of the cheek pouch	No anesthesia cost	500
  Ferret castration	Male (fixed price)	2500
  	Female (fixed price)	4300
  Dentistry of rodents	Correction of the length of cheek teeth	1000-2500
  	Correction of incisor length using a diamond blade	450
  	Removal of a set of incisors in rodents and rabbits	2600
  	Removal of one incisor	800
  	Surgical treatment of odontogenic abscess	1500-3000