💥 Vet Guide 2025: Lithotripsy for Dogs and Cats – Stone Removal Without Surgery 🐶🐱🩺

By Dr Duncan Houston, BVSc

🔬 What Is Lithotripsy?

Lithotripsy is a non-surgical procedure used to break urinary stones into smaller fragments so they can be passed naturally. The term comes from “lith” (stone) and “tripsis” (crushing). No cutting is involved. Instead, it uses laser or shock waves to fragment stones inside the urinary tract. 💥

🧪 Types of Lithotripsy

1. 💡 Intracorporeal Laser Lithotripsy (Most Common)

This technique uses a holmium:YAG laser delivered through a cystoscope to target bladder or urethral stones. The laser creates water vapor bubbles that rapidly expand and collapse, breaking the stone into fragments.

• 🔍 Effective for bladder and urethral stones
• ✅ 83–96% success in female dogs, 68–81% in males
• 📆 Median procedure time: 36 minutes
• 🔬 Fragments may be passed or removed with a scope basket

2. ⚡ Extracorporeal Shock Wave Lithotripsy (ESWL)

This form is used for kidney and ureter stones. High-energy shock waves are aimed at the stone to fragment it. The pet is placed in water or against a water cushion for effective wave transmission.

• ✅ 85% success for kidney stones in dogs
• 📆 Multiple sessions may be required
• ⚠️ 10% may develop ureter blockages post-procedure
• ⚠️ 2–3% risk of pancreatitis

⚖️ Pros vs. Cons of Lithotripsy

✅ Advantages (Laser Lithotripsy)

• 🛏️ Often same-day discharge
• 💉 No surgical incision or bladder cutting
• 💨 Less painful and faster recovery
• 📉 Lower risk of urethral scarring than surgery

⚠️ Limitations

• 📏 Not suitable for small male dogs or male cats (due to narrow urethra)
• 🔴 Less efficient if multiple or large stones (>½ inch in diameter)
• ⏱️ May take longer than surgery for bladder stones
• 💰 Often more expensive than surgery

⚡ Extracorporeal Shock Wave Lithotripsy – Pros

• 💡 Preserves kidney function better than surgery
• 🧪 Non-invasive and done under anesthesia

⚠️ Extracorporeal Lithotripsy – Cons

• 📉 30–50% of patients need repeat sessions
• 🧬 May cause pancreatitis or post-fragment obstruction
• 🩺 Stone fragments must be found for lab analysis

🧬 Ideal Candidates

Laser Lithotripsy

• 🐾 Female dogs or larger male dogs
• 🪨 5 or fewer stones <½ inch in diameter
• 🧪 Infection-free or well-controlled UTI

Shock Wave Lithotripsy

• 🐕 Dogs with kidney or ureter stones <1.5 cm
• 🧪 Stones not amenable to diet-based dissolution

🧪 Pre-Procedural Considerations

• 🧫 Urine culture is mandatory to rule out infection (which can be worsened by lithotripsy)
• 📸 Imaging (ultrasound or CT) to locate and measure stones

📆 Recovery & Aftercare

• 🏡 Pets often go home the same day for laser lithotripsy
• 💊 Pain meds and antibiotics if needed
• 💦 Encourage hydration to help flush out fragments
• 📅 Follow-up imaging may be needed

With shock wave lithotripsy, fragments may take weeks to pass, and some patients may need a second treatment or ureteral stent placement.

🩺 Summary from Dr Duncan Houston

Lithotripsy offers an excellent alternative to traditional stone surgery for select patients—especially those with stones in the bladder, urethra, or kidneys. While it may not be suitable for all pets or all stone types, it’s a minimally invasive option with strong success rates in the right candidates. 🐾

Discuss the option with your veterinarian and ask whether your pet might benefit from lithotripsy over traditional cystotomy or other surgical techniques.

📲 Considering Lithotripsy for Your Pet? Ask A Vet Today

Need help weighing your pet’s options for stone removal? Speak directly with Dr Duncan Houston or a veterinary expert via the Ask A Vet app—24/7. From procedure details to referrals, we’ve got your answers. 🐶🐱💬