Bladder Stones in Dogs: Signs, Types, and When Surgery Is Needed

If your dog is straining to urinate, peeing small amounts frequently, or you've noticed blood in the urine, bladder stones are one of the first things I check for. At Hearthstone Animal Clinic in Cypress, TX, I diagnose and treat bladder stones regularly, and the good news is most dogs do very well once we figure out what type of stone we're dealing with and choose the right treatment.

Here's what you need to know about bladder stones: what they are, why they form, how we diagnose them, and when your dog actually needs surgery versus a less invasive approach.

What are bladder stones, and why do dogs get them?

Bladder stones (the medical term is uroliths or cystic calculi) are mineral deposits that form in the bladder when urine becomes supersaturated with certain compounds. Think of it like salt crystals forming in a glass of water that's been sitting out too long. The minerals clump together, starting as tiny crystals and sometimes growing to the size of golf balls.

Several factors increase the risk:

• Genetics: Dalmatians, Miniature Schnauzers, Shih Tzus, Bichon Frises, and Yorkshire Terriers are significantly overrepresented. Some breeds are predisposed to specific stone types.
• Diet: High-mineral diets, inadequate water intake, or foods that shift urine pH can promote stone formation.
• Urinary tract infections: Certain bacteria produce enzite that changes urine chemistry, directly causing one common stone type.
• Metabolic abnormalities: Liver shunts, for example, can cause urate stones in young dogs.

The frustrating part for owners is that a dog can do everything "right" and still develop stones because of genetics. If you're reading this worried about your dog, you didn't cause this.

What are the signs of bladder stones in dogs?

The symptoms can range from subtle to alarming, depending on the stone's size and location:

Common signs

• Frequent urination (going out more often, producing small amounts)
• Straining to urinate (squatting for a long time with little result)
• Blood in the urine (pink, red, or brown tinged)
• Accidents in the house in a previously housetrained dog
• Licking the genital area excessively
• Cloudy or foul-smelling urine

Emergency signs (male dogs especially)

If a stone lodges in the urethra, it can cause a complete blockage. This is a life-threatening emergency. Signs include:

• Repeated attempts to urinate with nothing coming out
• Crying or whimpering when trying to urinate
• Distended, painful abdomen
• Vomiting or lethargy

Male dogs are at higher risk for obstruction because their urethra is longer and narrower. A blocked dog can die within 24 to 48 hours if the obstruction isn't relieved. If your male dog cannot urinate at all, get your pet seen the same day.

What types of bladder stones do dogs get?

This matters because the stone type determines treatment. We can't know for certain what a stone is made of until we send it to a lab, but we can make educated guesses based on breed, urine pH, X-ray appearance, and urinalysis findings.

Struvite stones (magnesium ammonium phosphate)

These are the most common type overall and are almost always associated with a urinary tract infection. The bacteria produce an enzyme called urease that makes urine more alkaline, creating the perfect environment for struvite crystals. Good news: these can often be dissolved with a prescription diet and antibiotics, avoiding surgery in many cases. Dissolution takes 4 to 12 weeks depending on stone size.

Calcium oxalate stones

The second most common type, and unfortunately, these cannot be dissolved with diet. Surgery or another removal method is required. Calcium oxalate stones have been increasing in prevalence over the past few decades. Miniature Schnauzers, Lhasa Apsos, and Yorkshire Terriers are particularly prone.

Urate stones

Most common in Dalmatians (due to a genetic quirk in purine metabolism) and dogs with liver shunts. Some urate stones can be dissolved with a combination of diet and medication (allopurinol).

Cystine and silica stones

Less common. Cystine stones occur in dogs with a genetic defect in amino acid transport. Silica stones are sometimes linked to diets high in plant-based ingredients.

How are bladder stones diagnosed?

Diagnosis typically involves a combination of:

• Urinalysis: Checks for crystals, blood, bacteria, and pH. Finding crystals in urine suggests stones may be present, though not all dogs with crystals have stones, and not all dogs with stones have visible crystals.
• X-rays: Most bladder stones (struvite, calcium oxalate, silica) show up clearly on radiographs. This is usually the first imaging step.
• Ultrasound: Helpful for stones that don't show well on X-rays (like urate stones) and for evaluating the bladder wall and kidneys.
• Urine culture: Identifies bacterial infection and which antibiotic will work.

Once we've confirmed stones are present, the question becomes: what kind, and what's the best way to get them out?

When does my dog need surgery for bladder stones?

Not every dog with bladder stones needs surgery. Here's how I think through it:

Medical dissolution (no surgery)

If we suspect struvite stones (infection present, alkaline urine, appropriate breed and history), I'll often recommend trying a prescription dissolution diet plus antibiotics for 4 to 8 weeks, then rechecking with X-rays. If the stones are shrinking, we continue. If they're not, we know they're likely calcium oxalate and need removal.

The advantage is avoiding anesthesia and surgery. The disadvantage is time, during which the dog remains uncomfortable and at risk for obstruction.

Surgical removal (cystotomy)

A cystotomy is the traditional approach: we open the abdomen, open the bladder, and physically remove the stones. This is indicated when:

• Stones are calcium oxalate or another non-dissolvable type
• Stones are large or numerous
• The dog has a urethral obstruction
• Medical management has failed
• The owner prefers definitive treatment without weeks of waiting

Cystotomy is a routine procedure with a good safety profile. Most dogs go home the same day or the next morning and recover fully within 10 to 14 days. At Hearthstone, surgical bladder stone removal typically runs $800 to $1,500 depending on complexity, anesthesia time, and whether additional procedures are needed.

Other removal options

Voiding urohydropropulsion: For very small stones (under 3 to 4mm), we can sometimes flush them out through the urethra with the dog under sedation. This only works for tiny stones in female dogs or small male dogs.

Cystoscopic removal: A specialist can sometimes retrieve small stones using a scope passed through the urethra. This requires referral to a veterinary specialty center and is more expensive, but it's minimally invasive.

According to the American College of Veterinary Surgeons, the choice between surgical and non-surgical approaches depends on stone type, size, number, and the individual patient's health status.

Can bladder stones come back?

Unfortunately, yes. Recurrence rates vary by stone type, but some studies show rates as high as 25 to 50% for calcium oxalate stones within three years. Prevention strategies include:

• Prescription diets: Formulated to reduce mineral concentration and maintain optimal urine pH. If your dog has had stones, they may need to stay on a therapeutic diet for life.
• Increased water intake: Dilute urine is less likely to form crystals. Adding water to food, using a pet fountain, or feeding canned food helps.
• Treating underlying infections: For struvite stones, keeping UTIs under control is key.
• Regular monitoring: Periodic urinalysis and X-rays catch recurrence early, when stones are small enough for non-surgical options.

I recommend wellness panels that include urinalysis for dogs with a history of bladder stones, typically every 6 to 12 months.

When to contact your veterinarian

Reach out if your dog shows any of the following:

• Straining to urinate or urinating small amounts frequently
• Blood in the urine
• New house-soiling in a trained dog
• Excessive licking of the genital area

Seek emergency care immediately if your dog (especially a male dog) is attempting to urinate but producing nothing, appears to be in pain, or becomes lethargic. A complete obstruction is a true emergency.

If you're noticing urinary symptoms in your dog, or if your dog has a history of stones and it's time for a recheck, I'm happy to help. As a Cypress veterinarian who's been treating this condition for over two decades, I can walk you through the diagnostic process, explain what we're dealing with, and help you decide on the best path forward. Schedule a visit at Hearthstone Animal Clinic or call us at (281) 859-9244. We'll get your dog comfortable and figure out what those stones are made of.