Iguana Bladder Stones

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Common Green Iguana’s occasionally have a problem with bladder stones (the medical term for bladder stone is urolithiasis). It is difficult to determine exactly why they have this problem. Just like in tortoises, the bladder stone can be very large. In addition to learning about the surgical removal of a bladder stone in an Iguana in this page, we also have pages that show a bladder stone removal in a dog and a tortoise. They also show pictures for interesting surgeries to remove them.

At the end of this page we have a short movie on the removal of a bladder stone from an iguana.

Graphic surgical photos on this page.


 

Symptoms

In dogs and cats there are several clues as to when a pet has a bladder stone. These include straining to urinate, blood in the urine, and lethargy. In reptiles the symptoms are not so clear cut since they don’t have the same habits as mammals and they easily hide symptoms of disease. Sometimes they don’t have any symptoms, in which case the diagnosis is made accidentally while looking for other problems. In general, the symptoms of a bladder stone in an Iguana might include lethargy and a poor appetite.

Diagnosis

 

A diagnosis of a bladder stone in reptiles is usually made by taking a radiograph.

This is the radiograph of Elvis, an Iguana with a very large bladder stone that is easily visualized as the large and circular white object

Another view gives some additional perspective as to the size. It has probably been there for years to progress to this size.

 

Treatment

The treatment of choice for this bladder stone is surgery. It takes about an 90 minutes from start to finish.

Its a meticulous surgery that requires a very gentle touch to an inflamed and sensitive bladder. It is performed under sterile conditions to minimize any chance of infection.

Here is Dr. Ridgeway working on his skin incision at the start of the procedure.

 

Anesthesia is initially induced with a face mask. Sometimes Iguana’s are given a tranquilizer before we given them anesthetic via the face mask. The anesthetic works rapidly, as long as they don’t hold their breath!

When she has relaxed enough, a special tube (called an endotracheal tube) is placed in the windpipe. This tube allows us to inflate the lungs and supply adequate amounts of oxygen and anesthetic.

The endotracheal tube is gently passed into the opening to the windpipe. This opening is at the back of the tongue, and can be difficult to visualize due to the fleshy tongue.

All of our surgeries are performed under sterile conditions. The skin is cleansed numerous times with a special antiseptic agent. The area is covered with a sterile drape and the surgeon uses sterile equipment for the duration of the procedure.

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While our nurse prepares our patient our doctor is doing the same cleansing of his hands.

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This is a major abdominal surgery, so our surgeon is fully gowned and masked

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A scalpel blade is used to nick the skin enabling us to use a special scissors to extend the incision. The incision is around 6 inches long in order to have an opening large enough to remove this stone from the coelomic (the reptile version of abdominal) cavity.

Great care must be taken when extending the incision with the scissors. Immediately below the skin is a large vein that must be avoided. You can see it here as the dark blue object running horizontally.

The bladder is then localized and brought out through the incision. It is carefully assessed to determine the correct location to place sutures and to make an incision. Notice the large number of blood vessels that cover the surface of the bladder.The bladders wall is quite thin and can easily tear, especially when inflamed because of the large stone.

The opening is draped with moistened sterile gauze to minimize contamination and keep the bladder moist. A small suture (called a stay suture) is placed at each end of the bladder to keep the bladder in position and to minimize handling during manipulation of the stone. The arrow is pointing to the suture as it is being placed at one end.

When the bladder has been properly stabilized an incision is made at an area where there is minimal blood supply. The incision is made just large enough to squeeze out the stone.

The stone is carefully squeezed out of the bladder. You can get an idea of its size in relation to Dr. Ridgeway’s hands. It is hard to imagine what type of pain this must be causing.

Internal organs like the bladder have to be kept continually moist when they are not in their usual position inside the body cavity. Here we are moistening the bladder with sterile saline just prior to suturing.

The bladder is sutured with a special suture material that will slowly dissolve over several months. This suture is very strong and will hold the cut edges together during the time the healing is progressing.

Reptile skin is sutured differently than mammalian and avian skin. For reptile skin to heal properly the edges must be “everted”. Within a month these sutures are taken out and within three months the scales are back to normal.

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Here is Elvis immediately after surgery and just prior to her pain injection. She is being kept warm to aid in her recovery. She went home the next day and is healing fine. We will be monitoring her condition to help prevent the recurrence of this stone.

Click on the link below to see a video of bladder stone removal in an iguana.  The sound you hear at the beginning and end is the Doppler monitoring the heart rate.

Iggie Bladder Stone Surgery