I've given this a lot of thought... I can't recall ever hearing of letting bladder stones resolve on their own or with diet change. I've always been told that this is quite serious as the stones could block the bladder which is life threatening.
If this were me, I'd have the stones surgically removed, and at the same time have an exploratory done and see if there's a shunt or not, repair it if there is one, and get the liver biopsy at the same time.
In older dogs (over 2YO), there is also the problem of Gall Bladder sludge, which causes the same symptoms as Liver shunt, and often does not show on xray or Ultrasound. It can show up in the liver enzyme bloodwork, if the vet knows to look for it. It will also be evident during an exploratory surgery, and the bile duct can be cleared at that time, or be put on a medication that helps to disolve the sludge and restore normal pressure in the liver..
Although any dog may feel and act better on Lactulose, Denamarin, and antibiotics, none of this helps or solves the problem of Gall Bladder sludge. This condition creates pressure in the liver and causes multiple tiny shunts to form to alleviate the building pressure.
Also a complete Urinalysis should be done, as various bacterias, one being E Coli, can cause the Gall Bladder to develope sludge. It takes at least a 30 day course of antibiotics to clear E coli, and may need to be repeated. |