In 1999, I was informed that a dog I had bred, Fraser, had been diagnosed with cystinuria. This was the first time I'd ever heard of the disorder, and no one in my breed who I asked about it had ever heard of it, either. I began to research it and was frustrated by how little information I was able to find.

I owned a dog, Skye, who was the littermate of the diagnosed dog, and about a year later, he suddenly showed signs of difficulty in urinating. We immediately took him to the veterinarian, and he, too, was diagnosed with cystinuria. Like his brother, he was loaded with cystine stones and required a cystotomy to remove the stones, and a pre-scrotal urethrostomy to create a new outlet for urination; they were unable to dislodge the stones from his urethra.

During this time, we experimented with diet and supplements to prevent the formation of more stones, and although he had a couple of UTIs, he seemed to be doing very well. However, about three and a half years after his diagnosis and urethrostomy, Skye began to show signs of being ill. A sonagram showed no stones, but his prostate was enlarged and cystic, and a UTI was diagnosed. We opted for a course of antibiotics, but there was no improvement. Skye's condition worsened rapidly and drastically, and he dropped from 105 to 67 pounds. We took him repeatedly to both the emergency vet and an internal medicine specialist, but he kept going downhill. He was hospitalized at our insistence, but they were reluctant even to do diagnostics that would require sedation, due to a previous adverse reaction to sedation and his present poor condition. They had to catheterize him, and at one point drained almost a cup of pus out of his bladder. The vets, both internists and surgeons, told us there was nothing they could do for him. We were specifically told there were no surgical options available.

I refused to accept this and in desperation contacted Dr. Gary Brown, the surgeon in Fremont, CA who had done Skye's original surgery, as well as that of his brother. Dr. Brown listened to the details and said, "Tough case. Tough case. I love a tough case. We won't give up on the little guy." He had our former veterinarian, internal medicine specialist and greyhound breeder Helen Hamilton, call us, and just hearing Helen's voice comforted me. The other vets had faxed some of Skye's records over, and she said, "Christie, go put him in the car right away and bring him to me."

My mother left immediately, and she got Skye out of the other veterinary hospital, where he had been for three days, and drove him at once to Helen's practice, three hours away. They admitted him, did more tests, and found that he did indeed have many stones, in his bladder and also in his prostate gland. The urethral wall had ruptured (the pus drained at the previous vet hospital, which they thought had come from the bladder, had actually come when the catheter had gone through the urethral wall into an abscess). They arranged for immediate surgery. Dr. Brown removed the stones (subsequently found to be cystine stones) from Skye's bladder and prostate gland, neutered him to reduce the size of the prostate, repaired the prostate, and then used omentum, the vascularized fatty lining of the stomach, to repair the ruptured urethral wall. It was now a waiting game, because if the rupture wouldn't heal, Skye would not be able to live.

Skye was catheterized, and hospitalized for a week. Every day either my mother or I went to the hospital to spend time with him, and try to coax him to eat the homecooked meals we brought. His condition was so poor that his inability to eat was compromising his chances of recovery. At one point we also were able to have a veterinary acupuncturist treat him in the hospital, which relieved some swelling in his limbs and also caused him to rest more peacefully.

After one week, tests revealed that Skye's urethra had sealed and he was discharged to us. He rapidly put his weight back on and enjoyed a complete recovery for nearly two years. In July of 2004, just after his 11th birthday, Skye suffered a recurrence of bacterial prostatitis, probably but not definitely related to his underlying cystinuria. While the bacteria in his urine did resolve after a course of antibiotic therapy, his symptoms did not get any better and he appeared to be in grave pain. Pain medication did not give him any relief, and after nearly 4 weeks of trying, we made the difficult decision not to put him through anymore. On August 16, 2004, we said goodbye to our Skye.

There are no words to express our gratitude to Dr. Hamilton and Dr. Brown, not only for their great skill, but also for their refusal to give up on Skye. Despite the three hour travel time through some of the worst traffic in the San Francisco Bay Area, Skye remained in Dr. Hamilton's care for the rest of his life, and we returned to her when another dog with cystinuria became part of our family.

Dr. S. Gary Brown DVM, Diplomate American College of Veterinary Surgeons, can be contacted in Fremont, CA, at 510-657-6343.

Dr. Helen B. Hamilton DVM, MS, Diplomate American College of Veterinary Internal Medicine is at 510-657-9151, also in Fremont, CA.