The signs of Teddy’s recent illness were subtle: when anybody went to pick him up, he started to snarl. There are many dogs that might do this normally, but  Antonia realised that there must be something bothering him. He’s such a good natured dog that he’d never normally behave like this. He enjoys human company, and always liked to be picked up. Antonia was worried about him so she decided to take him to the vet.

When I examined him, he seemed healthy in almost every way, with normal appetite and thirst, and no other signs of illness. But when I put my hands on his mid-body area, he was not happy. He growled, and looked anxiously at me.
After hearing Antonia describe how gentle and good-natured Teddy was, it seemed clear that there must be some cause of pain to make him growl like this. Fear and pain are the most common causes of aggression in dogs, and they’re often not recognised. It can be difficult to diagnose the source of pain in dogs: they can’t tell us where they’re hurting, and they can’t describe the nature of the pain.
It’s often possible to pinpoint the epicentre of the pain by examining a dog, poking and prodding while you watch the dog’s expression. This is especially useful for lameness evaluation: a dog will only yelp, whine or pull away when the sore joint is touched or flexed. With most other types of pain too, it’s usually possible to narrow down the area that’s causing discomfort.

When I examined Teddy, it seemed clear that the pain was somewhere in his mid-back area. He didn’t mind his neck being touched, and he was happy enough to have his hindlegs examined. But when I went anywhere near the middle of his back, he wasn’t happy. The next task was to work out what sort of underlying problem was causing his discomfort.
The only way to make a diagnosis in a case like this is to use so-called “diagnostic imaging”. Radiographs (x-rays) are the most commonly used method in most vet clinics, but ultrasound, MRI scans and CAT scans are all now available. In Teddy’s case, we decided to start with ultrasound: this can be done simply, with no sedation, so it’s easier than taking x-rays (animals cannot be held still due to the risk of radiation exposure to humans, so they always need to be sedated). I was expecting that Teddy’s ultrasound result would be normal, and we would then schedule him for x-rays. As it happened, ultrasound was able to give us a full and accurate diagnosis: Teddy was suffering from kidney stones.

Ultrasound uses sound waves to generate a moving, three-dimensional video of the inside of a dog’s body. The technique was able to see inside his kidneys and bladder, showing that there was a combination of sandy sediment as well as tiny solid stones. These are produced when dissolved minerals from his food pass into the urine then gather together into clumps. Most dogs with this problem have signs such as difficulty passing urine, but in Teddy’s case, there was just pain, as is often seen in humans.
While Teddy is on the road to recovery, he’s being  handled very gently. Teddy is a cute dog and many people who meet him want to lift him for a cuddle. For now, Antonnia is asking people not to lift him until she’s sure he’s completely pain free again.
The good news is that kidney stones in dogs can be dissolved using a special diet that contains a reduced level of the minerals involved.  Who would have guessed that serious pain could be curing simply by changing a dog’s diet?