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What is Cystotomy?

Cystotomy is a surgical procedure used in cats to treat bladder stones. Although it is sometimes used for exploratory purposes, cystostomy is more invasive than other exploratory measures, including cystoscopy and ultrasound. Cystotomy is typically recommended to remove obstructions within the bladder, such as tumors, stones, and clots, which cannot be treated conservatively. This procedure may also be used to collect tissue samples for biopsy.

Cystotomy Procedure in Cats

The approach and procedure steps may vary according to the expertise of the surgeon as well as the underlying condition.

  1. Prior to surgery, the veterinarian or surgeon will run tests to ensure it is safe for the cat to undergo anesthesia.
  2. The cat will be anesthetized. An oxygen tube will also be placed to administer gas anesthesia intraoperatively.
  3. The abdomen will be shaved, cleaned, clipped, and draped.
  4. Using a scalpel, the surgeon will incise the skin and abdominal muscle in order to access the abdominal cavity.
  5. The surgeon will use sterile sponges to pack and isolate the bladder.
  6. If urine is present in the bladder, it will be removed to avoid contamination.
  7. The surgeon will remove obstructions such as bladder stones, clots, or tumors.
  8. If the procedure is exploratory, the surgeon will explore the bladder and urinary organs during this time to identify the underlying condition. They may choose to take tissue samples.
  9. The surgeon may choose to place a catheter. 
  10. The abdominal cavity will be lavaged, or flushed, with a sterile saline solution prior to incision closure.
  11. If cystotomy was used to remove stones or obstructions, an x-ray will be taken after surgery to ensure all obstructions have been removed.
  12. The cat will be hospitalized for up to three days.
  13. The catheter is generally removed between 24 and 72 hours after surgery.
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Efficacy of Cystotomy in Cats

The efficacy of the procedure will vary based on the underlying condition. Cystotomy is generally considered a safe and effective procedure which presents few complications. Most cats make a full recovery within two weeks following surgery. However, the prognosis will vary based on the underlying condition as well as the efficacy of additional treatment methods.

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Cystotomy Recovery in Cats

The vet will prescribe the cat pain medication to manage postoperative pain. An Elizabethan collar may be required so that the cat does not irritate the surgery site. Owners should prevent their cat from engaging in activity for up to two weeks following surgery to prevent wound rupture. They should also check the incision site daily to ensure no drainage, bleeding, or swelling has occurred. Surgeons typically use absorbable sutures for cystotomy. If non-absorbable sutures are used, the surgeon will schedule a follow-up appointment for ten to fourteen days after surgery to remove them.

The cat’s urine should be monitored throughout the recovery period. Small amounts of blood in the urine are normal for the first few days after surgery. However, if the cat is having difficulty urinating, or if the bloody urine lasts for more than three days after surgery, owners should seek immediate veterinary attention.

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Cost of Cystotomy in Cats

The cost of cystotomy may vary based on standards of living and additional costs incurred. The national average cost of cystotomy, not including preoperative testing or postoperative medications, is $300.

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Cat Cystotomy Considerations

There are few risks associated with cystotomy, since it is a relatively simple procedure. However, complications are possible with any surgical procedure. Complications of cystotomy, although rare, may include:

  • Remaining stones or obstructions
  • Allergic reaction to anesthetic
  • Difficulty urinating
  • Recurrence of the condition
  • Wound rupture
  • Leakage of urine
  • Hemorrhage
  • Infection
  • Anesthetic death

Unfortunately, there is a chance that the surgeon will not remove all the stones or obstructions. This may happen for many reasons, which is why the postoperative x-ray is imperative for ensuring all obstructions have been removed.

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Cystotomy Prevention in Cats

Bladder stones may be caused by a cat’s diet. Dietary changes are recommended for certain cases of bladder stones, since an improper diet can cause bladder stones. Owners should follow their veterinarian’s dietary guidelines carefully. Other conditions, such as cancer and congenital defects, cannot be prevented. Cats with congenital defects treated by cystotomy should not be bred.

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Cystotomy Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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MAINE COON

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7 MONTHS

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Unknown severity

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2 found helpful

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Inapropriate Urination

Hi, MY KITTEN WAS SPAYED, AND HAVE A DIVERTICULUM BLADDER THAT WAS CORRECTED DURING THE SPAY. ITS BEEN A MONTH, AND WHILE SHE IS PEEING BETTER, SHE STILL PEES IN THE SINK, AND CRYS SOMETIMES. IS IT STILL PART OF THE HEALING PROCESS?

July 12, 2020

Owner

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Dr. Sara O. DVM

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2 Recommendations

Hello, This may be the bladder still healing. If she is not improving, it may be best to discuss these signs with the vet that did her surgery. Your cat may also need to have their urine check to make sure that there is not a bladder infection causing some of these issues. I hope your cat gets better soon.

July 12, 2020

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Bob

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DOMESTIC

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9 Years

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Fair severity

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None

My male cat had bladder cystotomy for calcium oxalate stones in 2016. The vet said his stones are back after seeing an X-ray for another concern. I have heard there is a less invasion option called PCCL that will use a scope and a basket to obtain all traces of stones, so we do not have to keep surgery every two years. However, no one in Dallas/Fort Worth has this equipment. What options do I have?

Aug. 17, 2018

Bob's Owner

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Dr. Michele K. DVM

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2 Recommendations

I am not aware of any veterinarians that perform this surgery. I'm not sure that you will need to have the surgery performed every two years, but the best option for Bob at this point is to have a 2nd surgery. If you are able to control the pH of his urine through diet, he should not continue to get the stones.

Aug. 18, 2018

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Mason

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tortious

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10 Years

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Serious severity

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1 found helpful

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Bladder Stones

Mason my 10 year old cat has bladder stones caked all in her bladder. we know they are not the dissolving type because they didn't go away when we switched to the special food. the vet it recommending surgery but with her age and the type of stones we don't know if surgery would be worth if if the stone with just keep recurring

July 25, 2018

Mason's Owner

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Dr. Michele K. DVM

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1 Recommendations

Once you know what type of stone she has, you'll be able to keep the stones from reoccurring. Getting the stones out of there with surgery is the next step to find out why they formed.

July 26, 2018

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Mason

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Tortoise

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10 Years

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Serious severity

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Bladder Stones

Mason, My 10 year old tortoise cat has bladder stones and not the ones that can be dissolved by food, they are just covering her bladder. we originally tried the changing the diet with the special foods but the x-rays were almost identical about a month later. we just don't know if the surgery is worth it considering the stones can't be dissolved.

July 25, 2018

Mason's Owner

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Dr. Michele K. DVM

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0 Recommendations

If the stones can't be dissolved with food, then surgery is needed to remove the stones - trying to make them dissolve with food was to see if surgery could be avoided, but Mason needs the surgery.

July 26, 2018

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Thomas

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Domestic shorthair

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5 Years

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Moderate severity

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1 found helpful

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Moderate severity

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Sleeping More

Cat came home after having a bladder stone removed and being unblocked. He is eating and drinking and on royal canin SO food. He goes to his litter box about once every 1.5-2 hrs and has throughout the night(he’s woken me up getting in it) this morning there was one pretty good pee spot but now when he get in I don’t really see any urine but it’s hard to tell with the new litter( the newspaper kind that Purina makes) he spends about 20 seconds in it before getting out. Is this normal? Also no blood

July 21, 2018

Thomas' Owner

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1 Recommendations

After having a urinary stone removed, there may be some discomfort and urination may be short little dribbles but if he isn’t urinating any real volume then I would be concerned he isn’t emptying his bladder especially if he has a high water intake. Try to keep an eye on him this weekend to look at his urinary habits and visit your Veterinarian if you have any concerns (without palpating his bladder I cannot determine whether he is emptying it). Regards Dr Callum Turner DVM

July 22, 2018

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Tumi

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“Himalayan”

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8 Years

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Serious severity

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“No Appetite”

My cat’s name is Tumi. Thank God I brought him to the vet as soon as possible when I found him in the litter box. He couldn’t pee and was blocked... the doctors had to stabilise him first, placed a catheter in him before performing cystotomy on him. They had to find out where the stones were and they were in his urethra. Poor boy, he was such in pain. His surgery was yesterday and I know he’s still in pain. He refused to eat but drank a lot of water. The doctor had to force feed him as he did not have any appetite yet. Is this normal for a cat after an operation to not gain his appetite yet? Is this because he’s still in pain? Or stressful because of his new environment? What should I do to keep him calm until he’s able to come home?

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Otis

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Domestic shorthair

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3 Years

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Mild severity

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Mild severity

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Blood In Urine

My cat Otis had surgery last thursday. Its Tuesday and there is still a small amount of blood in his urine. My vet said that's to be expected up to 2 weeks after. Is this correct?

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rascal

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Domestic Short Hair Brown Tabby

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8 Years

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Moderate severity

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Moderate severity

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Pain After Urinating
Pain After Bowel Movement
No Interest In Former Activities

my cat 8 years old male had Cystotomy 2 weeks ago...staples removed yesterday..urinating medium and bowel movement painful..x ray showed most of inflammation was gone after 2 rounds of Onsior but still a little bit in one area..he eats and drink not enough..does not play and appears in pain...i'm in touch with the vet but we wonder why he seems in so much pain..i give him Gabapentine for now as per vet orders....i hate seeing him in pain..surgery was a success...does anyone have any idea of what's going on?

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Sherman

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Siberian

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9 Years

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Serious severity

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Unable To Urinate

Hello, My male cat couldn't pee this morning so I took him to a hospital with large surgical facilities. Xray showed a stone and some small debris. We are awaiting urinalysis, which I assume based on alkaline or acid levels, we will determine if struvite or calcium oxalate. I have been asked to decide if I want to have surgery which they can't do for two days because they are very busy. He is currently catheterized, sedated and has been administered pain meds. My question is, if it is struvite, is there a real possibility to dissolve the stone(s) with diet and increased hydration or is the inclination to remove the stone to be on the safe side? I do understand that if the diagnosis is calcium oxalate, surgery will be a must. It's really tough making this decision. He is a Siberian. Many thanks for any advice. Kind regards, Karen

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Caesar

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tabby

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5 Years

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Mild severity

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Mild severity

Has Symptoms

Not Peeing And Pooping

My cat Caesar is 5 and just had Cystotomy procedure 2weeks ago. A couple days after he was home from surgery I had to take him back to the vet cause he was not urinating or having a BM. They kept him and catheterized him and stated he needed strong Antibiotic and said it was due to how inflamed he was. He is back to his normal eating habits on a special diet wet/dry food but is not drinking like he normally does nor is peeing or having a BM more then once a day. Is this normal?

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