Cystotomy in Dogs

A cystotomy in dogs is surgical procedure that involves creating an opening in the wall of the urinary bladder. This type of procedure is used to treat a number of canine conditions, but is also performed to diagnose a problem that other diagnostic tests did not reveal. A veterinarian may perform a cystotomy in a dog to collect a biopsy, conduct an exploratory, or to treat an identified problem such as a tumor, bladder stones and urethral obstructions. The total operation usually last approximately 45 minutes to an hour and the patient will be hospitalized for two to three days postoperatively. 

Prior to conducting the cystotomy procedure, a general health assessment will be completed on the dog. Blood work, radiographs and an ultrasound are usually the primary pre-operative exams done on a dog with a condition of the bladder. 

1. The patient will be placed in dorsal recumbency on the sterile surgical table and draped. The veterinary surgeon will be focusing on the ventral aspect of the bladder to better expose the trigone area. 
2. An incision will be created, allowing the urinary bladder to be exteriorized for easy access to the vet. Stay sutures will be placed to hold the bladder outside the dog’s body. To prevent the moist organ and surrounding tissues from drying out, laparotomy sponges will be moistened to be placed around the bladder. The bladder will then be aspirated to remove urine. 
3. The surgeon will then pierce the canine bladder lumen on the ventral midline, using a suction device to remove any remaining waste fluids in the organ. The incision will then be continued across the midline using Metzenbaum scissors. 
4. Once the surgical opening has been created, a scrubbed-in nurse will keep the bladder lumen open to allow the surgeon to remove the abnormality (polyps, tumors, urethral calculi, uroliths). If a biopsy or exploratory is in the treatment plan for this dog, the surgeon will also perform these test at this time. 
5. The bladder is then sutured using a continuous stitch pattern through the serosa, muscularis, and submucosa. Once the vet surgeon is content with his/her stitching and positive the bladder will not leak, the abdomen wall will also be closed. 

Cystotomy in dogs is a highly effective surgery for diagnosis, correcting and treating abnormalities within the urinary bladder. Like all surgical procedures, complications should be considered with this operation and discussed with a working veterinarian. 

Following a cystotomy procedure, the dog will be hospitalized for a period of time for monitoring purposes and to continue the administration of fluids. The passing of blood clots through the urine is a common occurrence for canines who have undergone a cystotomy and the patient will not be allowed home until the clots have minimized. Pain will be controlled through the use of opioids directly following surgery, but at home, NSAIDs (non-steroidal anti-inflammatory drugs) should continue for 3-5 days. The patient should receive a higher than normal water intake at home to keep the dog hydrated and to routinely flush the bladder. 

The estimated cost for a cystotomy in dogs is around $1,700. The total cost of the procedure includes the cost of medications, imaging and analysis of biopsied matter. 

Complications following a cystotomy in dogs is rare, but the patient should be monitored for the following post-operative problems: 

• Dehiscence or suture line leakage 
• Infection 
• Persistent hematuria 
• Excessive stranguria 
• Obstructions 
• Impaired urinary output 

Cystotomy in dogs is used to treat and diagnose a number of complications seen in canines. Some canine breeds are highly prone to developing bladder conditions, especially Dalmatian dogs with bladder stones. All Dalmatians are born without the ability to convert uric acid to allantoin acid, or urine. The high concentration of the acid within the bladder imbalances the pH levels between acid and basic, leading to calcified formations called urolithiasis (bladder stones).