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Cystotomy in Dogs
What is Cystotomy?
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.
Cystotomy Procedure in Dogs
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.
- 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.
- 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.
- 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.
- 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.
- 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.
Efficacy of Cystotomy in Dogs
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.
Cystotomy Recovery in Dogs
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.
Cost of Cystotomy in Dogs
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.
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Dog Cystotomy Considerations
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 Prevention in Dogs
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).
Cystotomy Questions and Advice from Veterinary Professionals
Miniature Schnauzer
Bella
7 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
Blood In Urine
Vomiting
Tired
My dog was diagnosed with bladder stones last week (Thursday), her symptoms were vomiting, no energy, not eating or drinking, not pooping, and lastly her new symptoms were blood in her urine. The vet did some X-rays on Thursday and it clearly showed some stones in her bladder and they said that surgery was the treatment option for her. They gave her fluids (because she was dehydrated), an anti nausea and vomiting shot, and an antibiotic shot, and sent her home. By Friday she was better, she was eating again, going to the bathroom normally, and was acting a little more energetic. By Saturday she starting vomiting again and not eating or drinking, and I could see her energy was low again. I decided that I was going to call first thing in the morning and schedule her surgery. Sunday came, and I checked her diaper (she has to wear diapers because she had an FCE 6 months ago) and I saw a stone. She kept passing stones all throughout Sunday and Monday. I called the vets on Monday morning and scheduled her cystotomy for Tuesday morning. I collected a total of 4 stones and took them to the vet on Tuesday morning. The vet tech who attended me was unbelief that they were stones and said that they “look like cereal” and and just ignored it. My dog got the surgery, and guess what? They said that they didn’t find any stones!!!! So they just cleaned her up and closer her. I’m currently very upset with the vet, and I’m clueless on what to do.
June 6, 2018
2 Recommendations
Thankfully there were no stones in the bladder and it seems that she may have passed them, however without seeing the stones which you took to the Veterinarian I cannot say if they were stones or not; however I probably would have done another x-ray to see if there were any stones in the urethra or bladder before surgery. Regards Dr Callum Turner DVM
June 7, 2018
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Mix
Belladonna
14 Years
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0 found this helpful
My pet has the following symptoms:
Uti
My 14 year old large mixed breed has been having UTIs for the last year and a half. In December 2016, she had x-rays, and an ultrasound that revealed no masses or stones. She went from late August 2017 to late January 2018 without an infection. She was on antibiotics for 10 weeks (4 weeks after the UA was all clear.) A week later, a different infection emerged. My vet thinks she needs to go for a cystotomy. Is there anyway they can do this without knocking her out? She faints occasionally due to a heart condition. There are no crystals or blood in the uas.
May 17, 2018
0 Recommendations
A cystotomy is a procedure where the abdominal cavity is opened surgically and the urinary bladder is cut open to view the inside; this is not a procedure to do in a conscious animal regardless of heart conditions etc… However, I’m not sure of the rationale behind a cystotomy if no masses or stones have been detected on ultrasound or x-ray. Regards Dr Callum Turner DVM
May 18, 2018
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Yorkshire Terrier
George
9 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
Incontinence
My nine-year old Yorkshire Terrier had a cystotomy to remove stones a few days ago. I am concerned that he has been quite swollen and red surrounding (maybe bruising) the surgical site, although it does not appear infected at the incision. He was prescribed antibiotics and a pain med, however, it does not appear any NSAIDS. He has been struggling to eliminate waste, dribbles urine and ribbon-like stools. My question is whether this is cause to visit the vet right away? Or is this just the process of healing?
May 2, 2018
Answered by Dr. Michele K. DVM
2 Recommendations
A surgery like that can require frequent follow ups to make sure that everything is healing well. Without seeing him, I'm not sure if George's incision is okay, and healing normally, or if he is having problems. If he is passing urine generally, it probably isn't an emergency, but it would be a good idea to have him seen by your veterinarian as soon as possible to have the incision site checked and make sure that everything is okay. I hope that all goes well for him!
May 2, 2018
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West Highland White Terrier
Hunter
3 Years
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Dysuria
last monday 9/4/2018 my 3yo west highland terrier Male in tact underwent and Cystotomy for confirmed struvite urethral obstruction. first the vet attempted to retropulse the urethral obstruction and confirmed this was successful but wanted to monitor for the next few hours 2 hours later my dog was unable to pass urine again so they decided on the Cystotomy .. after the surgery at 8pm i was called to collect my dog and to take him to Emergency Animal hospital and advised that he still had not been able to urinate and was experiencing severe urethral spasms they must insert an indwelling catheter.. from the Emergency hospital flow chart, i can see he was placed on 5ml/kg/hr IVFT but the emergency hospital did not insert the indwelling catheter .. i calculated approximately 600mls fluid 12h post op without urin flow. the next morning the referring vet told me to bring the dog back to their practice as the cost would be significantly cheaper, i explained they had not placed the indwelling catheter, they said they could do it there.. i noticed when i picked him up the urge for him to pee was there but he couldn't actuate the flow.. at this point his tummy seamed very full and obviously distressed. from the notes the vet scanned the bladder and noted the following -Bladder very firm and large. U/S
performed bladder 6.8cmx3.8cm, change in the bladder wall likely
cystotomy site with haematoma formation, no obvious sediment or
stones seen. No free fluid seen on U/SNeed to place urinary catheter today. Atempted to pass foley
catheter but unable to feed into bladder as so flexible and no stylette
or feeding wire. Passed rigid catheter & emptied bladder. Cather
passed quite easily, no evidence of gritty or granular material feels
like more spasmodic obstruction. Couldn't feel any small stones
being dislodged by passing catheter. Approx 30ml of dark
haematuric urine removed from bladder. Distilled & removed sterile
saline into bladder, bladder flushing until urine dilutely haematuric.
Removed rigid cather but still unable to pass flexible foley. Lateral
abdominal radiograph taken, no radiopaque stones visible in bladder
or urethara.
DM - re-placed rigid dog catheter and sutured in place with finger
trap suture to ventral abdominal wall.
From this point things get questionable- The referring vet rang me to say they passed the indwelling and the urine was closing nicely- 2 hours later they rang me and said one of the nurses would take him to the emergency hospital again because it would be safer.. i then called the emergency hospital and they said hunter arrived without and indwelling cath.. i called the Referring vet back to ask about the dog and she assumed i was from the emergency hospital staff and begin to explain they did not have the correct catheter so we used the rigid dog catheter and a long tube with a syringe and you guys would fix it.. Emergency Hospital initial Observations of Hunter(the dog)Penis is very inflamed and painful 6am 11/4/18 32h post op- bladder size on u/s 5cmx4cm (was 4cm x 3cm 4-5h prior) still straining to pee and penis is very inflamed, not passed urine overnight but small bladder still-noticed straining in cage attempted to pass foley catheter-would not pass- passed a buster catheter able to pass but with difficulty- Large amounts of foetid dark brown urine retrieved with chunks of fibrin, no uroliths or obvious christals noted prepared to re pass foley catheter but unable to proceed due to other emergency- then his bloods showed he was becoming AZOTAEMIC- PLAN- Place indwelling catheter to monitor ins and outs -Stop Meloxicam-- Placed 6f 55cm foley catheter(please note RV used 4f catheter for retropulse on day of surgery.)143mls of dark brown seemingly concentrated urine was voided- Mild azotaemia CREA 175 UREA 15.2 Mild hpoproteinaemia and hypoalbuminaemia but don't think significant at this stage as not eaten much post surgery- then he gained 800g in the next 24h in water im guessing.. but the whole time he has been unable to pee.. got fed up as i could see he was deteriorating .. i took him home on the friday following his operation with an indwelling catheter and a bag attached to him and i only gave him his antibiotics and 1/2 diazepam the next day sat his urine output was enough and it was clear of blood ect the next day am sun i woke up and the catheter was in i went to make a coffee and came back and he had removed the catheter .. before i freaked out i took him for a walk and slowly but surely he managed to pee on his own .... I feel in the early post days they destroyed his urethral smooth muscle and urethral bladder junction causing mass inflammation and trauma secondary to multiple catheterisation.. the RV said to me today it seems that i have been unlucky- how is luck even a part of veterinary science, she also said perhaps if the correct foley was used/available in her clinic the outcome may have been different but the owner doesn't like to stock them as they are expensive.. i just want to know were i stand and if anything extremely obvious stands out as being procedural error.. i have all the medical notes and pharmacology.
April 16, 2018
1 Recommendations
From your question, you’ve put the date in dd/mm/yyyy format so I am guessing that you are not in North America but I don’t know which country you are in (things are different from country to country or even region to region); however each country, state or territory has a veterinary licensing board, council or college (i.e: Royal College of Veterinary Surgeons in the UK, Veterinary Council of Ireland etc... not a veterinary school) which should be contacted if you believe that treatment wasn’t given correctly, you were given misinformation or the life of your pet was endangered through negligence. Regards Dr Callum Turner DVM
April 17, 2018
Dr Callum, i am in australia. The only reason i contacted your site is because the knowledge and resources available seemed genuine and i was impressed with your knowledge in particular.. i m trying to establish if there are significant things that were overlooked .. my healthy 3 yo has suffered and his life was significantly compromised i have endured 7 days of hell with a ransom style hospitalisation fee and after 7 days of no peeing and no answers i honestly felt as if i left him there any longer he would not have survived .. taking him home peeing thru a indwelling catheter was daunting trying to monitor his fluids and keep him hydrated was terrifying..Emergency hospitalisation with no end in sight nearly cost me my house.. I am not the first and i will not be the last to endure such hardship after cystotomy .. so im sorry Dr Callum that geographically my situation does not fit the north american profile, and i respect your comments regarding territorial procedural differences .. but my story and experience in Cystotomy are real, all be it in Australia. my dogs life was compromised and in context with forum.. Its ironic that most vets i have encounter practice veterinary science from the perspective that most dogs will be ok, so when a unique case like mine comes along a little greater care and attention is needed in the finer detail, sometimes fundamental principales of are overlooked because statistically most dogs will be ok.. yes "Most" will be ok, that doesnt mean "all" dogs will, and when things spiral out of control they get from bad to worse quicker than you could ever imagine and within the blink of eye your healthy loved one is in stage 2 renal failure ... That was my experience with AUSTRALIAN CYSTOTOMY. thanks for reading. good luck.
April 17, 2018
Hunter's Owner
Also i wanted to thank you for the local authority and regulative body information.. i think there is a fine line sometimes between overpresumtous owners and the reality of what sittuations the vetinarians face and the decisions they need to make.. i think overall in my case the main weakness was demonstrated in the hand over to the overnight/emergency care team.. consider this, your vet performs the operation later in the afternoon around 4 pm .. they close at 8pm but for unkown reasons the dog still cannot urinate.. Enter emegency overnight care and handover.. my question to you Dr. Callum Turner, if this animal was now in your care, all bloods etc were within normal range and you had no obvious reason to suspect physical obstruction, would you asume that any minute this dog is going to pee and place him on IV fluids 5ml/kg/hr and study him over the next 12 hours? i understand there is a strong desire to allow for natural expulsion, at what point past surgery would you say we need to look at indwelling and more permanent style catheterisation?and what difficulties would result in so many failed attemps at indwelling catheter post cystotomy.
April 17, 2018
Hunter's Owner
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Red tick Beagle
Randy
5 Years
0 found this helpful
0 found this helpful
My dog had cystotomy surgery and neutered 7 days ago. Today on the 7th day he started bleeding and passing blood clots. And he leaks urine all the time.( very strong odor) when will he stop bleeding and leaking urine?
April 5, 2018
0 Recommendations
Seven days is still early after surgery, however you should be seeing improvement day by day; if there has been no improvement over the past week you should speak with your Veterinarian and go for a follow up visit to be on the safe side to ensure that everything is healing like it should. Regards Dr Callum Turner DVM
April 5, 2018
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