Cystotomy
Your pet has been diagnosed with bladder stones, also known as urolithiasis or cystic calculi. Your pet has
been recommended to undergo surgical removal of their stones, either due to a failed attempt at dissolution,
a type of stone that cannot be dissolved, or physical discomfort requiring more immediate resolution.
Surgical Procedure
The surgery to remove bladder stones is called a cystotomy. To perform a cystotomy, your veterinarian will
make an incision into the belly toward the pelvis. The incision is big enough to find the urinary bladder
(typically 3-5 inches depending on the amount and size of stones). The urinary bladder will then be opened to
remove all stones and be thoroughly flushed out. Once this is done, your veterinarian will sew up the bladder
and belly wall and then take another x-ray to ensure all stones have been removed. Your pet will then recover
from anesthesia.
Urohydropulsion
If your pet has the right type and/or size of stones, your veterinarian may attempt urohydropulsion prior to
surgery. This is a method where your pet is placed under anesthesia and sterile saline is passed into the
urinary bladder using a catheter. Your pet is then held upright by a technician or two, while the veterinarian
squeezes your pet’s bladder to try and push the stones out through the urethra. This method does not always
work, so you and your veterinarian will be prepared to move straight into surgery if there are stones that
cannot be expelled.
Risks
A cystotomy is a relatively simple procedure and most pets do very well. Risks of anesthesia apply to any
surgical procedure (see Anesthesia Information handout).
Bleeding: The main risk of a cystotomy is bleeding after surgery. This often resolves on its own and is minimal
in most patients. If your pet bleeds more than expected, or has any anesthetic complications, your
veterinarian may recommend that they be monitored overnight at PETS Urgent Care.
Incision: Swelling, bruising, infection and dehiscence (opening of stitches) are a possible complication. These
can be minimized by keeping your pet strictly rested and keeping the incision clean during the recovery
period. If your pet allows, you can also ice there incision for 10 minutes twice daily for the first three days
following surgery, then move to warm compressing for 10 minutes twice daily for the remainder of the
recovery period.
Recovery
After surgery, your pet may be groggy from anesthesia for 24-48 hours (see Anesthesia Information handout).
Full recovery can take 2-4 weeks; this includes healing as well as resolution of symptoms, such as straining to
urinate. Your pet will need pain medication to control both the pain and inflammation for at least one week.
Your pet may also require antibiotic medication, depending on previous testing. Your pet will need to be
rested for 2 weeks following the surgery so they don’t damage the surgical sites or break internal stitches.
Urine may be blood-tinged for several days following surgery. This should improve day by day.
Your veterinarian will recommend that the stones be sent for analysis. This will tell them the specific type of
stones your pet had and what future prevention methods may be needed. These results typically take a few
weeks to return. If a special diet is recommended, it is VITAL that this is the ONLY food fed to your pet. Getting
your pet to drink water as much as possible to help dilute the urine to further decrease chances of bladder
stone formation.
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