Cystotomy in Dogs

What Is Cystotomy in Dogs?

If your veterinarian has diagnosed your dog with bladder stones, they may recommend a surgical procedure called a cystotomy. A cystotomy in dogs involves a vet cutting into your pup’s urinary bladder to remove the stones, which are clumps of minerals.

Bladder stones can be caused by a urinary tract infection, a genetic or acquired issue where your dog does not process higher levels of certain minerals, internal diseases such as diabetes and Cushing's disease, or other causes. Bladder stones can range in size. They may be tiny, like fine grit or grains of sand, or large, like pebbles.

Bladder stones in dogs can cause:

• Pain

• Severe inflammation and swelling

• Infection

• Difficulty urinating

• Urinary blockage

A cystotomy is one of the most common surgeries done in dogs. It’s needed if the stones cannot be fully dissolved by using a prescription urinary diet and antibiotics.

Anatomy of Dog Bladders

The bladder is a small sac in the lower part of the belly that stores urine. From the kidneys, urine flows into the bladder and exits the body through a small tube, the urethra.

Why Would a Dog Need a Cystotomy?

Some bladder stones can be dissolved using prescription urinary diet and antibiotics, but it can take up to several weeks. A cystotomy in dogs may be needed if:

• Your dog needs this lifesaving procedure because they are unable to urinate or have difficulty urinating (both emergency situations) because of the stones blocking the bladder or urethra.

• Attempts to dissolve the stones with a prescription diet and antibiotics didn’t work.

Risks of Cystotomy in Dogs

The thought of surgery for your dog may cause you anxiety. Your veterinarian has your dog’s best interest at heart, and they will  address any of your concerns. Cystotomy in dogs has a low risk of complications,especially when your dog is given the proper rest to heal and their stitches are protected in the recovery period.

The most common complication is recurrence of stones, which occurs roughly 40% of the time. Your veterinarian will submit the stones for analysis to help determine the type and how best to prevent them in the future. It is very important to follow their post-op instructions, such as if a diet change is needed for life to prevent stones from reoccurring.

Other possible complications include urinary tract infection, urine leaking from the bladder incision (uroabdomen), damage to the urinary tract, bleeding, incision infection, and anesthetic complications (allergic reaction to anesthesia or rarely, anesthetic-related death).

If a dog is of advanced age and/or has one or more of the following medical conditions, they have a higher risk of complications from anesthesia and surgery:

• Obesity

• Diabetes

• Kidney disease

• Heart disease

• Liver disease

• Adrenal gland disease (Cushing’s)

Benefits of Cystotomy in Dogs

Cystostomy in dogs is considered a safe, effective, and fast solution to remove bladder stones. Removing them allows your dog’s bladder to fully heal and for your dog to feel much better and be healthier.

Cost of Cystotomy in Dogs

The average cost of a cystotomy in dogs is $1,500 to $3,500. The cost for a cystotomy in your dog can vary depending on where you live, your veterinary hospital, and your dog’s health history and medical needs.

Most pet insurance policies cover unexpected surgery including cystotomy, but it’s important to understand that insurance plans can range considerably in coverage.

Preparation for Cystotomy in Dogs

The best way to prepare for cystotomy in dogs is to schedule a presurgical evaluation with your veterinarian.

Your vet will review your dog’s full medical history, make sure that your dog is up to date on vaccinations, do a full physical exam, and screen for any underlying health issues. This pre-anesthetic screening may involve blood work, urinalysis, and X-rays.

So what do you need to do to get ready for your dog’s cystotomy?

• Put a probiotic supplement (FortiFlora®, Proviable®) on your dog’s food to help ease digestion with any diet changes or medications.

• Slowly start transitioning your dog to the diet your veterinarian recommends.

• Get pet stairs or pet steps for safer and easier access to your dog’s favorite places.

• Make sure you have comfy dog beds.

• Get a water fountain to encourage your dog to drink more.

• Put an immune system support supplement (Imuquin®) on your dog’s food.

• Have short, fun training sessions to help your dog get accustomed to wearing a soft body suit or onesie to protect their incision (surgical cut).

Follow your veterinarian’s specific pre-surgery instructions about your dog’s medications, feeding, and exactly what time to withhold your dog’s food and water before their procedure.

On the day of surgery, the veterinary team will prepare your dog for the cystotomy.

The dog is placed under general anesthesia, where they are immobilized, breathing anesthetic gas and oxygen through a breathing tube while they are asleep.

The fur on the abdomen is shaved and prepped (cleaned) for sterile surgery.  The surgical team watches the dog’s vital signs to make sure they are stable and doing well under anesthesia.

The stones your veterinarian removes are sent to a laboratory for analysis to find out the exact mineral type. Depending on the results of stone analysis, your veterinarian will recommend a specific treatment plan and diet for your dog.

Post-Op Care and Recovery for Cystotomy in Dogs

Most dogs can go home the same day as their cystotomy, but some may stay overnight. They will be discharged when they are eating and able to urinate, but it will typically take two to three weeks to fully recover.

When you pick up your dog from the hospital, carefully review your veterinarian’s detailed discharge instructions, and discuss any questions and concerns you have about what to expect during your dog’s recovery.

There are several ways to help your furry companion recover from their cystotomy. They include:

• Providing a safe, comfortable space for your dog to rest and recover.

• Limiting your dog’s activity for the first two or more weeks after cystotomy. Your dog may be taken outside on a leash several times a day for bathroom purposes only. Running, jumping, and playing can cause the stitches to open on the inside and outside layers, putting your dog at risk of life-threatening complications.

• Using pet stairs and pet steps to prevent your dog from jumping up to their favorite places.

• Making their doggie bed easily accessible on the floor.

• Using Pill Pockets™ to make it easy and fun to give prescribed medications—such as pain relievers and antibiotics—to your dog.

• Protecting your dog’s stitches by having them wear a Comfy Cone™ and consider a soft body suit. Checking the area around the stitches daily for redness, swelling, or discharge.

• Watching your dog’s appetite, drinking, urination, and bowel movements. It’s common for your dog’s urine to be a little bloody for the first week or two after a cystotomy.

• Encouraging your dog to drink more water by providing a water fountain. This helps your dog stay well hydrated and creates more dilute (watery) urine to prevent stones from recurring.

• Only feeding the diet your veterinarian recommends. To prevent excess minerals forming new stones in your dog’s urine, your veterinarian will make a specific prescription urinary diet recommendation, such as Hill’s® c/d, Royal Canin® Urinary SO, Purina® Pro Plan® UR, or Hill’s® u/d.

• Transitioning your dog’s diet to canned (wet) food. A canned diet provides more water intake to create watery urine and prevent clumping of minerals in your dog’s urine.

Depending on the stone analysis results, your vet may do diagnostic testing to further investigate the underlying medical cause of your dog’s bladder stones. Your vet may also want to recheck tests to see how well treatment is working for your dog.

If you have any concerns about your dog’s symptoms during recovery or any questions about how their surgical incision looks, contact your veterinarian immediately.

Alternatives to Cystotomy in Dogs

Bladder stones must be dissolved, flushed out, or surgically removed. Instead of surgery, your veterinarian may recommend trying to dissolve your dog’s bladder stones by using a prescription urinary diet and antibiotics.

These therapeutic diets are made with a special recipe to dissolve stones and prevent the formation of crystals and stones mostly by regulating urinary pH, added antioxidants and omega fatty acids, and containing lower levels of minerals.

Dissolving bladder stones with diet does not always work. Some stones are too large or made of a certain mineral type that can’t be dissolved; these always need surgical removal.

Cystotomy in dogs is the fastest solution if your pup has a complete bladder blockage due to large stones or if your dog’s stones cannot be successfully dissolved by a prescription diet.