Over last month or so, I had done cystotomy- bladder surgery almost once a week to remove bladder stones from cats. A number of cats presented for dysuria, pollakiuria and haematuria etc. These signs are commonly seen with feline lower urinary tract disease (FLUTD). This problem is more common in cold weathers- winter and rainy days. Most of the time, cat owners notice their cats are visiting the litter tray more often and staying in the litter tray for a while without much urination. Sometimes, cats do cry while urinating as they feel pain and discomfort. Occasionally, urine may appear red in colour with blood in it. On examination, some of them have a sensitive bladder which urinates on palpation. If the bladder stones are big enough- they may be palpable through abdominal palpation. Next step of workup would be urinalysis- urine test checking for blood cells, white cells, crystals, pH etc. Imaging includes abdominal radiograph and ultrasonography focusing on the urinary tract system- bladder and kidneys. On radiographs, if there are cystoliths which are radioopaque (radiodense), they show up on plain radiograph. Ultrasonography is also sensitive in detecting small bladder stones in the bladder. If the cat has cystoliths which are removed by opening the bladder up to physically remove the cystoliths. The bladder is exteriorized out of the abdomen and incised open to flush with saline in order to remove cystoliths. Bladder closure is done in 2 layers with 5-0 PDS suture material. The aim of cystotomy is to remove all cystoliths which are causing cystitis (bladder inflammation) and obstruction. After surgery, a post-operative radiograph is taken to ensure all of the cystoliths have been removed. After surgery, animal is kept in the hospital for a few days to monitor for possible surgical complications- peritonitis, recurrence of urinary blockage etc. Peritonitis signs- abdominal pain, fever, abnormal discharge from wound. Once urinary patency is re-established, animal is sent home with oral medications to control infection, inflammation and bladder protection. They are usually returned in 14 days to have the sutures removed from the skin layer. |
