• To allow removal of uroliths.
• To allow complete flushing of bladder and removal of 'sand' if bladder catheterization and retrograde flushing is unsuccessful.
• To allow direct visualization of the bladder.
• To allow biopsies to be taken from the bladder.

Uses

• In the treatment or management of calcium carbonate crystalluria, urolithiasis Urolithiasis, urine scald Moist dermatitis, neoplasia, bladder rupture, and investigation of refractory cystitis.
• Urinalysis Urinalysis: dipstick analysis (including urine culture Urinalysis: culture and sensitivity), plain radiography Radiography: abdomen, contrast cystography, ultrasonography of the bladder Bladder: ultrasonographic examination and kidneys and an evaluation of renal function are recommended as part of the pre-operative evaluation of the patient.

Print-off the Owner Factsheet Caring for your rabbit before and after surgery to give to your clients.

Advantages

• Treatment or management of the main problem.

Disadvantages

• Anesthetic and surgical risks.
• The surgery may not be diagnostic.
• The surgery may not resolve the problem.
• The owner should be warned about the possibility of recurrence of urolithiasis Urolithiasis and bladder 'sand'.
• The radiographic finding of 'sand' in the urinary bladder can be an incidental finding in clinically healthy rabbits, whilst being associated with urine scald in others. This radiographic finding is not therefore pathognomic and should be evaluated in conjunction with other clinical findings.
• The urinary bladder may rupture when grossly distended or handled roughly during surgery.
• Associated structures, including the ureters, may be damaged during surgery.
• If incising into a flaccid bladder, there is a risk that both the ventral and dorsal walls will be cut.

Alternative techniques

• The 'sand' (usually calcium carbonate crystals) can be removed by flushing the bladder with warm saline via a urethral catheter.
• Supportive treatment should seek to reduce the calcium in the diet and promote diuresis (urine output).
• If these techniques are not successful, cystotomy to lavage the bladder is indicated.
• Cystectomy to remove tumors or traumatic injuries of the bladder wall.

Time required

Procedure

• 20-60 min depending upon reasons for performing cystotomy.

Decision taking

Risk assessment

• Ensure rabbit hydrated prior to surgery.
• IV fluids are recommended during surgery.
• Risk of bladder rupture if distended and handled roughly; care therefore required on entering the abdomen and when handling the bladder.