Cystotomy in Rabbits (Lapis) | Vetlexicon
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Cystotomy

ISSN 2398-2969


Introduction

  • 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

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.

Requirements

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Preparation

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Technique

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  •  Szabo Z & Bradley K (2016) Rabbit soft tissue surgery. Vet Clin North Am Exotic Anim Pract 19 (1), 159-188 PubMed.
  • Brown C (2011) Urolithiasis and cystotomy in the rabbit. Lab anim 40 (3), 73-74 PubMed.
  • Butterweck V & Khan S R (2009) Herbal medicines in the treatment of urolithiasis: alternative or complementary? Planta Med 75 (10), 1095-1103 PubMed.
  • Paul-Murphy J (2007) Critical care of rabbit. Vet Clin North Am Exotic Anim Pract 10 (2), 437-461 PubMed.
  • White R N (2001) Management of calcium ureterolithiasis in a French lop rabbit. JSAP 42 (12), 595-598 PubMed.
  • Leck G (1988) Removing a calculus from the urinary bladder of a rabbit. Vet Med 83 (1), 64-65 VetMedResource.

Other sources of information

  • Quesenberry K E, Orcutt C J, Mans C & Carpenter J W (2021) Ferrets, Rabbits and Rodents Clinical Medicine and Surgery. 4th edn. Elsevier, USA.
  • Harcourt-Brown F & Chitty J (2016) BSAVA Manual of Rabbit surgery, Dentistry and Imaging. BSAVA, UK.
  • Meredith A & Flecknell P (2006) BSAVA Manual of Rabbit Medicine and Surgery. 2nd edn. BSAVA, UK.