Practical Matters: Radiography helps confirm complete radiopaque calculi removal

Cystotomy is commonly performed in small-animal practice to remove cystic calculi that cannot be treated medically or with other nonsurgical extraction techniques (urohydropropulsion, catheter or basket removal). Unfortunately, if numerous smaller calculi are present in the bladder and urethra, particularly in male dogs, the risk of leaving calculi after cystotomy can be as high as 15% to 20%.1

Daniel D. Smeak, DVM, DACVS

Residual calculi may be responsible for acute urethral obstruction and can cause a poor response to antibiotic therapy for bladder infections after surgery. In addition, incomplete calculi evacuation may be misinterpreted as a failure of the medical therapy to prevent stone recurrence after surgery and may unnecessarily alter future diagnostic test and treatment plans.

When calculi have been removed completely yet the condition recurs early after surgery, owners may blame the surgeon for incomplete removal. Thus, to verify complete calculi removal and reduce these concerns, take orthogonal radiographs after cystotomy.

Daniel D. Smeak, DVM, DACVS

James L. Voss Veterinary Teaching Hospital

College of Veterinary Medicine and Biomedical Sciences

Colorado State University

Fort Collins, CO 80523

REFERENCE

1. Lulich JP, Osborne CA, Felice LD, et al. Managing calcium oxalate urolithiasis, in Proceedings. 11th Annu Meet Am Coll Vet Intern Med 1993;374-377.