VSR 421: Regional Veterinary Surgery (2+1)

ANESTHESIA AND PROCEDURE

• Correct the fluid and electrolyte imbalances because of chances of hyperkalemia associated with urinary obstruction
• Withdrawal of food and water 12-24 hours before surgery.  

Anesthesia

• Premedication
• Hydromorphone – 0.1-0.2 mg/kg SC or IM
• Butorphenol – 0.2-0.4 mg/kg SC or IM
• Buprenorphine –5-15 microgm/kg IM
• Induction
• Thiopental -10-12 mg/kg IV
• Propofol –4-6 mg/kg IV
• Maintenance
• Isoflurane or sevoflurane

Procedure

• Place the animal in dorsal recumbency.
• Prepare ventral abdominal region and vulvar area in female for aseptic surgery.
• Incise skin and subcutis on the ventral midline.
• In male incise skin and subcutis parallel and adjacent to prepuce.
• Identify and ligate preputial branches of caudal superficial epigastric artery in the subcutis.
• Incise linea alba from umbilicus to pubis and para preputial approach in male dogs.
• Identify bladder and isolate it by moistened laparotomy sponges.
• Place stay sutures on the bladder apex to facilitate manipulation.
• Make incision on the dorsal or ventral aspect of bladder away from ureters , urethra and between major blood vessels. and remove the calculus with a forceps

Bladder exteriorization from the abdomen	Placement of incision on the bladder	Calculi from the bladder

• Remove urine by suction or intraoperative cystocentesis before cystotomy.
• Examine bladder and mucosa for defects.
• Pass a catheter down the urethra to check for patency.
• Close the UB in a single layer using continuous suture pattern.
• If two layer closure, suture the seromuscular layer by two continuous inverting suture lines (cushings followed by lembert).

Cystotomy in a female dog showing
single calculus removal