At Coastal Creek Animal Hospital, we understand that discovering your pet has bladder stones can be concerning. These mineral formations in your pet’s urinary system can cause significant discomfort and health issues if left untreated. When medication and dietary changes aren’t enough, a surgical procedure called cystotomy may be necessary. This article explains what cystotomy is, when it’s needed, and what you can expect during your pet’s treatment journey.
What Are Bladder Stones?
Bladder stones, also known as uroliths or urinary calculi in veterinary medicine, are hard mineral deposits that form in the bladder. These stones can vary in size from tiny crystals to larger formations that may occupy significant space within the bladder. They develop when minerals in the urine become concentrated and crystallize, often due to factors such as urinary tract infections, imbalanced urine pH, certain dietary factors, low water intake, or underlying medical conditions. In rare cases, some medications or genetic predispositions can contribute to stone formation.
Common signs of bladder stones include blood in the urine (hematuria), frequent urination, straining to urinate, and signs of discomfort or pain during urination. However, some pets may not show obvious symptoms, and stones may be discovered incidentally during routine exams. If your pet is unable to urinate, this is a medical emergency and requires immediate veterinary attention.
Diagnosing Bladder Stones
To diagnose bladder stones, your veterinarian will start with a thorough physical examination. Diagnostic tests may include urinalysis to look for bacteria, crystals, or other abnormalities; radiographs (X-rays) to visualize certain types of stones; and ultrasound to provide detailed images of the urinary tract. It’s important to note that not all bladder stones are visible on standard X-rays types such as urate or cystine stones may require ultrasound or special imaging techniques to detect.
Blood tests may also be recommended to assess your pet’s overall health and kidney function. In select cases, advanced diagnostic procedures such as a retrograde urethrogram (a specialized X-ray using contrast material to highlight the urethra) or fluoroscopy (real-time moving X-ray imaging) may be used, especially if a urinary obstruction is suspected or if standard imaging does not provide sufficient information.
Your veterinarian will tailor the diagnostic approach to your pet’s specific situation to ensure the most accurate diagnosis and appropriate treatment plan.
When Is Cystotomy Necessary?
While some small bladder stones-such as certain types of struvite stones-may pass naturally through the urethra or dissolve with a specially formulated diet, many other types of stones (such as calcium oxalate or urate stones) cannot be dissolved and typically require surgical removal.
A cystotomy, which is a surgical procedure to open the bladder and remove stones, is generally recommended when the stones are too large to pass naturally, are unlikely to dissolve with medical management, are causing a urinary blockage (which is a life-threatening emergency), or when conservative treatments have not been successful.
Cystotomy may also be indicated if the stones are causing significant pain, recurrent urinary tract infections, or inflammation that does not respond to other treatments. In some cases, this procedure is performed to prevent injury to the urinary tract or to address other bladder conditions, such as tumors or polyps.
If your pet is unable to urinate or is showing signs of severe discomfort, seek immediate veterinary attention, as these can be signs of a urinary obstruction that requires urgent intervention.
The Cystotomy Procedure: What to Expect
Pre-Surgical Preparation
Before surgery, your pet will undergo a thorough pre-anesthetic evaluation to ensure they are healthy enough for general anesthesia. This typically includes blood tests to check organ function, a physical assessment of heart and lung health, review of any current medications, and fasting instructions for the night before surgery. Additional diagnostics, such as urinalysis and imaging (like X-rays or ultrasound), may also be performed to assess the urinary tract and plan the procedure.
The Surgical Procedure
During a cystotomy, your pet is placed under general anesthesia to ensure they feel no pain throughout the procedure. The veterinary surgeon makes a surgical incision in the abdomen to access the bladder, then carefully opens the bladder to remove the stones. The bladder tissue is examined for signs of disease or inflammation, and the surgeon may also check the ureters and urethra for additional stones.
A urinary catheter is often placed to help flush the urinary tract and ensure no small stones remain. The bladder is then closed with absorbable suture material appropriate for urinary tissue, and the abdominal incision is closed in layers to protect surrounding tissues, nerves, and blood vessels.
The removed stones are typically sent for laboratory analysis to determine their mineral composition, which helps guide future prevention and treatment.
While minimally invasive procedures such as cystoscopy or laser lithotripsy are available in some specialty veterinary centers-primarily for select cases and larger patients-traditional open cystotomy remains the standard surgical approach for most pets. This is due to the anatomical differences and size of the urinary tract in animals, which can make minimally invasive techniques less feasible in many cases.
Recovery After Cystotomy
Post-surgical care is essential for a successful recovery after cystotomy. In the immediate post-operative period, your pet will be closely monitored as they wake from anesthesia. Pain medication will be administered to ensure comfort, and your veterinarian will watch for complications such as redness, swelling, discharge, or discomfort at the surgical site, as well as any difficulty urinating. Water is typically available as soon as your pet is fully awake, unless your veterinarian provides different instructions.
At home, your veterinarian may prescribe antibiotics if there is evidence of infection or a high risk of infection, but antibiotics are not always necessary for every case. Strict activity restriction is important while the surgical wound heals usually means no running, jumping, or playing for at least 10-14 days. Your veterinarian may recommend using an Elizabethan collar (cone) to prevent licking or chewing at the incision.
A special diet may be recommended depending on the type of stones removed, but dietary changes should only be made under your veterinarian’s guidance and after stone analysis. Monitoring your pet’s urination habits is very important. Some blood in the urine and increased frequency of urination are common for a few days after surgery, but if your pet is unable to urinate or appears to be in significant distress, contact your veterinarian immediately.
Your veterinarian will schedule follow-up exams to assess healing, remove any skin sutures or staples if non-absorbable materials were used, verify the urinary system is functioning normally, and check for any signs of stone recurrence. Urinalysis may be performed to monitor for bacteria, crystals, or other abnormalities.
Preventing Future Bladder Stones
Prevention strategies are based on the type of stones identified through laboratory analysis. Dietary changes may be recommended to help prevent recurrence, and ensuring your pet has access to fresh water at all times is essential to help dilute the urine and reduce the risk of crystal formation. Regular urinalysis can help monitor urine pH and detect early signs of crystal formation or infection, allowing for prompt intervention if needed.
Prompt treatment of any urinary tract infections is important to reduce the risk of future stone development. In some cases, your veterinarian may prescribe medications to alter urine chemistry or address underlying health conditions that contribute to stone formation. Regular veterinary checkups are key to monitoring your pet’s urinary health and catching any early signs of stone recurrence.
When to Seek Care for Urinary Issues
If your pet shows signs of urinary problems, such as straining to urinate, passing small amounts frequently, or blood in the urine, don’t wait to seek veterinary care. Early intervention can sometimes prevent the need for surgery.
For pets with a history of bladder stones, regular preventive care appointments are especially important for monitoring their urinary health. Your veterinarian may recommend periodic ultrasound or X-ray evaluations to check for early stone formation, even if symptoms aren’t present.
Modern approaches to bladder stone management incorporate comprehensive care that extends beyond just the surgical removal of stones. This may include nutritional counseling, stress reduction techniques, and long-term monitoring plans tailored to your pet’s specific risk factors.
If you have concerns about your pet’s urinary health or suspect bladder stones might be causing problems, contact Coastal Creek Animal Hospital to schedule an exam. Our team is committed to providing compassionate care using the latest advances in veterinary medicine to keep your pet comfortable and healthy.
Related Soft Tissue Surgery Topics
Curious about other advanced procedures we perform beyond Cystotomy for Bladder Stone Removal? Visit our Soft Tissue Surgery Services in Summerville, SC to learn how Dr. Mack and our team handle everything from mass removals to emergency abdominal surgery—safely and compassionately.
Continue learning with our next article: Understanding Splenectomy in Dogs and Cats — a must-read if you’re concerned about unusual growths in your pet’s abdomen.
Frequently Asked Questions about Cystotomy for Bladder Stone Removal
How do I know if my pet has bladder stones?
Your pet may have bladder stones if they show symptoms such as frequent urination, straining to urinate, blood in the urine (hematuria), urinary accidents in house-trained pets, or signs of pain during urination. Some pets may lick their urinary opening excessively or show abdominal discomfort. However, not all bladder stones cause obvious symptoms, so regular veterinary exams are important. While large stones can occasionally be felt during a physical exam, most bladder stones require diagnostic imaging, such as X-rays or ultrasound, for confirmation. Your veterinarian may also recommend a urinalysis to check for crystals, bacteria, and inflammation in the urine. If your pet shows any signs of urinary distress, prompt veterinary evaluation is crucial, as bladder stones can lead to serious conditions like complete urinary obstruction.
What happens during a cystotomy procedure?
A cystotomy is a surgical procedure performed under general anesthesia to remove bladder stones. The surgeon makes an incision in the abdomen to access the bladder and then carefully opens the bladder wall to remove the stones. The entire urinary tract, including the urethra and ureters, is examined for additional stones. In some cases, a urinary catheter may be placed to help flush the lower urinary tract. After stone removal, the bladder is sutured closed with absorbable materials suitable for urinary tissue, and the abdominal incision is closed in layers. The removed stones are typically sent to a laboratory for analysis to determine their mineral composition. The procedure usually takes about 45-90 minutes, depending on the complexity and number of stones.
What is the recovery process after a cystotomy for bladder stone removal?
Recovery after a cystotomy involves several stages. Immediately after surgery, your pet will be monitored as they recover from anesthesia and receive pain medication for comfort. Intravenous fluids may be given to support kidney function and help flush the urinary system. Most pets stay in the hospital for 24-48 hours for observation. At home, recovery typically takes 10-14 days, during which your pet will need restricted activity to allow the surgical incision to heal. Antibiotics may be prescribed if an infection is present or suspected, but they are not always necessary. Your veterinarian may recommend a special diet to prevent stone recurrence, based on the mineral analysis of the removed stones. Some blood in the urine and increased frequency of urination are common for a few days after surgery. Follow-up appointments are important to ensure proper healing and to monitor for any signs of recurrence.
What are the risks associated with cystotomy surgery?
Like all surgical procedures, cystotomy carries certain risks. These include risks associated with general anesthesia, which vary based on your pet’s age, overall health, and any pre-existing conditions. Specific risks of cystotomy include urinary tract infection, wound infection at the surgical site, temporary or (rarely) permanent urinary incontinence, bladder wall inflammation, or leakage at the bladder incision site (rare but serious). There is also a risk of stone recurrence if underlying causes are not addressed. Your veterinary surgeon will take precautions to minimize these risks, including careful tissue handling, appropriate use of antibiotics when indicated, and thorough pre-surgical evaluation. Cystotomy is generally considered a safe procedure with a high success rate when performed by an experienced veterinary surgeon.
Can bladder stones come back after surgery?
Yes, bladder stones can recur after cystotomy if the underlying causes are not addressed. Recurrence rates vary depending on the type of stone, with some types having recurrence rates as high as 30-50% within a year if preventive measures are not taken. After surgery, your veterinarian will recommend a prevention plan based on the analysis of the removed stones. This may include dietary modifications specific to the stone type, increased water consumption, medications to alter urine chemistry if needed, and prompt treatment of any urinary tract infections. Regular monitoring through exams, urinalysis, and occasional imaging is important for early detection of new stones or crystals. With proper management and follow-up care, many pets can avoid recurrence and the need for additional surgery.
How long does a cystotomy procedure take, and will my pet be in pain afterward?
A typical cystotomy procedure takes approximately 45-90 minutes, depending on the number and size of stones and the complexity of the case. During surgery, your pet is under general anesthesia and will not feel pain. After surgery, pain medication is administered before your pet wakes up, and you will receive instructions for continued pain management at home. Most pets experience mild to moderate discomfort for a few days after surgery, which is usually well-controlled with prescribed medication. Signs of discomfort may include decreased appetite or reluctance to move. It is important to follow your veterinarian’s instructions for pain management and to contact them if your pet seems unusually uncomfortable or if pain persists beyond the expected recovery period.
Are there alternatives to cystotomy for treating bladder stones?
Yes, there are alternatives to cystotomy in certain cases. For some types of stones, dissolution therapy using specialized prescription diets may be effective, but this approach is only suitable for specific stone types and requires strict adherence to the diet. Urohydropropulsion is a non-surgical technique where a veterinarian uses a catheter to flush small stones out through the urethra while the pet is sedated; this is only possible with very small stones. In some specialty veterinary centers, minimally invasive procedures such as percutaneous cystolithotomy or laser lithotripsy using cystoscopy may be available. These advanced techniques are not suitable for all pets or all stone types and may not be widely accessible. For most pets, especially those with larger or multiple stones, traditional cystotomy remains the most reliable and complete method for stone removal and evaluation of the urinary tract.
