• 1. Appel S, Otto SJ, Weese JS. Cystotomy practices and complications among general small animal practitioners in Ontario, Canada. Can Vet J 2012;53:303310.

    • Search Google Scholar
    • Export Citation
  • 2. Cornell KK. Cystotomy, partial cystectomy, and tube cystotomy. Clin Tech Small Anim Pract 2000;15:1116.

  • 3. McLoughlin MA. Complications of lower urinary tract surgery in small animals. Vet Clin North Am Small Anim Pract 2011;41: 889913.

  • 4. Thieman-Mankin KM, Ellison GW, Jeyapaul CJ, et al. Comparison of short-term complication rates between dogs and cats undergoing appositional single-layer or inverting double-layer cystotomy closure: 144 cases (1993–2010). J Am Vet Med Assoc 2012;240:6568.

    • Search Google Scholar
    • Export Citation
  • 5. Grant DC, Harper TAM, Werre SR. Frequency of incomplete urolith removal, complications, and diagnostic imaging following cystotomy for removal of uroliths from the lower urinary tract in dogs: 128 cases (1994–2006). J Am Vet Med Assoc 2010;236:763766.

    • Search Google Scholar
    • Export Citation
  • 6. Lipscomb VJ. Bladder. In: Tobias KM, Johnston SA, eds. Veterinary surgery: small animal. Vol 2. St Louis: Saunders-Elsevier, 2012;19781992.

    • Search Google Scholar
    • Export Citation
  • 7. Léveillé R. Ultrasonography of urinary bladder disorders. Vet Clin North Am Small Anim Pract 1998;28:799821.

  • 8. Sutherland-Smith J, Penninck DG. Bladder and urethra. In: Penninck DG, d'Anjou MA, eds. Atlas of small animal ultrasonography. Ames, Iowa: Wiley-Blackwell, 2015;363385.

    • Search Google Scholar
    • Export Citation
  • 9. Widmer WR, Biller DS, Adams LG. Ultrasonography of the urinary tract in small animals. J Am Vet Med Assoc 2004;225:4654.

  • 10. Crowe DT. Ventral versus dorsal cystotomy: an experimental investigation. J Am Anim Hosp Assoc 1986;22:382386.

  • 11. Hildreth BE, Ellison GW, Roberts JF, et al. Biomechanical and histologic comparison of single-layer continuous Cushing and simple continuous appositional cystotomy closure by use of poliglecaprone 25 in rats with experimentally induced inflammation of the urinary bladder. Am J Vet Res 2006;67:686692.

    • Search Google Scholar
    • Export Citation
  • 12. Radasch RM, Merkley DF, Wilson JW, et al. Cystotomy closure: a comparison of the strength of appositional and inverting suture patterns. Vet Surg 1990;19:283288.

    • Search Google Scholar
    • Export Citation
  • 13. Buote NJ, Kovak-McClaran JR, Loar AS, et al. The effect of preoperative antimicrobial administration on culture results in dogs undergoing cystotomy. J Am Vet Med Assoc 2012;241:11851189.

    • Search Google Scholar
    • Export Citation
  • 14. Hamaide AJ, Martinez SA, Hauptman J, et al. Prospective comparison of four sampling methods (cystocentesis, bladder mucosal swab, bladder mucosal biopsy, and urolith culture) to identify urinary tract infections in dogs with urolithiasis. J Am Anim Hosp Assoc 1998;34:423430.

    • Search Google Scholar
    • Export Citation
  • 15. Geisse AL, Lowry JE, Schaeffer DJ, et al. Sonographic evaluation of urinary bladder wall thickness in normal dogs. Vet Radiol Ultrasound 1997;38:132137.

    • Search Google Scholar
    • Export Citation
  • 16. Kojima M, Inui E, Ochiai A, et al. Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: a preliminary report. Urology 1996;47:942947.

    • Search Google Scholar
    • Export Citation
  • 17. Kuzmić AC, Brkljacić B, Ivanković D. Sonographic measurement of detrusor muscle thickness in healthy children. Pediatr Nephrol 2001;16:11221125.

    • Search Google Scholar
    • Export Citation
  • 18. Müller L, Jacobsson B, Mårild S, et al. Detrusor thickness in healthy children assessed by a standardized ultrasound method. J Urol 2001;166:23642367.

    • Search Google Scholar
    • Export Citation
  • 19. Oelke M. International consultation on incontinence-research society (ICI-RS) report on non-invasive urodynamics: the need of standardization of ultrasound bladder and detrusor wall thickness measurements to quantify bladder wall hypertrophy. Neurourol Urodyn 2010;29:634639.

    • Search Google Scholar
    • Export Citation
  • 20. Hastings JC, Van Winkle W, Barker E, et al. The effect of suture materials on healing wounds of the bladder. Surg Gynecol Obstet 1975;140:933937.

    • Search Google Scholar
    • Export Citation
  • 21. Rasmussen F. Healing of the urinary bladder wounds. Morphologic and biochemical studies. Proc Soc Exp Biol Med 1966;123:470475.

  • 22. Degner DA, Walshaw R. Healing response of the lower urinary tract. Vet Clin North Am Small Anim Pract 1996;26:197206.

  • 23. Bellah JR. Wound healing in the urinary tract. Semin Vet Med Surg (Small Anim) 1989;4:294303.

  • 24. Dinesh D, Behl SM, Singh P, et al. Diagnosis of urinary bladder diseases in dogs by using two-dimensional and three-dimensional ultrasonography. Vet World 2015;8:819822.

    • Search Google Scholar
    • Export Citation
  • 25. Kundu P, Ghosh D. Ultrasonographic study of urinary bladder diseases in dogs. Indian J Vet Surg 2006;27:3334.

  • 26. Mahaffey MB, Barber DL, Barsanti JA, et al. Simultaneous double-contrast cystography and cystometry in dogs. Vet Radiol Ultrasound 1984;25:254259.

    • Search Google Scholar
    • Export Citation
  • 27. Mahaffey MB, Barsanti JA, Crowell WA, et al. Cystography: effect of technique on diagnosis of cystitis in dogs. Vet Radiol Ultrasound 1989;30:261267.

    • Search Google Scholar
    • Export Citation
  • 28. Martinez I, Mattoon JS, Eaton KA, et al. Polypoid cystitis in 17 dogs (1978–2001). J Vet Intern Med 2003;17:499509.

  • 29. Takiguchi M, Inaba M. Diagnostic ultrasound of polypoid cystitis in dogs. J Vet Med Sci 2005;67:5761.

  • 30. Allen HS, Swecker WS, Becvarova I, et al. Associations of diet and breed with recurrence of calcium oxalate cystic calculi in dogs. J Am Vet Med Assoc 2015;246:10981103.

    • Search Google Scholar
    • Export Citation
  • 31. Appel SL, Lefebvre SL, Houston DM, et al. Evaluation of risk factors associated with suture-nidus cystoliths in dogs and cats: 176 cases (1999–2006). J Am Vet Med Assoc 2008;233:18891895.

    • Search Google Scholar
    • Export Citation
  • 32. Brown NO, Parks JL, Greene RW. Recurrence of canine urolithiasis. J Am Vet Med Assoc 1977;170:419422.

  • 33. Clark WT. The distribution of canine urinary calculi and their recurrence following treatment. J Small Anim Pract 1974;15:437444.

    • Search Google Scholar
    • Export Citation
  • 34. Julian TD, Ravitch MM. Closure of the urinary bladder with stainless steel and absorbable staples. Ann Surg 1986;204:186192.

  • 35. Koehler LA, Osborne CA, Beuttner MT, et al. Canine uroliths: frequently asked questions and their answers. Vet Clin North Am Small Anim Pract 2009;39:161181.

    • Search Google Scholar
    • Export Citation
  • 36. Osborne CA. Improving management of urolithiasis: canine struvite uroliths. April 1, 2004. Available at: veterinarynews.dvm360.com/improving-management-urolithiasis-canine-struvite-uroliths. Accessed May 30, 2016.

    • Search Google Scholar
    • Export Citation
  • 37. Case GD, Glenn JF, Postlethwait RW. Comparison of absorbable sutures in the urinary bladder. Urology 1976;7:165168.

  • 38. Greenberg CB, Davidson EB, Bellmer DD, et al. Evaluation of the tensile strengths of four monofilament absorbable suture materials after immersion in canine urine with or without bacteria. Am J Vet Res 2004;65:847853.

    • Search Google Scholar
    • Export Citation
  • 39. Schiller TD, Stone EA, Gupta BS. In vitro loss of tensile strength and elasticity of five absorbable suture materials in sterile and infected canine urine. Vet Surg 1993;22:208212.

    • Search Google Scholar
    • Export Citation
  • 40. Bezwada RS, Jamiolkowski DD, Lee IY, et al. Monocryl suture, a new ultra-pliable absorbable monofilament suture. Biomaterials 1995;16:11411148.

    • Search Google Scholar
    • Export Citation
  • 41. Nary Filho H, Matsumoto MA, Batista AC, et al. Comparative study of tissue response to poliglecaprone 25, polyglactin 910 and polytetrafluorethylene suture materials in rats. Braz Dent J 2002;13:8691.

    • Search Google Scholar
    • Export Citation
  • 42. Molea G, Schonauer G, Bifulco G, et al. Comparative study on biocompatibility and absorption times of three absorbable monofilament suture materials (polydioxanone, poliglecaprone 25, glycomer 631). Br J Plast Surg 2000;53:137141.

    • Search Google Scholar
    • Export Citation

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Ultrasonographic evaluation of the canine urinary bladder following cystotomy for treatment of urolithiasis

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  • 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 2 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 3 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 4 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Abstract

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis.

DESIGN Prospective, longitudinal study.

ANIMALS 18 client-owned dogs.

PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening.

RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery).

CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

Abstract

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis.

DESIGN Prospective, longitudinal study.

ANIMALS 18 client-owned dogs.

PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening.

RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery).

CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

Contributor Notes

Address correspondence to Dr. Penninck (dominique.penninck@tufts.edu).