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Cystoscopy

Cystoscopy

Cystoscopy is a diagnostic tool (scope) that allows us, in real time, to visualize what is going on inside the urinary bladder and urethra of both dogs and cats.

by  Amy Eberle, DVM
Animal Specialty Group


A tour of the lower urinary tract

When we start to see lower urinary problems or incontinence in our dogs and cats, there are many diagnostic tests that can be run to determine the primary problem. Cystoscopy is often recommended after other diagnostic tests such as abdominal x-rays, abdominal ultrasound, have been performed to evaluate anatomy and structure of the lower urinary tract.

Common reasons for recommending cystoscopy

  • Diagnose the cause of urinary tract signs such as hematuria (bloody urine), urinary incontinence, urinary retention, and persistent or recurrent urinary tract infections.
  • Obtain bladder wall or mass biopsies for cytologic and histologic evaluation.
  • Removal of bladder polyps or stones
  • Correct ectopic ureters

Pre-anesthetic work-up

Cystoscopy requires general anesthesia, so before any pet is placed under general anesthesia blood work and often chest x-rays are run to ensure they are good anesthetic candidates.

Dogs and cats are fasted ~12hours prior to the procedure to decrease the risk of aspirating into the lungs while under general anesthesia.

After placed under general anesthesia, the dog or cat is placed on their side in preparation for cystoscopy.

Procedure (Diagnostic and therapeutic)

While the patient is anesthetized a small rigid scope (camera) is placed through the urethra to obtain good visualization of the bladder, urethra and ureteral (a tubular structure connecting the kidneys and bladder) insertions. The urethral and bladder surface is closely examined for abnormalities including inflammation, stones, and masses.

When the scope reaches the bladder, the bladder is filled with saline to improve visualization of the bladder wall. A video recording documents any abnormalities during the procedure. If bladder stones are found, the stones can be removed using grasping forceps, a snare or a basket retrieval device. Also, biopsy samples may be collected from the bladder wall or any tumors detected.

A helpful diagnostic tool during cystoscopy is taking biopsies of various tissues in order to receive a definitive diagnosis. If small bladder stones are present, they can be removed at the time of cystoscopy and sent out to characterize what the stones are made up so an appropriate therapeutic plan can be recommended.

The procedure usually takes ~30 minutes to 1 hour depending on what additional procedures were performed. The pet is then woken up from anesthesia and usually they can be sent home same day. Hematuria, or blood in the urine, can be seen a couple days after the procedure.

Complications

As long at the pet is a good anesthetic candidate, cystoscopy is a fairly benign procedure. The most common complication expected after cystoscopy is hematuria, or blood in the urine a couple days after the procedure. Occasionally pets can have difficulty urinating days after due to regional inflammation secondary to the scope, and less likely a urinary tract infection.


 

Animal Specialty Group


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