In around 20% of cases there is incomplete removal of uroliths from the bladder/urethra at the time of cystotomy for removal (Grant 2010 JAVMA). Tip 1: Ensure you flush the urethra in both directions via a catheter and especially retrograde into the bladder (i.e. from the urethra into the bladder) to dislodge the cystoliths that may have fallen to the region of the trigone (the most common place to find them).
Tip 2 : If there is any doubt about whether there are urethroliths (stones in the urethra), perform a retrograde urethro-cystogram pre and post surgery. This will highlight these stones in the urethra. This procedure is described on this website http://www.online-vets.com/contrast_4.html. Scroll down to retrograde urethro-cystography.
Tip 3 : ALWAYS perform a post-operative radiograph after cystotomy.
I have the advantage of being able to perform cystotomies laparoscopically assisted. This gives me the benefit of being able to inspect the bladder more thoroughly and via a much smaller incision (I appreciate we are very lucky to have this technology). Find the link to the abstract to the paper mentioned below. https://pubmed.ncbi.nlm.nih.gov/20367043/
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