Tube cystostomy and bi-directional cysto-urethral irrigation for the management of acute cystitis and urolithiasis in two dogs

Two dogs, one spitz and one non-descript aged 4 and 8 years, respectively, were presented with common clinical signs like stranguria, dysuria, restlessness, constipation, anorexia and vomition for three to four days. Heart and respiratory rates were above the normal range in both animals but rectal temperature was within normal limits. Palpation of abdomen revealed distended abdomen with tense bladder, but on plain radiography no calculi were seen in urethra or the bladder. Catheterization of urethra was possible in both cases with lots of flushing and manipulation using a fine infant feeding tube (No. 6). The urine that dribbled through the catheter was full of small crystals and epithelial debris. Both animals reported on the second day of the treatment with blockade and even dislodgement of catheter in one case. Tube cystostomy was performed through the ventral approach in both dogs. The contents of the bladder were removed through the Foley's catheter in both cases. The urine was full of variable sizes of crystals and debris. Cystic irrigation was performed through the cystostomy tube to remove the contents of the bladder through the urethra as much as possible. Retrograde flushing of the urethra was done to remove the crystals and debris from the urethra through the cystostomy tube. In this way a bidirectional flushing was done with normal saline containing 0.5% enrofloxacin on alternate days. Animals were kept on suitable antibiotics after conducting antibiotic sensitivity test. Both animals urinated clean urine within ten days of the treatment. The cystostomy tube was removed on 12^th day and both animals recovered without any complication and recurrences. It was concluded that tube cystostomy and bidirectional cysto-urethral irrigation can be used for the management of acute cystitis and urolithiasis in dogs, if the calculi are of smaller size.