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Urinary tract surgery
/content/chapter/10.22233/9781910443163.chap15
Urinary tract surgery
- Authors: Emma Keeble and Livia Benato
- From: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging
- Item: Chapter 15, pp 190 - 211
- DOI: 10.22233/9781910443163.15
- Copyright: © 2013 British Small Animal Veterinary Association
- Publication Date: January 2013
Abstract
Urinary tract surgery can be technically demanding in rabbits due to their relatively small size and unique anatomy. Some techniques, however, such as cystotomy, are relatively common and fairly straightforward procedures. This chapters assesses Anatomy of the urinary tract; Patient assessment and decision-making; Hypercalciuria and urolithiasis; Lower urinary tract disease; Medical management of urinary tract disease; Surgical considerations and specialist equipment; Surgical procedures; and Postoperative care. Operative Technique: Nephrectomy; Cystotomy.
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Figures
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15.1
Post-mortem dissection showing the urinary tract of a rabbit. Notice the left kidney is free of its peritoneal attachment. A = left adrenal gland; B = right adrenal gland; C = left kidney; D = right kidney; E = left renal vessels; F = left ureter; G = right ureter; H = bladder; I = distal colon. © 2013 British Small Animal Veterinary Association
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15.1
Post-mortem dissection showing the urinary tract of a rabbit. Notice the left kidney is free of its peritoneal attachment. A = left adrenal gland; B = right adrenal gland; C = left kidney; D = right kidney; E = left renal vessels; F = left ureter; G = right ureter; H = bladder; I = distal colon.
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15.2
Post-mortem dissection showing the retroperitoneal attachment of the kidney (A). It also shows the anatomical position of the kidney in relation to the adrenal gland (B) and ureter (C). © 2013 British Small Animal Veterinary Association
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15.2
Post-mortem dissection showing the retroperitoneal attachment of the kidney (A). It also shows the anatomical position of the kidney in relation to the adrenal gland (B) and ureter (C).
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15.3
Schematic diagram of the upper urinary tract. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.3
Schematic diagram of the upper urinary tract. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.4
Diagrammatic representation of a cross-section through the rabbit unipapillate kidney. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.4
Diagrammatic representation of a cross-section through the rabbit unipapillate kidney. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.5
Schematic drawing of the urinary tract of a female rabbit (ventral view); the bladder and urethra have been opened to show the internal structure. The ureters run over the dorsal surface of the bladder and open level with each other into the neck of the bladder. The distal urethra opens into the vagina, approximately half way along the latter at the external urethral orifice. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.5
Schematic drawing of the urinary tract of a female rabbit (ventral view); the bladder and urethra have been opened to show the internal structure. The ureters run over the dorsal surface of the bladder and open level with each other into the neck of the bladder. The distal urethra opens into the vagina, approximately half way along the latter at the external urethral orifice. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.10
(a) Right lateral abdominal retrograde double-contrast cystogram in a 5-year-old male rabbit with hypercalciuria (16 ml air instilled via urinary catheter plus 2 ml Omnipaque). (b) Right lateral abdominal radiograph of the same rabbit using intravenous urography (4 ml Omnipaque), which revealed no obvious abnormalities of the kidneys or ureters. Contrast material can be clearly seen delineating both ureters 15 minutes after injection. © 2013 British Small Animal Veterinary Association
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15.10
(a) Right lateral abdominal retrograde double-contrast cystogram in a 5-year-old male rabbit with hypercalciuria (16 ml air instilled via urinary catheter plus 2 ml Omnipaque). (b) Right lateral abdominal radiograph of the same rabbit using intravenous urography (4 ml Omnipaque), which revealed no obvious abnormalities of the kidneys or ureters. Contrast material can be clearly seen delineating both ureters 15 minutes after injection.
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15.11
Transverse section ultrasound examination of the left kidney of a rabbit, showing slight dilation of the renal pelvis and mild mineralization of the renal crest. © 2013 British Small Animal Veterinary Association
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15.11
Transverse section ultrasound examination of the left kidney of a rabbit, showing slight dilation of the renal pelvis and mild mineralization of the renal crest.
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15.12
Ultrasound examination of the urinary bladder of a rabbit, showing a measurable wall thickness of 0.61 cm due to chronic inflammation. © 2013 British Small Animal Veterinary Association
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15.12
Ultrasound examination of the urinary bladder of a rabbit, showing a measurable wall thickness of 0.61 cm due to chronic inflammation.
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15.14
Lateral abdominal radiograph showing an abnormal accumulation of radiodense material within the rabbit’s bladder, consistent with hypercalciuria. © 2013 British Small Animal Veterinary Association
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15.14
Lateral abdominal radiograph showing an abnormal accumulation of radiodense material within the rabbit’s bladder, consistent with hypercalciuria.
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15.15
Ultrasound scan of the urinary bladder of a rabbit with hypercalciuria. Note the large amount of hyperechoic material (with associated acoustic shadow) filling the urinary bladder and proximal urethra. The bladder wall is not obviously thickened in this case. © 2013 British Small Animal Veterinary Association
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15.15
Ultrasound scan of the urinary bladder of a rabbit with hypercalciuria. Note the large amount of hyperechoic material (with associated acoustic shadow) filling the urinary bladder and proximal urethra. The bladder wall is not obviously thickened in this case.
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15.16
Renal biopsy can be performed by removing a wedge of parenchyma or using a needle. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.16
Renal biopsy can be performed by removing a wedge of parenchyma or using a needle. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.17
Post-mortem dissection showing the lateral (paracostal) approach to the kidney. (© John Chitty) © 2013 British Small Animal Veterinary Association
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15.17
Post-mortem dissection showing the lateral (paracostal) approach to the kidney. (© John Chitty)
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15.18
Nephrotomy is performed by making a sagittal incision along the greater curvature of the kidney, after atraumatic clamping of the vessels. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.18
Nephrotomy is performed by making a sagittal incision along the greater curvature of the kidney, after atraumatic clamping of the vessels. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.19
Pyelolithotomy is performed by making a longitudinal incision along the proximal ureter. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.19
Pyelolithotomy is performed by making a longitudinal incision along the proximal ureter. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.20
Ureterotomy to remove calculi. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.20
Ureterotomy to remove calculi. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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15.21
Urethral catheterization in the female rabbit is straightforward in a sedated animal, with slight elevation of the hindlimbs. Note the perineal scalding in this patient. The rabbit has been placed in sternal recumbency and the hindlimbs elevated by placement of a sandbag under the pelvic area. An absorbent pad has been placed over the sandbag to contain any urine passed around the catheter. © 2013 British Small Animal Veterinary Association
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15.21
Urethral catheterization in the female rabbit is straightforward in a sedated animal, with slight elevation of the hindlimbs. Note the perineal scalding in this patient. The rabbit has been placed in sternal recumbency and the hindlimbs elevated by placement of a sandbag under the pelvic area. An absorbent pad has been placed over the sandbag to contain any urine passed around the catheter.
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15.22
Cystotomy in a rabbit to remove excessive accumulation of calcium carbonate crystals. (Courtesy of Elisabetta Mancinelli) © 2013 British Small Animal Veterinary Association
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15.22
Cystotomy in a rabbit to remove excessive accumulation of calcium carbonate crystals. (Courtesy of Elisabetta Mancinelli)
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15.23
Lateral abdominal radiograph of a male rabbit, showing a large urolith lodged in the distal urethra. This was obstructing urine flow and a distended bladder is visible. © 2013 British Small Animal Veterinary Association
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15.23
Lateral abdominal radiograph of a male rabbit, showing a large urolith lodged in the distal urethra. This was obstructing urine flow and a distended bladder is visible.
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15.24
Diagrammatic representation of the urethrotomy technique. Gentle dissection exposes the body of the penis. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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15.24
Diagrammatic representation of the urethrotomy technique. Gentle dissection exposes the body of the penis. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Midline abdominal incision with reflection of the viscera, showing a benign embryonal nephroma in a 3-year-old male neutered Dutch rabbit. The mass was detected on routine clinical examination with no other clinical signs reported by the owner. (© Mikel Sabater)
Midline abdominal incision with reflection of the viscera, showing a benign embryonal nephroma in a 3-year-old male neutered Dutch rabbit. The mass was detected on routine clinical examination with no other clinical signs reported by the owner. (© Mikel Sabater) © 2013 British Small Animal Veterinary Association
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Midline abdominal incision with reflection of the viscera, showing a benign embryonal nephroma in a 3-year-old male neutered Dutch rabbit. The mass was detected on routine clinical examination with no other clinical signs reported by the owner. (© Mikel Sabater)
Midline abdominal incision with reflection of the viscera, showing a benign embryonal nephroma in a 3-year-old male neutered Dutch rabbit. The mass was detected on routine clinical examination with no other clinical signs reported by the owner. (© Mikel Sabater)
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Kidney detached by blunt dissection, with vessels and ureter ligated. (© Mikel Sabater)
Kidney detached by blunt dissection, with vessels and ureter ligated. (© Mikel Sabater) © 2013 British Small Animal Veterinary Association
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Kidney detached by blunt dissection, with vessels and ureter ligated. (© Mikel Sabater)
Kidney detached by blunt dissection, with vessels and ureter ligated. (© Mikel Sabater)
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Exteriorized bladder with stay sutures. An incision has been made to reveal a urolith. (Courtesy of Joanna Hedley)
Exteriorized bladder with stay sutures. An incision has been made to reveal a urolith. (Courtesy of Joanna Hedley) © 2013 British Small Animal Veterinary Association
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Exteriorized bladder with stay sutures. An incision has been made to reveal a urolith. (Courtesy of Joanna Hedley)
Exteriorized bladder with stay sutures. An incision has been made to reveal a urolith. (Courtesy of Joanna Hedley)
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The urolith has been removed revealing the grossly thickened and oedematous mucosal layer of the bladder wall. (Courtesy of Joanna Hedley)
The urolith has been removed revealing the grossly thickened and oedematous mucosal layer of the bladder wall. (Courtesy of Joanna Hedley) © 2013 British Small Animal Veterinary Association
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The urolith has been removed revealing the grossly thickened and oedematous mucosal layer of the bladder wall. (Courtesy of Joanna Hedley)
The urolith has been removed revealing the grossly thickened and oedematous mucosal layer of the bladder wall. (Courtesy of Joanna Hedley)
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(Courtesy of Joanna Hedley)
(Courtesy of Joanna Hedley) © 2013 British Small Animal Veterinary Association
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(Courtesy of Joanna Hedley)
(Courtesy of Joanna Hedley)
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© 2013 British Small Animal Veterinary Association
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