9.8.2016 Emergency, South Bay, CA

Case Count: 10

I feel like I was just here. I had a day and a half off to switch from nights to days and my brain unkindly requests more. Then, my technician started exploding my mind with recent literature that may fundamentally change the medications I use to manage pain in my canine patients. More to come. Also, I had a Boston Terrier injure his penis pretty badly and need treatment for bruising/hematoma. Ouch.

Favorite Quotes

  • "I have a cystotomy for you to do today. You're up for it, right?" I love this job :)

Case of the Day:

7yo male neutered Domestic Shorthair (DSH) cat
Urinary bladder stone removal
     "Cystotomy" is the technical term for cutting (-otomy) into the urinary bladder (cyst-). Many male cats get urethral obstructions, a subset get obstructed by stones, a subset of those have stones that need surgical removal. This cat received a pre-op epidural, where we place meds directly around the end of the spinal cord to numb the rear end. This makes the whole thing less painful and require less anesthetic drugs. Cystotomy involves an abdominal incision, pulling out the urinary bladder and packing it off to avoid contaminating the abdomen, and then cutting into the apex, which is the part furthest forward (fewer blood vessels, far from important sphincters and such). The urinary bladder should be a light pink, stretchy water balloon, but this cat had a severely thickened, angry urinary bladder filled with clots and a few small stones. i was only able to feel and see one stones, so I flushed and flushed as best I could. Usually the urinary bladder gets closed in two layers, the second one causing the whole thing to fold inward to create a tight seal. This bladder was too thick and delicate for that, so I could only place one layer. Luckily, it healed up to a pressure test, shown at the end.