Evaluation of costs and time required for laparoscopic-assisted versus open cystotomy for urinary cystolith removal in dogs: 43 cases (2009-2012).

OBJECTIVE: To compare required time and costs of surgery and hospitalization as well as prevalence of incomplete urinary cystolith removal associated with laparoscopic-assisted cystotomy versus open cystotomy in dogs. DESIGN: Retrospective case series. ANIMALS: 20 dogs with urolithiasis treated by laparoscopic-assisted cystotomy and 23 dogs treated by open cystotomy. PROCEDURES: Medical records were reviewed. Surgery cost, hospitalization cost, total cost, surgery time, days in hospital, incomplete cystolith removal, and number of doses of analgesic administered IV after surgery were compared between the laparoscopic-assisted cystotomy and open cystotomy groups. Results-Surgery cost and total cost were significantly higher in the laparoscopic-assisted cystotomy group. Hospitalization cost, days in hospital, and prevalence of incomplete cystolith removal did not differ significantly between groups. Number of doses of analgesic was significantly lower in the laparoscopic-assisted cystotomy group. CONCLUSIONS AND CLINICAL RELEVANCE: Laparoscopic-assisted cystotomy was more time-consuming and expensive but associated with fewer postoperative doses of injectable analgesics, compared with open cystotomy. Laparoscopic-assisted cystotomy is an acceptable, more expensive, and minimally invasive alternative to open cystotomy for the removal of urinary cystoliths in dogs.

Comparison of laser lithotripsy and cystotomy for the management of dogs with urolithiasis.

OBJECTIVE: To compare efficacy, required resources, and perioperative complications between laser lithotripsy and cystotomy for urolith (ie, urocystoliths and urethroliths) removal in dogs. DESIGN: Retrospective case-control study. ANIMALS: 66 dogs with urolithiasis treated by laser lithotripsy (case dogs) and 66 dogs with urolithiasis treated by cystotomy (control dogs). PROCEDURES: Medical records were reviewed. Complete urolith removal rate, resources (ie, duration of hospitalization, procedure time, anesthesia time, procedure cost, and anesthesia cost), and complications (ie, hypotension, hypothermia, incomplete urolith removal, and requirement of an ancillary procedure) were compared between cystotomy group dogs and lithotripsy group dogs. RESULTS: Duration of hospitalization was significantly shorter for lithotripsy group dogs, compared with cystotomy group dogs. Procedure time was significantly shorter for cystotomy group dogs, compared with lithotripsy group dogs. Cost of anesthesia was significantly less for cystotomy group dogs, compared with lithotripsy group dogs. No significant differences were found between cystotomy group dogs and lithotripsy group dogs with regard to urolith removal rate, procedure cost, anesthesia time, or any of the evaluated complications. CONCLUSIONS AND CLINICAL RELEVANCE: Laser lithotripsy is a minimally invasive procedure that has been shown to be safe and effective in the removal of urocystoliths and urethroliths in dogs. No significant differences were found in the required resources or complications associated with laser lithotripsy, compared with cystotomy, for removal of uroliths from the lower portions of the urinary tract of dogs. Laser lithotripsy is a suitable, minimally invasive alternative to surgical removal of urethroliths and urocystoliths in dogs.