I frequently find myself encountering new things in practice, even if they are variations of something I have done before. Even the removal of a skin mass can have plenty of intricacies and odd characteristics that make it interesting. You never know what you will find until you get rolling with a surgical procedure. These ever-changing occurrences are one of my favorite parts of our job as veterinarians – they always keep us actively thinking and making judgments based on our reasoning and experience.
I had a patient that had recurrent blood in its urine despite antibiotic treatments. Another veterinarian had done radiographs to look for a cause but was unsuccessful. It was a frustrating situation, and the owner’s attitude reflected their frustration and hopeless feelings. Something did not make sense, and by a unique turn of events, one of our staff members happened to glance at the radiographs that were previously taken and noticed a bladder stone that had been missed! Bladder surgery, a cystotomy, was the next step to solve this problem. This was my first solo cystotomy, and I will admit that I was nervous. I perused the surgical textbooks during the week or so before the surgery. Even though all of the other doctors in our practice told me that cystotomy surgeries were easy and I had nothing to worry about, I was still nervous! I discussed it with the other doctors, and the general consensus was that the bladder heals very well the surgery is straightforward.
While I was a little anxious before the surgery began, I had my plan in my head already and I stuck to it. The stone came out easily, and I could not find any other stones. We flushed the bladder well and the bleeding was minimal. Closing the bladder was easy enough, and I did it in a two-layer pattern to ensure no leakage post-op. We sent the stone off to a laboratory to determine its makeup, allowing us to recommend the best diet that will make the formation of another stone like this less likely.
Just like with most surgeries, the hardest one is the first one you do. After that, you begin to become more of an expert each and every time you do another procedure. It takes time, but trusting the process is the most important part.
