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How to Retropulse Urethral Stones Intra-Operatively in a Dog with Dr. Chris Ralphs, DACVS | VETgirl Veterinary Continuing Education Videos

In this VETgirl online veterinary continuing education video, Dr. Chris Ralphs, DACVS at Ocean State Veterinary Specialists reviews how to retropulse urethral stones intra-operatively in a dog. This is much easier intra-operatively versus pre-op because the bladder is open so you don’t have to worry about rupturing it. After your cystotomy, pack lap sponges around the bladder (to minimize stones being dropped into the abdomen) and use a stay suture to bring the bladder out of the abdomen. Pass a large red rubber catheter (ideally 8-10 French, depending on the dog size) into the penis. Have an assistant extrude the penis, holding it with gauze to maintain grip and exposure of the penis tip. (If you don’t have anyone else scrubbed in, a gloved assistant like your anesthesia tech can hold the syringe.) Pass the catheter while flushing saline with a 60-cc catheter tip; occlude the tip of the penis to maintain pressure during flushing. Occluding tightly will help also prevent saline from coming back out the tip. Make sure that the pressure of the flushing does not force the red rubber to squirt out the end of the penis. As you hold the red rubber catheter in place and hold the penis tip closed around it, your assistant should inject saline with force into the catheter. After each flushing, check the bladder for stones and see if the catheter can move farther into the urethra. You can also use the catheter to help try to move the stone towards the bladder by repeatedly pushing the catheter into the stone.

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