The Parapreputial vs Paramedian approach in the male dog (Single View)


Welcome the 6th month of the Mentorship Program!

In this short and final month of the mentorship program, we’ll be focusing on cystotomies, one of the most commonly performed procedures in general practice. I personally love this surgery; the bladder is a remarkably forgiving organ, easy to access, and highly rewarding to work with. My hope is that, by the end of this month, you’ll feel the same sense of confidence and clarity every time you walk into a cystotomy.

Please be sure to mark the date of our upcoming webinar in your calendar. This session will follow our signature discussion-based “Ask Me Anything” (AMA) format. Come prepared to ask questions, share cases, or simply listen and learn from the collective experience of your colleagues.

While cystotomies are most often performed to remove uroliths in canine and feline patients, our emphasis will be on building a strong, reliable foundation for the procedure itself. We’ll take a close look at the key anatomical landmarks, surgical decision points, and practical techniques that empower you to approach any cystotomy with assurance. Understanding these fundamentals will allow you to adapt smoothly to whatever variations or challenges arise during surgery.

We’ll also address the most common post-operative complication: urolith recurrence. Together, we’ll explore strategies to significantly reduce this risk and improve long-term outcomes for your patients.

I’m looking forward to wrapping up this mentorship series with you and helping you feel even more confident in the surgical care you provide.

1 Comments

Questions & Answers (1)

Tina Longtin
April 1, 2026 at 12:41 pm

Hi Dr. Brock,
I was wondering if I could ask a question about a reply you had given last month to a colleague's question about a feline neuter anesthetic protocol for a cat with a heart murmur. You had mentioned at the end: "Listen carefully for upper respiratory noises such as gurgling both before and also in the half hour or so after extubation and treat with IM glycopyrrolate at 0.01mg/kg." I do sometimes hear this in feline patients after extubation during neuter procedures, (does not occur in patients we do IM sedation for other procedures and are not intubated). I was told or assumed it may be due to the lidocaine spray upon intubation and we tell clients this should resolve within 24-48h. Should I be treating this with glycopyrrolate and is the lidocaine spray the actual reason for this??

A question for Dr. Sylvestre also: I was just looking for the spay and neuter workshop to see if I could watch the cryptorchid videos, do we still have access to this?

Thank you very much,
Tina

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