Cystotomy Release Form

Save time during your appointment. Complete your cystotomy release form online from any device before your visit.

Cystotomy Release Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.


You may use the PDF version by clicking the DOWNLOAD FORM button and completing the printed form by hand. Please bring the completed PDF form for your pet’s appointment.

A cystotomy is a surgical procedure involving the creation of an opening in the wall of the urinary bladder. Typically, this procedure is necessary for the removal of urinary obstructions, bladder stones, obtaining a biopsy, or removing a bladder tumor. In rare cases, leakage from the bladder surgical site may cause severe problems, necessitating additional surgery.

Before conducting any procedure requiring anesthesia, bloodwork is performed to confirm your pet’s overall health. This helps identify any health conditions that could pose risks during anesthesia. Usually, this bloodwork is completed before the day of surgery for optimal surgical and medical planning. However, there may be situations where we perform this bloodwork on the day of the surgery at our hospital. If the results are abnormal, the doctor will contact you to discuss treatment options.

All animals undergoing anesthesia require an overnight fast and a full day of hospitalization. Our pre-medications and anesthesia can induce nausea during the procedure. If your pet vomits while under anesthesia, there is a risk of aspirating the vomit, potentially leading to aspiration pneumonia.

A leg is shaved for an intravenous catheter, which is placed prior to surgery for direct access to the vein in the event of any complications. Intravenous fluids are administered during surgery to support normal physiologic functions. Our doctors routinely administer an injection of a 24-hour pain reliever at the time of surgery, with additional pain medication provided post-operatively for your pet to take at home.

If you checked off a steroid, the doctor will be informed and will proceed accordingly with your consent. These medications can impact your pet’s platelets, which play a crucial role in blood clotting. Additionally, there can be adverse gastrointestinal effects when these pain relievers are administered in combination with our pre-surgical medications and the pain medications provided for your pet to take home.

Financial responsibilities for services are due at the time of discharge. I also understand that Cranston Animal Hospital is not staffed 24 hours a day, and after-hour treatment of patients is at the discretion of the veterinarian.

I, the undersigned owner or agent of the pet named above, certify that I am 18 years of age or older and authorize the veterinarians of Cranston Animal Hospital to treat or perform needed procedures on my animal. You are to use all reasonable precautions against pain, injury, or escape of my animal. You will not be held liable or responsible in any manner for unforeseen incidents or accidents caused by the care, treatment, or safekeeping of my pet. It is thoroughly understood that I assume all risks, and that some risks always exist with anesthesia. As with any general anesthetic procedure, there is a slight risk of an Idiopathic (unknown cause) Anesthetic Reaction (IAR), in rare situations may be serious and result in death. IAR is thought to be a cardiac hypersensitivity when given the anesthetic at its accepted and standard dosage. IAR has no predisposing factors, does not appear to favor one breed or species over the other. It is not revealed in standard screening tests and thus making it impossible to predict in advance.