TECHNIQUE

Nephrectomy in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description This description is based primarily on that given by Jenkins (2004) (B602.22.w22).

Note: only consider nephrectomy if an intravenous excretory pyelogram has indicated adequate function of the contralateral kidney (J213.9.w2, J513.6.w1) and if an intravenous excretory pyelogram shows the damaged kidney is non-functional; a partially functioning kidney may be removed in certain cases, such as neoplasia. (V.w122)

Preparation
  • Anaesthetise the rabbit. See: Treatment and Care - Anaesthesia and Chemical Restraint - Lagomorph Anaesthesia
  • Shave from pubis to midthorax.
  • Place the rabbit in dorsal recumbency.
  • Prepare the rabbit for aseptic surgery.
  • In one case, "Hydromorphone (0.11 mg/kg administered epidurally), buprenorphine (0.025 mg/kg administered intravenously), carprofen (2.3 mg/kg administered subcutaneously), and metoclopramide (0.32 mg/kg administered subcutaneously) were administered along with a 10-mL lactated Ringerís solution intravenous bolus. Constant rate infusion (5 mL/kg/h) of lactated Ringerís solution was continued throughout the operative period." (J213.9.w2)
Initial surgery
  • Make a midline incision sufficiently long for abdominal exploration. See: Laparotomy in Rabbits
  • Drape saline-moistened laparotomy pads along the incision.
  • Place a Balfour retractor to provide better visibility. 
  • Check for additional lesions in the abdomen.
  • Gently remove the caecum, colon and small intestines from the abdomen to facilitate kidney exposure; wrap these in moistened gauze. (B602.22.w22)
  • OR preferably retract the intestines to provide access. This is more difficult to achieve but gives a lower risk of post-operative adhesions than if the intestines are removed from the abdomen. (V.w122)
Nephrectomy
  • Dissect the kidney free of its peritoneal attachments.
  • Rotate the kidney medially to expose the renal pelvis and proximal ureter.
  • Using vascular clips, ligate the renal artery, vein and ureter.
  • Incise through the ureter and associated tissues distal to the ligatures and remove the kidney.
  • Check for bleeding; ensure proper haemostasis.
  • Suture the retroperitoneum in a simple continuous pattern with 4-0 (1.5 metric) Vicryl. (J213.9.w2)
Closing the abdomen
  • Gently replace the small intestines, colon and caecum into the abdomen.
  • Close the abdomen in a routine manner. See: Laparotomy in Rabbits

(B602.22.w22)

Post-operative care

Post-operative care includes:

  • Antibiotics as required. (J213.9.w2)
  • Fluids as required.
  • Analgesia, e.g. Buprenorphine 0.025 mg/kg orally once daily and Meloxicam orally for seven days. (J213.9.w2)
    • Meloxicam doses of 0.3 - 1.0 mg/kg every 24 or every 12 hours are now recommended. (V.w122)
  • See: Treatment and Care - Surgery - Post-operative Care
Appropriate Use (?)
  • When one kidney is severely diseased or damaged and the other kidney retains sufficient normal function. (B602.22.w22)
  • Nephrectomy has been used successfully to treat rabbits with hydronephrosis, unilateral nephrolithiasis or pyelonephritis. (J213.9.w2)
  • For example, with renal calculi:
    • When a calculus has obstructed the renal pelvis causing hydronephrosis and severe damage to the renal parenchyma. (B602.18.w18)
    • This may be considered if an intravenous excretory pyelogram has indicated adequate function of the contralateral kidney. (J513.6.w1) AND if an intravenous excretory pyelogram shows the damaged kidney is non-functional; a partially functioning kidney may be removed in certain cases, such as neoplasia. (V.w122)
Notes --
Complications/ Limitations / Risk
  • Only consider nephrectomy if an intravenous excretory pyelogram has indicated adequate function of the contralateral kidney. (J213.9.w2, J513.6.w1) AND if an intravenous excretory pyelogram shows the damaged kidney is non-functional; a partially functioning kidney may be removed in certain cases, such as neoplasia. (V.w122)
  • Not suitable if the function of the other kidney is inadequate. (J513.6.w1)
Equipment / Chemicals required and Suppliers
  • Standard anaesthetic equipment for rabbits.

  • Surgical equipment appropriate for rabbits.

  • Suture materials.

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost/ Availability

The costs of a surgical operation include those associated with: (J15.30.w1)

  • Pre-operative diagnostics (e.g. radiography, ultrasonography, blood tests)
  • Anaesthesia.
  • Perioperative medication (e.g. analgesics, antibiotics, fluids).
  • Surgical preparation (of the operating theatre and the patient, including staff time).
  • Consumables and equipment.
  • Time of the surgeon and assistant(s).
  • Post-operative hospitalisation.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee Aidan Raftery MVB CertZooMed CBiol MIBiol MRCVS (V.w122)
References B602.22.w22, J15.30.w1, J213.9.w2, J513.6.w1, V.w122

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