Cell therapy with adipose tissue-derived human stem cells in the urinary bladder improves detrusor contractility and reduces voiding residue / A terapia celular com células-tronco humanas derivadas do tecido adiposo na bexiga urinária melhora a contratilidade do detrusor e reduz o resíduo miccional

Detrusor hypocontractility (DH) is a disease without a gold standard treatment in traditional medicine. Therefore, there is a need to develop innovative therapies. The present report presents the case of a patient with DH who was transplanted with 2 x 106 adipose tissue-derived mesenchymal stem cells twice and achieved significant improvements in their quality of life. The results showed that cell therapy reduced the voiding residue from 1,800 mL to 800 mL, the maximum cystometric capacity from 800 to 550 mL, and bladder compliance from 77 to 36.6 mL/cmH2O. Cell therapy also increased the maximum flow from 3 to 11 mL/s, the detrusor pressure from 08 to 35 cmH2O, the urine volume from 267 to 524 mL and the bladder contractility index (BCI) value from 23 to 90. The International Continence on Incontinence Questionnaire - Short Form score decreased from 17 to 8. Given the above, it is inferred that the transplantation of adipose tissue-derived mesenchymal stem cells is an innovative and efficient therapeutic strategy for DH treatment and improves the quality of life of patients affected by this disease.

A Hipocontratilidade Detrusora (HD) é uma doença sem um tratamento padrão-ouro na medicina tradicional. Logo, há a necessidade de desenvolvimento de terapias inovadoras. O presente relato apresenta um caso de paciente com HD transplantado duas vezes com 2 x 106 células-tronco mesenquimais derivadas do tecido adiposo que obteve melhoras significativas em sua qualidade de vida. Os resultados demonstraram que a terapia celular reduziu o resíduo miccional de 1.800mL para 800mL; a Capacidade Cistométrica Máxima de 800 para 550mL; a complacência de 77 para 36,6mL/cmH2O. A terapia celular também aumentou o fluxo máximo de 3 para 11mL/s; a pressão detrusora de 08 para 35cmH2O; o volume urinado de 267 para 524mL e o índice de contratilidade vesical (BCI) de 23 para 90. O score do International Continence on Incontinence Questionare - Short Form passou de 17 para 8. Diante do exposto, infere-se que o transplante de células-tronco mesenquimais derivadas do tecido adiposo é uma estratégia terapêutica inovadora e eficiente para o tratamento da HD e para melhoria da qualidade de vida de pacientes acometidos por essa doença.

Urethral reconstruction combined with modified urethrostomy in a cat after prepubic urethrostomy

Background: In cats, urethral obstruction is generally caused by various reasons, including feline idiopathic cystitis, urethral crystals, urethral trauma, mucous plug, congenital or acquired anatomical deformity, and urolithiasis, especially in male cats. Depending on the severity and duration of clinical signs, immediate management including conservative or surgical therapy for restoration of urethral patency is required. Repetitive urethral obstruction due to intraluminal plugs, obstruction that cannot be resolved by medical management, and urethral strictures, trauma, or neoplasia should be managed by surgery. When the penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineal skin by repetitive perineal urethrostomy, prepubic urethrostomy is indicated. Potential complications of prepubic urethrostomy include urinary incontinence, peristomal dermatitis. In such cases, management of the peristomal site or placement of an artificial urethral sphincter have been reported previously. However, to date, urethral reconstruction using pre-existing penis has not been reported after prepubic urethral stricture following prepubic urethrostomy. The objective of this report is to describe surgical procedure of the urethral reconstruction combined with modified perineal urethrostomy in a cat with prepubic urethral stricture after prepubic urethrosotmy. Case: A 3-year-old castrated Scottish straight cat presented with dysuria after prepubic urethrostomy. The owner reported that the patient was diagnosed with urethral rupture, had undergone prepubic urethrostomy 2 months prior to presentation, and had persistent dysuria despite repetitive surgical revision of the prepubic urethral stoma at a local hospital. On physical examination, the preputial orifice and the penis appeared grossly normal. On ultrasonography, pericystic and periurethral fat had an edematous, striated appearance with alternating hyperechoic and anechoic regions. A small amount of free fluid was visible around the urethra. Abdominal radiography revealed a mildly distended bladder and loss of serosal detail around the area of the urinary bladder neck, consistent with inflammation and free fluid observed on ultrasonography. The retrograde urethrogram showed no leakage in either sites of the prepubic urethral orifice or the penis. Hence, complete urethral reconstruction with modified perineal urethrostomy was performed. The patient had normal urination at the 15-month follow-up. Discussion: Prepubic urethrostomy is beneficial for the patients whose penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineum. Complications of prepubic urethrostomy include skin necrosis around the stoma; urinary incontinence; stricture of the urethral stoma due to several reasons such as surgical-site irritation; poor mucosa-skin apposition; failure to provide tension-free stoma; and failure to expose wider pelvic urethra. In these cases, surgical management of the level of prepubic urethral stoma has been recommended by previous studies. However, no studies have been reported urethral reconstruction using pre-existing penile urethra in a patient with prepubic urethral stricture so far. To the author's knowledge, this case is the first report describing urethral reconstruction in a cat with urethral stricture after prepubic urethrostomy.

Carcinoma uretral primário em uma cadela - tratamento multimodal / Primary urethral carcinoma in a bitch - multimodal treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After preanesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma.

Intoxicação de cães por maconha: sinais clínicos e tratamento / Marijuana poisoning in dogs: clinical signs and treatment

Intoxicações por drogas recreativas como Cannabissativa, comumente conhecida como maconha, estão cada vez mais presentes nas clínicas de atendimento veterinário. A Cannabis contém mais de 500 compostos diferentes e mais de 80 canabinoides conhecidos; destes, o delta-9 tetrahidrocanabinol (THC) é o mais psicoativo e responsável pela maioria dos sintomas de intoxicação. Os canabinoides são substâncias exógenas extraídas da Cannabis e se ligam aos receptores CB1 e CB2 do sistema endocanabinoide. Em cães, dentre os sinais clínicos de intoxicação mais presentes destacam-se: agitação, ataxia, midríase, aumento da sensibilidade ao som, hiperestesia, sialorreia, distúrbios neurológicos, espasmos musculares e início agudo de incontinência urinária. Muitas vezes o diagnóstico de intoxicação por maconha é difícil, principalmente porque os tutores resistem em admitir a exposição a drogas ilícitas com receio das implicações legais. O médico-veterinário deve ganhar a confiança do tutor do animal para que o diagnóstico possa ser realizado precocemente e iniciado o tratamento mais adequado para a situação. O tratamento inclui monitoramento clínico, cuidados de suporte, administração de fluidos intravenosos, administração de carvão ativado, indução de vômitos, administração de antieméticos, suporte térmico (aquecimento/resfriamento) e monitoramento da pressão arterial. Os médicos-veterinários são os principais responsáveis pela educação dos tutores nessas circunstâncias, sendo de grande importância enfatizar para os tutores manterem agentes tóxicos fora do acesso dos animais.(AU)

Intoxications by recreational drugs such as Cannabissativa, commonly known as marijuana, are increasingly present in veterinary care clinics. Cannabis contains over 500 different compounds and over 80 known cannabinoids; of these, delta-9 tetrahydrocannabinol (THC) is the most psychoactive and responsible for most symptoms of intoxication. Cannabinoids are exogenous substances extracted from Cannabis and bind to the CB1 and CB2 receptors of the endocannabinoid system. Among the most common clinical signs of intoxication in dogs are: agitation, ataxia, mydriasis, increased sensitivity to sound, hyperesthesia, drooling, neurological disorders, muscle spasms and acute onset of urinary incontinence. The diagnosis of marijuana intoxication is often difficult, mainly because tutors resist in admitting exposure to illicit drugs for fear of the legal implications. The Veterinarian must gain the trust of the animal's tutor so that the diagnosis can be carried out early and the most appropriate treatment for the situation can be initiated. Treatment includes: clinical monitoring, supportive care, administration of intravenous fluids, administration of activated charcoal, induction of vomiting, administration of antiemetics, thermal support (warming/cooling), and blood pressure monitoring. Veterinarians are primarily responsible for the education of tutors in these circumstances, and it is of great importance to emphasize that tutors must keep toxic agents away from animal's acess.(AU)

Prevalence and risk factors for urinary incontinence in bitches five years after ovariohysterectomy / [Prevalência e fatores de risco para incontinência urinária em cadelas cinco anos após ovário histerectomia]

Ovariohysterectomy (OHE) is the most performed elective surgery in veterinary medicine. Although this procedure brings benefits both to the animal and public health, acquired urinary incontinence is a possible complication resultant from it. The aim of this study was to determine the prevalence of urinary incontinence and evaluate size, breed, and time of surgery as risk factors in a population of spayed female dogs in the Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul, in the year of 2013, through the use of a multiple-choice screening instrument. Identified estimated prevalence was 11.27% and main risk factors were as follows: large size (OR = 7.12 IC95% = 1.42 - 35.67), Rottweiler breed (OR = 8.92; IC95% = 5.25 - 15.15), Pit-bull breed (OR = 4.14; IC95% = 2.19 - 7.83), and Labrador breed (OR = 2.73; IC95% = 1.53 - 4.87). Time of surgery was not considered a risk factor for urinary incontinence in this population (OR = 1.45; IC95% = 0.86 - 2.40). Even though most owners reported a small impact on their relationship with the animal, urinary incontinence hazard should be addressed before spaying.(AU)

A ovário-histerectomia (OHE) é a cirurgia eletiva mais realizada em medicina veterinária. Embora seja um procedimento que beneficie a saúde pública e do animal, a incontinência urinária adquirida é uma complicação possível resultante desse procedimento. O objetivo deste estudo foi determinar a prevalência de incontinência urinária e avaliar porte, raça e momento da castração como fatores de risco em uma população de cadelas castradas no HCV/UFRGS, no ano de 2013, através do uso de um instrumento de triagem de múltipla escolha. A prevalência estimada foi de 11,27% e os principais fatores de risco foram: grande porte (OR = 7,12 IC95% = 1,42 - 35,67), raça Rottweiler (OR = 8,92; IC95% = 5,25 - 15,15), raça Pitbull (OR = 4,14; IC95% = 2,19 - 7,83) e raça Labrador (OR = 2,73; IC95% = 1,53 - 4,87). O tempo da cirurgia não foi considerado fator de risco para incontinência urinária nessa população (OR = 1,45; IC95% = 0,86 - 2,40). Embora a maioria dos proprietários tenha relatado um pequeno impacto no relacionamento com o animal, a possibilidade de incontinência urinária deve ser devidamente discutida antes da castração.(AU)

Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.(AU)

Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.

Ultrasonographic and radiographic diagnosis of ectopic ureter in a dog

Background: Ureteral ectopia (or ectopic ureter) is a congenital anomaly of the urinary system in which the ureter insertsanywhere other than the vesical trigone. This anatomical change may have unilateral or bilateral involvement. The mostevident clinical sign, occurring mostly in females, is urinary incontinence, however in some cases the condition may progressto nephritis and dilation of the renal pelvis. The diagnosis is established through imaging, and definitive treatment requiressurgical approach. The present study reports a case of ureteral ectopia in a dog which was diagnosed by ultrasound andcontrast radiography (excretory urography) and successfully treated by neoureterostomy.Case: A 10-month-old female American Pit Bull Terrier was attended at the Veterinary Hospital of the Federal Rural University of the Semi-Arid (UFERSA), in Mossoró, RN. Her owner reported incontinence of dark, malodorous urine sincebirth as the chief complaint. After clinical examination, cystitis was suspected, and a complete blood count, urinalysis,and abdominal ultrasound was requested. The blood count and creatinine were within the reference values. The presenceof struvite crystals were found on urinalysis. Ultrasound examination revealed a tortuous, dilated right ureter from therenal pelvis to the urinary bladder; no uroliths were identified as a cause of potential obstruction, but the ipsilateral kidneyshowed increased cortical echogenicity, loss of corticomedullary definition, and moderate pelvic dilation. These findingssupported a presumptive diagnosis of ectopic ureter. For the purpose of confirming this suspicion, excretory urography wasperformed, revealing unilateral ureteral dilation and radiopaque contrast uptake following the path of the urethra. Once thediagnosis was confirmed, surgery was performed to correct the ureteral ectopia using the standard...

Ultrasonographic and radiographic diagnosis of ectopic ureter in a dog

Background: Ureteral ectopia (or ectopic ureter) is a congenital anomaly of the urinary system in which the ureter insertsanywhere other than the vesical trigone. This anatomical change may have unilateral or bilateral involvement. The mostevident clinical sign, occurring mostly in females, is urinary incontinence, however in some cases the condition may progressto nephritis and dilation of the renal pelvis. The diagnosis is established through imaging, and definitive treatment requiressurgical approach. The present study reports a case of ureteral ectopia in a dog which was diagnosed by ultrasound andcontrast radiography (excretory urography) and successfully treated by neoureterostomy.Case: A 10-month-old female American Pit Bull Terrier was attended at the Veterinary Hospital of the Federal Rural University of the Semi-Arid (UFERSA), in Mossoró, RN. Her owner reported incontinence of dark, malodorous urine sincebirth as the chief complaint. After clinical examination, cystitis was suspected, and a complete blood count, urinalysis,and abdominal ultrasound was requested. The blood count and creatinine were within the reference values. The presenceof struvite crystals were found on urinalysis. Ultrasound examination revealed a tortuous, dilated right ureter from therenal pelvis to the urinary bladder; no uroliths were identified as a cause of potential obstruction, but the ipsilateral kidneyshowed increased cortical echogenicity, loss of corticomedullary definition, and moderate pelvic dilation. These findingssupported a presumptive diagnosis of ectopic ureter. For the purpose of confirming this suspicion, excretory urography wasperformed, revealing unilateral ureteral dilation and radiopaque contrast uptake following the path of the urethra. Once thediagnosis was confirmed, surgery was performed to correct the ureteral ectopia using the standard...(AU)

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Lúpus eritematoso sistêmico associado a manifestações neurológicas em cadela da raça Border Collie / Systemic lupus erythematosus associated with neurological manifestations in a Border Collie bitch

Background: Systemic lupus erythematosus (SLE) is an immune-mediated and multisystemic disorder which etiology is believed to be multifactorial. Its clinical signs vary accordingly to affected organs, cutaneous lesions being the most frequently observed. There are few reports of SLE in dogs with neurological manifestations. Therefore, the aim of this report is to describe a case of SLE in a dog with indicative signs of nervous system involvement. Case: A 6-year-old Border Collie bitch was referred to the Veterinary Hospital (HVU) of the University of Uberaba (UNIUBE) with a history of cluster seizures, inappetence and urinary incontinence. Erythema and flaking of nasal plan were noted on physical examination, and splenomegaly on abdominal palpation. Thrombocytopenia and slightly increased ALT were found on blood tests. Ehrlichiosis was suspected and doxycycline was prescribed along with phenobarbital for the control of seizures. In the follow-up visit, the dog was still presenting urinary incontinence, thrombocytopenia and splenomegaly. Also, an ulcer on the nasal mucocutaneous junction was observed. The patient went through a neurological examination which indicated thalamocortical lesion. Cerebrospinal fluid samples were obtained for cytology, culture and canine distemper test, and serology tests for leishmaniasis, toxoplasmosis and neosporosis were done. No alterations were found in these exams. The histopathology of the nasal lesion was proceeded and showed results consistent with lupus erythematosus. It was prescribed a 15-day course of prednisolone at immunosuppressive dose. The patient showed clinical improvement with this treatment. Azathioprine was started along with gradual removal of prednisolone. After twenty days of discontinuation of this drug, the dog presented epileptic seizures, urinary incontinence, thrombocytopenia, increased ALT and worsened nasal lesion. Prednisolone at immunosuppressive dose was reintroduced and the dose of phenobarbital, increased. One week past this, the patient showed inappetence and an extensive hematoma in the thoracic region. Lab exams confirmed drug-induced acute pancreatitis. All medications were interrupted, the patient was hospitalized, and treatment for pancreatitis was initiated, but the dog passed away. Discussion: For involving multiple body systems and for presenting varied clinical signs, diagnosing SLE can be challenging in clinical routine. The dog from this report was a Border Collie; this breed is considered to be predisposed to this disease. The animal had a history of being exposed to solar radiation for a large part of the day, had dyspigmentation of nasal plan and had no application of sunscreen, predisposing the occurrence of SLE. Neurological signs are uncommon in SLE, but the seizures and the urinary incontinence were the main reasons for the dog's guardian to look for medical assistance. The suspicion for SLE was raised due to cutaneous manifestations and persistent thrombocytopenia along with splenomegaly. Histopathological findings are essential for diagnosing SLE, as well as antinuclear antibody tests. Nonetheless, due to financial limitations, this last test was not performed. Azathioprine is an immunomodulating drug largely used along with glucocorticoids when treating SLE; however, this medication is prone to induce side effects as the ones presented by the dog from this report. Therefore, it is concluded that SLE should be considered as a differential diagnosis in patients showing cutaneous, hematological, systemic and neurological manifestations, considering the variety of signs caused by this disorder.(AU)

Trato sinusal por reação ao fio de algodão em ovariohisterectomia de cadela / Sinusal tract due to cotton yarn reaction in canine ovariohysterectomy / Tracto sinusal por reacción del hilo de algodón en ovario histerectomía de perra

A castração em fêmeas pode ser feita pela ovariectomia (retirada dos ovários), ou ovariohisterectomia (retirada dos ovários e do útero). Essa última técnica é a mais recomendada em cães e gatos, devido à prevenção de afecções que podem ocorrer posteriormente no útero. Dentre essas complicações pode-se encontrar sangramento por ligadura mal feita em coto, hidroureter, hidronefrose, piometra de coto, formação de tratos sinusais, aderência, obstrução crônica, incontinência urinária, retenção abdominal de compressas cirúrgicas, transcecção de parte do ureter e ovário remanescente. Em cadelas castradas, a causa mais comum da formação de tratos sinusais é a presença de reação tecidual ao redor do fio de sutura. O presente estudo teve como objetivo relatar um caso de uma cadela sem raça definida, 8,7 kg, seis anos, que deu entrada no Hospital Veterinário de Uberaba, MG com queixa principal a presença de ferida no flanco direito sendo tratada há nove meses, porém sem sucesso. Já haviam feito uso de vários antibióticos sistêmicos e antinflamatorios esteroidais e não esteroidais. Diante do caso observado, foram realizados exames laboratoriais e de imagem. Perante o resultado do exame de imagem, a principal suspeita foi a formação de trato sinusal com comunicação com a cavidade abdominal devido a uma reação ao fio de algodão utilizado na ovariohisterectomia.(AU)

Female animals can be castrated by ovariectomy (removal of the ovaries), or ovariohysterectomy (removal of the ovaries and uterus). The latter is the most recommended in dogs and cats due to the prevention of conditions that may subsequently occur in the uterus. Among these complications, one can find bleeding by poor ligation in the stump, hydroureter, hydronephrosis, stump pyometra, formation of sinus tracts, adherence, chronic obstruction, urinary incontinence, abdominal retention of surgical compresses, transection of part of the ureter and remaining ovary. In castrated bitches, the most common cause of the formation of sinus tracts is the presence of tissue reaction around the suture thread. This study aimed at reporting a case of a mixed breed, six-year-old dog, 8.7 kg that was admitted to the Veterinary Hospital of Uberaba with the main complaint of the presence of a wound on the right flank being unsuccessfully treated for nine months. Several systemic antibiotics and steroidal and non-steroidal anti-inflammatory drugs had already been used. In view of the observed case, laboratory and imaging exams were performed. In view of the result of the imaging examination, the main suspicion was the formation of a sinus tract with communication to the abdominal cavity due to a reaction to the cotton thread used in the ovariohysterectomy.(AU)

La castración en hembras se puede realizar mediante ovariectomía (extirpación de los ovarios) u ovario histerectomía (extirpación de los ovarios y del útero). Esa última técnica es la más recomendada en perros y gatos, debido a la prevención de afecciones que pueden presentarse posteriormente en el útero. Entre estas complicaciones se puede encontrar hemorragias por ligadura mal realizada en muñón, hidruréter, hidronefrosis, piometra de muñón, formación de tractos sinusales, adherencia, obstrucción crónica, incontinencia urinaria, retención abdominal de compresas quirúrgicas, transección de parte del uréter y ovario remanente. En las perras castradas, la causa más común de formación de trayectos sinusales es la presencia de reacción tisular alrededor del hilo de sutura. El presente estudio tuvo como objetivo reportar el caso de una perra sin raza definida, de 8,7 kg, de seis años de edad, que ingresó en el Hospital Veterinario de Uberaba, MG con el principal síntoma de presencia de una herida en el flanco derecho siendo tratada durante nueve meses, pero sin éxito. Ya habían usado varios antibióticos sistémicos y medicamentos antiinflamatorios esteroides y no esteroides. A la vista del caso observado, se realizaron exámenes de laboratorio y de imagen. A la vista del resultado del examen de imagen, la principal sospecha fue la formación de un tracto sinusal con comunicación con la cavidad abdominal debido a una reacción al hilo de algodón utilizado en el ovario histerectomía.(AU)

Symptomatic orthotopic ureterocele in a dog

Background: Ureteroceles are cystic dilatations of the terminal ureter and is a rare diagnosed condition in dogs. They can be classified as orthotopic when it is entirely within the bladder and the ureteral orifice emerges normally or ectopic if the ureteral orifice is not in the normal position in the trigone. Orthotopic are usually clinically silent. Ureterocele can contribute to lower urinary tract disease leading to infections and loss of the renal function. As long as this injury can arise slowly, it might be underdiagnosed in companion animals. This case aims to report a case of a bitch with diagnosed symptomatic orthotopic ureterocele efficacious surgical treatment. Case: A 5-month-old female mixed breed was referred to the veterinary hospital, with a major complaint of urinary incontinence since the birth date after the first attendance in a colleague who have suspected of ureterocele considering ultrasound report of a vesicle of 1.4 x 1.5 cm in lefts ureter bladder’s insertion topography with ipsilateral hydroureter and renal dilatation. Beside the urinary dysfunction, the animal presented good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. A new ultrasound exam and Computerized Urotomography with contrast gave the definitive diagnosis of left orthotopic ureterocele with twisted hydroureter (proximal 1.29 cm and distally 0.98 cm) and hydronephrosis (3.32 cm). The marsupialization was chosen scientifically based to correct the ureterocele and the patient presented good general condition since then with prompt improvement of clinical signs. The patient was submitted to serial image exams in six weeks following up to check the consequent urinary tract dilatation from the previous disease regression. After the last follow up animal received...

Symptomatic orthotopic ureterocele in a dog

Background: Ureteroceles are cystic dilatations of the terminal ureter and is a rare diagnosed condition in dogs. They can be classified as orthotopic when it is entirely within the bladder and the ureteral orifice emerges normally or ectopic if the ureteral orifice is not in the normal position in the trigone. Orthotopic are usually clinically silent. Ureterocele can contribute to lower urinary tract disease leading to infections and loss of the renal function. As long as this injury can arise slowly, it might be underdiagnosed in companion animals. This case aims to report a case of a bitch with diagnosed symptomatic orthotopic ureterocele efficacious surgical treatment. Case: A 5-month-old female mixed breed was referred to the veterinary hospital, with a major complaint of urinary incontinence since the birth date after the first attendance in a colleague who have suspected of ureterocele considering ultrasound report of a vesicle of 1.4 x 1.5 cm in lefts ureter bladders insertion topography with ipsilateral hydroureter and renal dilatation. Beside the urinary dysfunction, the animal presented good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. A new ultrasound exam and Computerized Urotomography with contrast gave the definitive diagnosis of left orthotopic ureterocele with twisted hydroureter (proximal 1.29 cm and distally 0.98 cm) and hydronephrosis (3.32 cm). The marsupialization was chosen scientifically based to correct the ureterocele and the patient presented good general condition since then with prompt improvement of clinical signs. The patient was submitted to serial image exams in six weeks following up to check the consequent urinary tract dilatation from the previous disease regression. After the last follow up animal received...(AU)

Ureteral stent placement using a double J-catheter in the treatment of ectopic ureter in a dog

Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is locateddistal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs isrecommended and the approach varies with the classification. In the postoperative period, complications are common.When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at usingthe double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatmentof an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinaryhospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on theright side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography)and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographicexamination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteralstenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical interventionwas indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed witha urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epiduralcatheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm wasmade in the distal portion of the right ureter to increase the circumference of the...

Ureteral stent placement using a double J-catheter in the treatment of ectopic ureter in a dog

Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is locateddistal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs isrecommended and the approach varies with the classification. In the postoperative period, complications are common.When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at usingthe double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatmentof an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinaryhospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on theright side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography)and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographicexamination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteralstenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical interventionwas indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed witha urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epiduralcatheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm wasmade in the distal portion of the right ureter to increase the circumference of the...(AU)

Colectomia subtotal em gato com megacólon / Cat subtotal colectomy with megacolon

Megacólon consiste em um aumento persistente do diâmetro do cólon. Nos gatos, a forma idiopática é a mais observada. Relata-se um caso de megacólon em um felino fêmea, sem raça definida, de quatro anos, com histórico de constipação intermitente, cauda flácida e incontinência urinária. Os exames de imagem evidenciaram a presença de grande conteúdo fecal em cólon e peristaltismo lento. O paciente foi submetido a tratamento clínico. Devido a resposta insatisfatória a terapêutica, optou-se por colectomia subtotal, preservando-se a válvula íleo-cecólica. Após 30 dias do procedimento, o animal ainda apresentava quadro de constipação e incontinência urinária, não retornando para consulta. A etiologia do megacólon está relacionada com o prognóstico do animal, em que desordens neurológicas fazem parte do diagnóstico diferencial.

Megacolon consists of a persistent increase in the diameter of the colon. In cats, the idiopathic form is the most observed. We report a case of megacolon in a four-year-old female, feline, with a history of intermittent constipation, flaccid tail and urinary incontinence. Imaging exams showed the presence of large fecal content in the colon and slow peristalsis. The patient underwent clinical treatment. Due to the unsatisfactory response to therapy, we opted for subtotal colectomy, preserving the ileocecolic valve. After 30 days of the procedure, the animal still had constipation and urinary incontinence, not returning for consultation. The etiology of megacolon is related to the prognosis of the animal, in which neurological disorders are part of the differential diagnosis.

Use of monopolar cauterization by cystoscopy for ectopic intramural ureter correction in a bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a positionother than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics forsurgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show thesurgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guided monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few monthsof life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profoundgrowth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Dueto a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously ofits intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostiumcould be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orientthe ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EUchannel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside theurinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed inboth ureters...

Use of monopolar cauterization by cystoscopy for ectopic intramural ureter correction in a bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a positionother than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics forsurgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show thesurgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guided monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few monthsof life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profoundgrowth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Dueto a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously ofits intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostiumcould be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orientthe ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EUchannel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside theurinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed inboth ureters...(AU)