Management of obstructive urethroliths, urethral pseudodiverticulum, and stricture by diverticulectomy, urethroplasty, and urethral stenting placement in a male goat.

A 5-year-old wether was presented for an acute onset of loss of appetite and inability to urinate. Urethral urolithiasis causing urethral obstruction was diagnosed and a cystostomy catheter was placed. The wether continued to be unable to urinate through the urethra and further developed a perineal pseudodiverticulum. Diverticulectomy followed by a urethroplasty using porcine small intestinal submucosa was performed to relieve the obstruction. The wether developed a urethral stricture following urethroplasty and the owners refused a perineal urethroplasty. Cystourethrography, fluoroscopic-guided balloon dilations, and urethral stent placement were done to establish urethral patency. The wether developed tissue ingrowth through the stent, resulting in recurrent obstruction that necessitated placement of covered urethral stents. Key clinical message: Although obstructive uroliths usually carry a guarded prognosis in small ruminants, the use of novel interventional radiology techniques along with urethroplasty using a xenograft allowed a wether to achieve urethral patency and normal urinations.

Prise en charge d'un bouc présentant des urétrolithes osbtructifs, un pseudodiverticule urétral et une stricture par diverticulectomie, urétroplastie et placement d'un stent urétral. Un bouc castré de 5 ans a été présenté pour une perte aigüe d'appétit et une incapacité à uriner. Un calcul urétral provoquant une obstruction urinaire a été diagnostiquée et une sonde de cystotomie placée. Le bouc a continué d'être incapable d'uriner pas son urètre et a développé un pseudodiverticule périnéal. Une diverticulectomie suivie d'une urétroplastie utilisant de la sous-muqueuse d'intestin grêle de porc a été réalisée pour soulager l'obstruction. Le bouc a développé une stricture urétrale à la suite de l'urétroplastie et les propriétaires ont refusé une urétroplastie périnéale. Une cystourétrographie, des dilatations par ballonnets guidées par fluoroscopie ainsi que le placement d'un stent urétral ont été réalisés afin de résoudre l'obstruction urétrale. Le bouc a développé une réaction tissulaire envahissant la lumière du stent, entrainant ainsi une nouvelle obstruction et nécessitant la mise en place de stents urétraux couverts.Message clinique clé :Bien que les urolithes obstructifs aient généralement un pronostic réservé chez les petits ruminants, l'utilisation de nouvelles procédures provenant de la médecine interventionnelle associées à une urétroplastie utilisant une xénogreffe a permis d'obtenir une perméabilité de son urètre et des mictions normales chez ce bouc.(Traduit par les auteurs).

Minimally invasive removal of obstructive ureteral stones by intracorporeal lithotripsy in horses: 3 patients.

Three client-owned horses diagnosed with obstructive ureteral stones were referred and treated in a minimally invasive manner by retrograde ureteroscopy in conjunction with electrohydraulic lithotripsy (EHL) or laser Holmium:YAG lithotripsy (HYL). For all 3 horses, additional tests revealed variable degrees of azotemia and ureteral obstruction. Ultrasound examination (2 horses) revealed a loss of cortico-medullary distinction consistent with a chronic nephropathy. Ultrasound-guided biopsy of the right kidney in 1 horse revealed moderate glomerulosclerosis and lymphoplasmacytic nephritis. A standing anesthesia with a coccygeal epidural was done for each horse. A perineal urethrotomy was performed in 2 horses before the urethrocystoscopy. One horse was treated with Holmium:YAG laser lithotripsy and 2 others were treated using a electrohydraulic lithotripsy probe. Each procedure was successful. The ureteroscopy was successfully performed and visualization was excellent. Fragmentation of stones seemed easier with the electrohydraulic lithotripsy probe. No complications, pain, or signs of discomfort after the procedure were noticed. All 3 horses were discharged from the hospital. Key clinical message: Obstructive ureteral stones in horses can be successfully treated in a minimally invasive manner by retrograde ureteroscopy accompanied by lithotripsy. This technique is safe, not painful and did not require general anesthesia. Electrohydraulic lithotripsy appeared superior for stone fragmentation.

Exérèse minimalement invasive de calculs urétéraux obstructifs par lithotritie intracorporelle chez le cheval : trois patients. Trois chevaux appartenant à des clients diagnostiqués avec des calculs urétéraux obstructifs ont été référés et traités de manière peu invasive par urétéroscopie rétrograde en conjonction avec une lithotripsie électrohydraulique (EHL) ou une lithotripsie au laser Holmium:YAG (HYL). Pour les trois chevaux, des tests supplémentaires ont révélé des degrés variables d'azotémie et d'obstruction urétérale. L'échographie (deux chevaux) a révélé une perte de distinction cortico-médullaire compatible avec une néphropathie chronique. La biopsie échoguidée du rein droit chez un cheval a révélé une glomérulosclérose modérée et une néphrite lymphoplasmocytaire. Une anesthésie debout avec une péridurale coccygienne était effectuée pour chaque cheval. Une urétrotomie périnéale a été réalisée chez deux chevaux avant l'urétrocystoscopie. Un cheval a été traité par lithotripsie au laser Holmium:YAG et deux autres ont été traités à l'aide d'une sonde de lithotripsie électrohydraulique. Chaque procédure a réussi. L'urétéroscopie a été réalisée avec succès et la visualisation était excellente. La fragmentation des calculs semblait plus facile avec la sonde de lithotripsie électrohydraulique. Aucune complication, douleur ou signe d'inconfort après la procédure n'a été remarqué. Les trois chevaux ont obtenu leur congé de l'hôpital.Message clinique clé :Les calculs urétéraux obstructifs chez les chevaux peuvent être traités avec succès de manière peu invasive par urétéroscopie rétrograde accompagnée de lithotripsie. Cette technique est sûre, non douloureuse et ne nécessite pas d'anesthésie générale. La lithotritie électrohydraulique est apparue supérieure pour la fragmentation des calculs.(Traduit par Dr Serge Messier).

Removal of lower urinary tract stones by percutaneous cystolithotomy: 68 cases (2012-2017).

OBJECTIVE: To describe the use and outcome of percutaneous cystolithotomy (PCCL) for removal of urethral and bladder stones in dogs and cats. STUDY DESIGN: Retrospective case series. ANIMALS: Sixty-eight client-owned dogs and cats. METHODS: Records were reviewed and analyzed for dogs and cats that underwent PCCL between January 2012 and December 2017. Signalment, clinical presentation, laboratory and imaging data, procedure time, use of lithotripsy, biopsy, perioperative and immediate postoperative complications, hospitalization times, stone composition, and urine culture results were recorded. Owners were contacted by phone or email 3 weeks after the procedure. Follow-up communications with the owner and referring veterinarian were also recorded. RESULTS: Seventy percutaneous cystolithotomies were performed in 59 dogs and nine cats. The median duration of the procedure was 95 minutes (45-420), and lithotripsy was required in 3% (2/70) of PCCL. Complications during the procedure were reported in one case. In eighty-three percent of procedures (58/70), animals were discharged within 24 hours postoperative. Twenty-four percent (16/68) of animals had minor complications (lower urinary tract signs), and one dog had a major complication (surgical wound dehiscence) during the 3 weeks after the operation. Long-term follow-up revealed stone recurrence in 21% of cases followed more than a year after the procedure (7/33). CONCLUSION: Percutaneous cystolithotomy allowed removal of bladder and urethral stones with rapid postoperative recovery and few major perioperative or short-term postoperative complications. CLINICAL SIGNIFICANCE: Percutaneous cystolithotomy provides an attractive minimally invasive surgical alternative for removal of lower urinary tract stones in small animals.

Uretero-Cutaneous Fistula and Renal Abscessation as a Complication of Ureteral Stenting in a Dog.

An 11 yr old female spayed shih tzu was referred for treatment of left ureterolithiasis with complete obstruction of the left ureter and pyonephrosis. A ureteral stent was placed surgically to relieve the obstruction and pyonephrosis was treated with antibiotics. Three and a half years following stent placement, the patient developed an abscess on the left flank with chronic purulent discharge. Diagnostic imaging confirmed the presence of a left uretero-cutaneous fistula and renal abscess. A left ureteronephrectomy was performed. The dog was euthanatized 4 mo later for cardiac insufficiency unresponsive to medical treatment. This is the first report of a uretero-cutaneous fistula and renal abscessation as a complication of ureteral stenting in a dog.

Vulvar calcinosis cutis in a female dog with urinary incontinence secondary to an ectopic ureter.

A 2-year-old, spayed female standard schnauzer dog was presented with a history of urinary incontinence and painful whitish lesions localized to the vulvar region. An ectopic ureter was diagnosed by cystoscopy. Histopathology of the biopsy specimens from the vulvar lesions was compatible with calcinosis cutis. Seven weeks following the cystoscopic laser ablation of the ectopic ureter and resolution of the urinary incontinence, the calcinosis cutis lesions completely resolved without any specific treatment. To the authors' knowledge, vulvar calcinosis cutis secondary to urinary incontinence has not been previously reported in a dog. Key clinical message: This is the first case report in the veterinary literature of vulvar calcinosis cutis in a female dog due to urinary incontinence.

Calcinose cutanée au niveau de la région vulvaire chez une chienne présentant une incontinence urinaire secondaire à un uretère ectopique. Une femelle stérilisée Schnauzer standard âgée de 2 ans a été présentée pour une histoire d'incontinence urinaire et des lésions blanchâtres douloureuses localisées en région vulvaire. Un uretère ectopique a été diagnostiqué par cystoscopie. L'analyse histopathologique des biopsies des lésions de la vulve était compatible avec une calcinose cutanée. Lors de la réévaluation 7 semaines après la résection cystoscopique de l'uretère ectopique par ablation au laser, les lésions de calcinose cutanée étaient complètement résolues sans traitement spécifique. D'après les auteurs, une calcinose cutanée secondaire à une incontinence urinaire et affectant la région vulvaire chez une chienne n'a pas été rapportée à ce jour.Message clinique clé:Ceci constitue le premier rapport dans la littérature vétérinaire d'un cas de calcinose cutanée vulvaire chez une chienne due à de l'incontinence urinaire.(Traduit par les auteurs).

Evaluation of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester lipase concentrations in cats with kidney disease and with normal SNAP fPL.

Measuring 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase activity is a cost-effective test for diagnosing pancreatitis compared to the feline pancreas-specific lipase (Spec fPL) test. However, little is known about the influence of renal insufficiency on DGGR lipase in cats. This study evaluated the influence of renal function on serum DGGR lipase in the cat. Serum samples from 49 cats with normal pancreas-specific lipase immunoreactivity were analyzed for DGGR lipase activity and serum creatinine. Median serum DGGR lipase activity for cats with kidney disease (KD+) was 22 IU/L (range: 9 to 29 IU/L), whereas for cats without kidney disease (KD-) and healthy cats, the medians were 16 IU/L (range: 6 to 32 IUI/L), and 15 IU/L (range: 9 to 23 IU/L), respectively. The KD+ group had significantly higher DGGR lipase concentrations compared to the healthy group (P = 0.030), but most results were within the reference range. There was a weak positive correlation between creatinine and DGGR lipase values (R 2 = 19.6%; P = 0.0014) and no significant correlation between symmetric dimethylarginine (SDMA) and DGGR lipase. Key clinical message: Although cats with kidney disease had significantly higher serum DGGR lipase concentrations than the healthy controls, the difference was small and does not appear to be clinically relevant.

Évaluation de la concentration de la lipase de l'ester de l'1,2-o-dilauryl-rac-glycero-3-acide glutarique-(6'-methylresorufine) chez les chats présentant une maladie rénale et un SNAP fPL normal. La lipase d'ester 1,2-o-dilauryl-rac-glycero-3-glutarique ester (6'-méthylrésorufine) (DGGR) semble être utile pour le diagnostic ante-mortem de pancréatite et s'avère également une méthode économique par rapport au dosage de la lipase féline spécifique du pancréas (Spec fPL). Toutefois, l'influence de l'insuffisance rénale sur la lipase DGGR, est encore méconnue chez le chat. Le but de cette étude prospective est d'établir l'influence de la fonction rénale sur la lipase DGGR chez les chats. Du sérum a été prélevé chez 49 chats ayant un test semi-quantitatif normal pour l'estimation de l'immunoréactivité pancréatique féline (SNAP fPL) et a été analysé pour déterminer l'activité sérique de la DGGR lipase et de la créatinine. La médiane sérique de la lipase DGGR chez les chats atteints de maladie rénale (groupe KD+) était de 22 (intervalle: 9­29) UI/L, tandis que celle des chats sans maladie rénale (groupe KD−) et celle des chats sains était de 16 (6­32) UI/L et 15 (9­23) UI/L, respectivement. Le groupe KD+ présentait des concentrations sériques de lipase DGGR significativement plus élevées que le groupe de chats sains (P = 0,030), mais la plupart des résultats se situaient dans les valeurs de référence. Il y avait une corrélation positive statistiquement significative, mais faible, entre les valeurs de la créatinine et de la lipase de DGGR (R 2 = 19,6 %; P = 0,0014). Il n'y avait pas de corrélation significative entre la symétrique diméthylarginine (SDMA) et la lipase DGGR.Message clinique clé:Ainsi, les chats atteints d'une maladie rénale présentent des concentrations sériques de lipase DGGR significativement plus élevées que celles des chats sains. Cependant, la différence est légère et ne semble pas être cliniquement pertinente.(Traduit par les auteurs).

Retained laser fiber in the nidus of a recurrent cystine urolith in an intact male English bulldog.

A lithotripsy and percutaneous cystolithotomy (PCCL) were performed on a 5-year-old intact male English bulldog. The composition of the uroliths was 100% cystine. When a second PCCL was performed 2 months later, the nidus of the largest urolith was a segment of an optical fiber broken off during laser lithotripsy.

Fibre laser formant le nidus d'une urolithiase à cystine récurrente chez un Bulldog Anglais mâle entier. Une lithotripsie et une cystolithotomie percutanée (PCCL) ont été réalisées sur un Bulldog Anglais mâle entier de 5 ans. L'urolithe était constitué à 100 % de cystine. Lors d'une seconde PCCL réalisée 2 mois plus tard, le nidus du plus grand calcul de cystine se révéla être un fragment de fibre optique brisée durant la lithotripsie au laser.(Traduit par Dre Emmanuelle Butty).

ENDOSCOPIC REMOVAL OF A FOREIGN BODY IN A MEXICAN AXOLOTL (AMBYSTOMA MEXICANUM) WITH THE USE OF MS222-INDUCED IMMOBILIZATION.

This communication briefly describes the use of tricaine methanesulfonate (MS222) to induce chemical restraint/general anesthesia of a Mexican axolotl (Ambystoma mexicanum) for the endoscopic retrieval of a gastric foreign body. There is very little published scientific literature concerning the anesthesia of Mexican axolotls. The anesthesia used in this case was an immersion bath of tricaine methanesulfonate where the concentration of tricaine methanesulfonate was gradually increased to 500 mg/L (ppm) over a 15-min period. A loss of righting reflex was observed within 3 min of attaining the final concentration of the anesthetic bath. The first voluntary movements following the transfer to a freshwater bath occurred within 7 min. The recovery was uneventful. Tricaine methanesulfonate in this case proved to be an effective anesthetic agent for a short, minimally invasive procedure.

Use of percutaneous cystolithotomy for removal of urethral uroliths in a pot-bellied pig.

A 6-month-old neutered male pot-bellied pig was presented for an obstructive urethral stone which was successfully removed by percutaneous cystolithotomy (PCCL). The pig recovered well although suspected urethral spasms and pollakiuria persisted for 2 weeks after surgery. The owner reported a good urine stream 2 months after discharge. This novel minimally invasive approach provided excellent visualization and allowed complete evaluation of the lower urinary tract. Percutaneous cystolithotomy holds great promise for the future treatment of various lower urinary tract disorders in this species.

Utilisation de la technique de cystolithotomie transcutanée pour le retrait d'un calcul urétral chez un cochon vietnamien. Un cochon vietnamien mâle castré de 6 mois a été présenté suite à un calcul urétral obstructif qui a pu être retiré par cystolithotomie transcutanée. Le cochon s'est bien remis bien qu'une pollakiurie persistante possiblement secondaire à des spasmes urétraux fut observée pendant deux semaines après la procédure. Le propriétaire a rapporté la présence d'un bon jet urinaire deux mois après la procédure. Cette nouvelle technique minimalement invasive permet une excellente visualisation et évaluation de l'ensemble du système urinaire inférieur. C'est une option thérapeutique d'avenir dans la gestion des cas d'affection du système urinaire chez cette espèce.(Traduit par les auteurs).

Syndrome of inappropriate antidiuretic hormone secretion in a dog with a histiocytic sarcoma.

A 7-year-old female neutered Bernese mountain dog was presented in a semi-comatose state. Based on serum hypo-osmolality with inappropriate urine hyper-osmolality and urine sodium excretion, the dog was diagnosed with a syndrome of inappropriate antidiuretic hormone secretion secondary to a histiocytic sarcoma. This report describes the first case of this syndrome in a dog with histiocytic sarcoma.

Syndrome de sécrétion inappropriée d'hormone antidiurétique chez un chien avec un sarcome histiocytaire. Une chienne stérilisée de 7 ans, Bouvier bernois, est présentée dans un état semi-comateux. Basé sur une hypo-osmolalité sérique associée à une hyper-osmolalité urinaire et une excrétion sodique urinaire toutes deux inappropriées, un diagnostic de syndrome de sécrétion inappropriée d'hormone antidiurétique secondaire à un sarcome histiocytaire est posé. Ce cas est le premier cas de ce syndrome chez un chien avec un sarcome histiocytaire.(Traduit par les auteurs).

Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum.

BACKGROUND: Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. HYPOTHESIS/OBJECTIVES: Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). ANIMALS: Eight client-owned dogs with UD treated with an AUS. METHODS: Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. INCLUSION CRITERIA:  diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow-up. Urinary continence score (UCS) was attributed retrospectively. RESULTS: Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). CONCLUSION: Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.

Feline leptospirosis serosurvey from a Quebec referral hospital.

Epidemiologic studies have linked interactions with cats as a risk factor for human leptospirosis, but serosurveys of feline Leptospira spp. infection are scarce in the veterinary literature. The objective of this study was to conduct a serosurvey of Leptospira spp. infection in cats presenting to an eastern Canadian veterinary teaching hospital (VTH). All serum samples collected from cats presented to the VTH were tested by the microscopic agglutination test (MAT) for the Leptospira serovars Canicola, Grippotyphosa, Icterohaemorrhagiae, Bratislava, Pomona, and Autumnalis. Ten of 40 cats [25%; 95% confidence interval (CI): 12.7% to 41.2%] tested had positive antibody titers (≥ 1:100). All 10 cats with positive titers were positive for Bratislava and 2 were also positive for Autumnalis. This high incidence of seropositivity for Leptospira spp. may suggest that the disease could be of more clinical importance than previously recognized.

Enquête sérologique sur la leptospirose féline dans un hôpital de référence du Québec. Les études épidémiologiques ont associé les interactions avec les chats comme un facteur de risque pour la leptospirose humaine, mais les enquêtes sérologiques sur l'infection à la leptospirose féline sont rares dans les publications vétérinaires. La présente étude avait pour objectif de réaliser une enquête sérologique de l'infection à Leptospira chez les chats présentés dans un hôpital d'enseignement vétérinaire (HEV) de l'Est du Canada. Tous les échantillons de sérum prélevés auprès des chats présentés à l'HEV ont été testés à l'aide du sérodiagnostic d'agglutination microscopique pour les sérotypes de Leptospira Canicola, Grippotyphosa, Icterohaemorrhagiæ, Bratislava, Pomona et Autumnalis. Dix des 40 chats [25 %; intervalle de confiance (IC) de 95 % : 12,7 % à 41,2 %] ont obtenu des titres d'anticorps positifs (≥ 1:100). Les 10 chats avec des titres positifs étaient positifs pour Bratislava et 2 étaient aussi positifs pour Autumnalis. Cette incidence élevée de séropositivité pour Leptospira peut suggérer que la maladie pourrait être d'une importance clinique supérieure à ce qui était reconnu auparavant.(Traduit par Isabelle Vallières).

Benign ureteral obstruction in cats: Outcome with medical management.

BACKGROUND: Limited information is available regarding the outcome of medical management (MM) of benign ureteral obstruction in cats (BUO). HYPOTHESIS: Describe clinical characteristics and outcome of MM of BUO. ANIMALS: Seventy-two client-owned cats with 103 obstructed kidneys. METHODS: Medical records of cats diagnosed with BUO between 2010 and 2021 that received >72 hours of MM were retrospectively reviewed. Clinical data, treatment, and outcome were reviewed. Outcome was classified as success, partial success, or failure based on ultrasound findings. Factors associated with outcome were assessed. RESULTS: Seventy-two cats with 103 obstructed kidneys were enrolled. The causes of obstruction were uroliths in 73% (75/103), strictures in 13.5% (14/103), and pyonephrosis in 13.5% (14/103) of affected kidneys. Median serum creatinine concentration at presentation was 4.01 mg/dL (range, 1.30-21.3 mg/dL). Outcome after MM was considered a success in 30% (31/103), partial success in 13% (13/103), and failure in 57% (59/103) of kidneys. Success was reported in 23% (17/75) of kidneys with uroliths, 50% (7/14) with pyonephrosis, and 50% (7/14) with strictures. Median time to a successful outcome was 16 days (range, 3-115 days). Distal and smaller uroliths (median length, 1.85 mm) were significantly associated with success (P = .05 and P = .01, respectively). Median survival times were 1188 days (range, 60-1700 days), 518 days (range, 7-1812 days), and 234 days (range, 4-3494 days) for success, partial success, and failure, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: We found a higher success rate for MM of BUO than previously reported. Smaller distal uroliths (<1-2 mm) were more likely to pass.

Pseudomembranous cystitis in cats with presumed or confirmed mineralization: A retrospective study of 26 cases (2016-2021).

BACKGROUND: Pseudomembranous cystitis (PMC) in cats is a recognized disease, but concurrent mineralization is reported rarely and its outcome is poorly described. HYPOTHESIS AND OBJECTIVES: Describe a population of cats with PMC and the prevalence of concurrent mineralization. ANIMALS: Twenty-six cats with PMC. METHODS: Medical records were retrospectively reviewed (January 2016 to December 2021). Cats with an ultrasound diagnosis of PMC were included. Clinicopathologic results, imaging, treatment, and outcome were reviewed. RESULTS: All cats were male and 21 (80%) were diagnosed with urethral obstruction (UO). Five cats (23.8%) had positive urine culture (Staphylococcus felis, 3/5; Proteus mirabilis, 2/5) with a median urine pH of 8 (range, 6-9). All cats had ultrasonographic changes suggestive of mineralization. On ultrasound examination, 10 cats (38.5%) had pseudomembranes with acoustic shadowing suggestive of mineralization, 15 (57.7%) had changes indicative of ulceration, and 8 (31%) had changes compatible with of a urachal anomaly. Twenty-two cats received medical treatment, 4 underwent surgery (3 percutaneous cystolithotomy, 1 cystotomy). Twenty cats (77%) survived to discharge. Follow-up ultrasound examination indicated resolution of PMC in 6/7 cats, 4 had persistent hyperechoic bladder lining. Five of 12 cats with follow-up had a relapse of lower urinary tract signs. CONCLUSIONS AND CLINICAL IMPORTANCE: Pseudomembranous cystitis was diagnosed mainly in male cats with UO and imaging findings suggestive of mineralization were present in all cases. Frequent negative urine culture suggests a different etiology than encrusting cystitis related to urease-positive bacteria. Good outcomes can be achieved with medical management.

Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices.

OBJECTIVES: The aim of this study was to evaluate the efficacy and tolerability of a 4% tetrasodium EDTA (tEDTA) infusion protocol in the subcutaneous ureteral bypass (SUB) devices of cats with intraluminal obstruction at a veterinary teaching hospital between July 2017 and April 2020. METHODS: This was a retrospective controlled study. Cats with an obstructed SUB device underwent a 4% tEDTA infusion protocol. Obstruction of the device was diagnosed based on renal pelvic dilation, dilatation of the ureter, mineralized material within the device (cystostomy or nephrostomy catheters) seen on ultrasound, the absence of visible bubbles within the renal pelvis and/or urinary bladder following ultrasound-guided flushing of the device with saline. RESULTS: A total of 16 tEDTA infusion protocols were performed in 14 cats. The infusion protocol was considered successful in 11/16 SUB devices (68.8%). Six devices (n = 6/11; 54.5%) had recurrence of obstruction with a median time of 87 days. One or more episodes of self-limiting pollakiuria and/or hematuria following infusion was seen in eight patients (n = 8/14; 57.1%). CONCLUSIONS AND RELEVANCE: Infusions of 4% tEDTA successfully relieved intraluminal obstruction in patients with occluded SUB devices; however, the recurrence of obstruction was common. Additional studies evaluating case selection and optimal protocols are warranted.

Feline urinary incontinence: a retrospective case series (2009-2019).

OBJECTIVES: The objective of this retrospective study was to describe the feline population presented for urinary incontinence at a veterinary teaching hospital between 2009 and 2019, with a particular focus on cats with a non-neurologic underlying cause. METHODS: The medical records of cats diagnosed with urinary incontinence were retrospectively evaluated. Signalment, clinical presentation, results of diagnostic tests, diagnosis of the underlying cause and treatments were recorded. When information was available, outcome was recorded and follow-ups divided into three time frames (0-1 week, 1 week to 3 months and >3 months). RESULTS: Thirty-five cats were presented with urinary incontinence. Of these, 18 cats with complete medical records presented urinary incontinence of non-neurologic origin. The most common clinical signs at presentation were urine leakage while resting (12/18), urine-soiled perineum (8/18), urine dribbling (8/18) and no spontaneous micturition (5/18). The most common underlying cause was urethral obstruction (67%; 12/18), with a majority due to urethral strictures (58%; 7/12). Other causes were suspected inflammation (2/12), neoplasia (1/12), urolithiasis (1/12) and foreign body (1/12). In 8/10 cats in which it was performed, cystoscopy and contrast cystourethrography were the methods that led to the diagnosis. Twelve cats with urethral obstruction underwent interventional procedures, resulting in complete resolution of incontinence in 7/12 and improvement in 1/12. Urinary tract infection was a common complication after 3 months (4/18). CONCLUSIONS AND RELEVANCE: When incontinence of non-neurologic origin is suspected in a cat, urethral obstruction should be considered. Advanced imaging studies (cystoscopy and contrast studies) are useful for diagnosis. A good prognosis was reported in cats undergoing interventional procedures with no long-term treatment.

Retrospective evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs.

BACKGROUND: Cytoscopic-guided laser ablation (CLA) is a technique that can be used to correct intramural ectopic ureters (EUs) in dogs. HYPOTHESIS/OBJECTIVES: To describe clinicopathologic, imaging, and cystoscopic findings in dogs undergoing CLA for intramural EU correction, and whether any of these findings are associated with continence outcomes. ANIMALS: Thirty-one client-owned dogs undergoing CLA between 2009 and 2019. METHODS: Retrospective cohort study. Data collected from medical records included signalment, clinical findings (including continence score at presentation), clinicopathologic findings (serum biochemistry profile, urinalysis, and urine culture results before CLA), ultrasonography, and cystoscopy findings. Follow-up information was collected at 1 day to 1 week, 1 week to 1 month, and at >1 month time points after CLA. Final continence score was determined based on this follow-up information. Multiple logistic regression was used to determine factors that were associated with final continence score. RESULTS: Median continence score of dogs at initial evaluation was 2 (range, 2-4). Median continence score after CLA alone was 3 (range, 1-5). Seventeen of 31 (54.8%) dogs received adjunctive medical management after CLA. Median continence score after CLA with or without adjunctive medical management was 5 (range, 1-5). Overall, 67.7% of dogs were considered continent after CLA with or without adjunctive medical management. No preoperative or perioperative factors were found to be associated with final continence score. CONCLUSIONS: Cystoscopic-guided laser ablation for intramural EU in female dogs provides improvement in incontinence. Dogs remaining incontinent after CLA may improve with adjunctive medical management. Surgical management is required to manage incontinence in dogs with extramural EU.

Association between hyperlipidemia and calcium oxalate lower urinary tract uroliths in dogs.

BACKGROUND: Metabolic syndrome is associated with formation of calcium oxalate (CaOx) uroliths in humans. OBJECTIVES: To investigate the association between obesity and hyperlipidemia with CaOx lower urinary tract uroliths in client-owned dogs. ANIMALS: Dogs with (n = 55, U [uroliths]-dogs) and without (n = 39, UF [uroliths-free]-dogs) CaOx lower urinary tract uroliths. METHODS: Case-control study. U-dogs were retrospectively enrolled and compared to UF-dogs. Body condition score (BCS; 1-9 scoring scale), serum triglyceride (TG) and total cholesterol (CH) concentrations and glycemia (after >12-hour food withholding) were recorded in both groups. RESULTS: On univariate logistic regression, when excluding Miniature Schnauzers, odds of having uroliths increased by a factor of 3.32 (95% CI 1.38-11.12) for each mmol/L of TG (P = .027), of 39 (95% CI 9.27-293.22) for each mmol/L of glycemia (P < .0001), and of 2.43 (95% CI 1.45-4.45) per unit of BCS (P = .002). In multivariable models, the effect of TG was retained when all breeds were included for analysis and odds of having uroliths increased by a factor of 4.34 per mmol/L of TG (95% CI 1.45-19.99; P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE: Serum lipid screening in dogs diagnosed with CaOx uroliths might be recommended to improve their medical staging and management.

Comparison of percutaneous cystolithotomy and open cystotomy for removal of urethral and bladder uroliths in dogs: Retrospective study of 81 cases (2014-2018).

OBJECTIVE: Compare percutaneous cystolithotomy (PCCL) and open cystotomy (OC) for removal of bladder and urethral uroliths. DESIGN: Retrospective study. ANIMALS: Client-owned dogs and cats that underwent PCCL (n = 41) or OC (n = 40) between January 1, 2014 and February 28, 2018 at a referral center. METHODS: Medical records of dogs and cats that underwent a PCCL or an OC were reviewed. History, signalment, physical examination, diagnostic tests, length of the procedure and anesthesia, complications, and duration of hospitalization were recorded. RESULTS: A total 17 cats (PCCL = 10; OC = 7) and 64 dogs (PCCL = 31; OC = 33) were included. There was no significant difference, regardless of species, in the mean surgical time (45 min [24-160 min] and 48.5 min [15-122 min] with P = .54 in dogs, P = .65 in cats) nor mean duration of anesthesia (90 min [50-120 min] and 98 min [54-223 min] with P = .87 in dogs, P = .08 in cats) in the PCCL and OC groups respectively. Number of uroliths did not affect duration of surgery in either group. Complete urolith removal was achieved in 98% of dogs and cats in both groups. The median hospitalization time was significantly shorter in the PCCL group for dogs (11.3 hours [range 4 to 51.3] in the PCCL vs 56.6 hours [range 7.3 to 96] in the OC group; P < .001) but did not differ for cats (24.5 hours [range 8.3 to 30] in the PCCL vs 56.6 hours [range 10.1 to 193.2] in the OC group; P = .08). CONCLUSION AND CLINICAL RELEVANCE: Bladder urolith removal by PCCL procedure is no longer than OC. Further studies are needed to compare the pain related to procedure between PCCL and OC.

Multicenter retrospective evaluation of transmural migration of subcutaneous ureteral bypass devices within the digestive tract in cats.

BACKGROUND: Placement of a subcutaneous ureteral bypass (SUB) device is an effective method to relieve all causes of ureteral obstruction in cats. Complications involving migration within the gastrointestinal tract have been seldomly described. OBJECTIVES: To characterize transmural migration of SUB devices within the digestive tract in cats. ANIMALS: Eleven migrated SUB catheters identified in 8 cats between 2017 and 2021. METHODS: Retrospective review of medical records of cats with a SUB device in which migration into the gastrointestinal tract was identified. RESULTS: The median time from SUB device placement to implant migration was 928 days (201-2298 days). Seven cats had obstruction of the SUB device and a positive urine culture at diagnosis. The migration was identified by ultrasound in 6/11, pre-operative contrast radiography in 2/2, and only at time of surgery in 3 SUB devices. All cats underwent surgical correction. Four nephrostomy and 7 cystotomy catheters migrated. Migration occurred into the duodenum (3/11), jejunum (7/11), and colon (1/11). SUB devices were removed in 7 cats and replaced in 2 cats, with 1 cat diagnosed with 2 migration events. Gastrointestinal resection and anastomosis were performed in 7/8 cats and an enterotomy in 2 cats. Six cats survived to discharge. The median follow-up time after migration diagnosis was 365 days (range, 0-1114 days) and 2 cats are still alive. CONCLUSIONS AND CLINICAL IMPORTANCE: Although a rare complication, migration of SUB device should be considered in cats with SUB device obstruction and a positive urine culture.