Surgical management of urethral obstruction secondary to perineal liposarcoma in a dog: a case report.

BACKGROUND: Swelling of the perineal region in male dogs is most commonly caused by a perineal hernia. Clinical signs associated with perineal hernia are constipation, tenesmus or stranguria. This case report documents a rare cause of perineal swelling created by the growth of a malignant tumour leading to urethral obstruction and subsequent stranguria. CASE PRESENTATION: An 11-year-old neutered male German Shepherd was presented for swelling in the perineal region and stranguria for three days. Complete blood count and serum biochemistry were unremarkable. Ultrasound revealed a heterogeneous mass in the perineal region. Retrograde urethrography showed a severe narrowing of the urethra caudal to the pelvis. A fine-needle aspirate of the mass was highly suspicious for liposarcoma. Staging was performed by computed tomography (CT) of the thorax and abdomen. Total penile amputation in combination with pubic-ischial pelvic osteotomy, transposition of the remaining urethra through the inguinal canal, V-Y-plasty cranial to the prepuce and preputial urethrostomy were performed to remove the tumour. Histopathology confirmed a well-differentiated liposarcoma with complete histological margins. Six months after the surgery the dog was doing well and there were no signs indicating local tumour recurrence. CONCLUSIONS: Wide surgical excision is generally recommended for soft tissue sarcomas, however this is sometimes not feasible for large tumours. In the case reported here, tumour resection was achieved by a combination of several surgical techniques with a good clinical outcome.

Blood plasma and urinary biomarkers of oxidative stress in cats with urethral obstruction.

BACKGROUND: This study aimed to investigate variations of the oxidative status in cats affected by urethral obstruction (UO) under Feline Idiopathic Cystitis (FIC) and Bacterial Cystitis (BC), in comparison with a group of healthy subjects. In both groups, the levels of several markers (either direct or indirect) indicative of the oxidative attack and of the antioxidant response were analyzed on plasma and urine samples. In particular, the plasma samples were evaluated for nitric oxide (NO), hydroperoxides derived by reactive oxygen activity (d-ROMs test), superoxide anion (O2-), glutathione peroxidase activity (GPx), superoxide dismutase activity (SOD), and ferric reducing antioxidant power (FRAP test); while on urine the levels of NO, d-ROMs, FRAP, SOD, malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured. Urine of UO patients was also subjected to urine-culture test. RESULTS: The analytical data on plasma showed that UO, independently of the FIC or BC etiology, induced the insurgence of oxidative stress conditions at the systemic level. In the urine of the UO patients, except for SOD that increased, the markers of redox status were markedly decreased due probably their compromised filtration, thus suggesting involvement of renal function (assessed also by the high levels of plasma creatinine and proteinuria) with no oxidative damage of the lower urinary tract. Moreover, the adoption of a novel oxidative stress index' (OSI) allowed to establish, by means of a numerical value, the different degrees of oxidative stress conditions for single UO patients, both in terms of oxidative attack and antioxidant response. CONCLUSIONS: Feline urethral obstruction, induced by Idiopathic Cystitis and Bacterial Cystitis, causes oxidative stress conditions at the systemic level that do not interest the lower urinary tract. Despite to the high variability of the profiles of oxidative stress indexes both in healthy and UO patients, the determination of OSI made possible the evaluation of their single degrees of oxidative stress. Possibly the results of this investigation can be compared with those of correspondent pathologies both in humans and in other animal species.

Occurrence of cardiovascular events in 168 cats with acute urinary tract obstruction.

Background: Cardiovascular dysfunction associated with acute kidney injury has been recently described in veterinary medicine, but limited information is available for cats with urinary tract obstruction (UTO). Objective: This retrospective study aimed to describe the type, frequency, timeline, and risk factors for cardiovascular events (CVEs) in cats treated for acute UTO. Animals and procedures: Medical records of cats admitted to the intensive care unit for either upper (ureteral: UUTO) or lower (urethral: LUTO) UTO from 2016 to 2021 were reviewed. Cardiovascular events were defined as development of arrhythmia, heart murmur or gallop sound, clinical signs consistent with fluid overload (CRFO), or decreased tissue perfusion (DTP). Results: One hundred and sixty-eight cats with UTO were recruited (56 with UUTO and 112 with LUTO). Cardiovascular events were reported in 61.9% of cases, including arrhythmia (33.6%), gallop rhythm (28.1%), heart murmur (15.3%), CRFO (14.4%), and DTP (8.6%). Potassium concentration, preexisting chronic kidney disease, and renal pelvic dilation at abdominal ultrasonography were associated with CVE occurrence in multivariate analysis. Conclusions: This study highlighted frequent CVEs in cats treated for UTO, with a potential strong impact on outcome. Therefore, cardiovascular parameters of cats with preexisting chronic kidney disease or those admitted with hyperkalemia or renal pelvic dilation should be closely monitored.

Survenue d'anomalies cardio-vasculaires chez 168 chats présentés pour obstruction du tractus urinaire. Contexte: Si des anomalies cardiovasculaires secondaires à une insuffisance rénale aigue ont été décrites récemment en médecine vétérinaire, ces données restent limitées concernant les obstructions du tractus urinaire (OTU) chez le chat. Objectif: Décrire le type, la fréquence, le délai d'apparition et les facteurs de risques d'anomalies cardio-vasculaires (ACV) chez des chats hospitalisés pour OTU aigue. Animaux et protocoles: Les dossiers médicaux des chats admis en unité de soins intensifs pour obstruction du tractus urinaire haut ( urétérales-OTUH) et bas (urétrales-OTUB) entre 2016 et 2021 ont été consultés. Les ACV retenus étaient des arythmies cardiaques, le développement de souffles cardiaques et de bruits de galop, les signes relatifs à une surcharge en fluide (SRSF) et de diminution de la perfusion tissulaire (SDPT). Résultats: Cent soixante-huit chats avec des OTU ont été recrutés (56 OTUH, 112 OTUB). Des ACV ont été observés dans 61,9 % des cas, incluant des arythmies (33,6 %), l'apparition de bruits de galop (28,1 %) et de souffles cardiaques (15,3 %), des SRSF (14,4 %) et des SDPT (8,6 %). La concentration plasmatique en potassium, la présence d'une MRC sous-jacente et d'une dilatation pyélique à l'échographie abdominale ont été associées à la présence d'ACV par l'analyse multivariée. Conclusions: Cette étude montre que les ACV surviennent fréquemment chez les chats présentés pour OTU, et suggère un impact sur la survie de ces animaux. Les animaux avec un historique de MRC, ceux présentés avec une hyperkaliémie et/ou avec une dilatation pyélique à l'échographie abdominale devraient être surveillés avec plus de précautions que les autres.(Traduit per les auteurs).

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).

Transpelvic urethrostomy in a female dog with congenital vestibulovaginal and urethral stenosis: A case report.

OBJECTIVE: To describe transpelvic urethrostomy (TPU) as a surgical technique for the successful treatment of vestibulovaginal and urethral stenosis in a 7 month old female spayed mixed-breed dog. STUDY DESIGN: Case report. SAMPLE POPULATION: Female spayed mixed-breed dog with obstructive vaginal tissue present on vaginal examination. METHODS: The dog presented with a history of persistent urine dribbling, stranguria, and dysuria since birth. Vaginoscopy and fluoroscopy revealed severe vestibulovaginal and urethral stenosis. An episiotomy and partial vaginectomy were performed to remove stenotic tissue. A perineal urethrostomy was attempted from a blind-ended pouch associated with the stenotic urethral tissue but was unsuccessful. The dog was repositioned in dorsal recumbency and a postpubic urethrostomy was performed. RESULTS: Six days postoperatively, incisional dehiscence occurred at the cranial aspect of the urethrostomy. The site was revised at this location using a TPU to decrease tension at the urethrostomy site. The dog recovered uneventfully with no further complications identified after surgery. Forty-two months after surgical intervention, the dog continued to show no clinical signs. CONCLUSION: Transpelvic urethrostomy may be a viable surgical alternative for dogs diagnosed with urethral stenosis.

Ureteropyeloscopic removal of a nephrolith from a 19 year old Hanoverian gelding.

OBJECTIVE: To describe the ureteropyeloscopic removal of a nephrolith in a horse. ANIMALS: A 19 year old Hanoverian gelding with history of urolithiasis requiring surgical intervention. STUDY DESIGN: Case report METHODS: The horse presented with signs of abdominal straining and stranguria. A proximal urethral calculus was palpable externally within the perineal urethra. Perineal urethrostomy (PU) at the location of the urethral calculi was performed to remove the urethral obstruction. Left nephrolithiasis was then treated by endoscopic retrieval, inserting the endoscope through the PU. The procedures were performed over 2 consecutive days, with the horse standing and sedated. Medical therapy included antimicrobial and anti-inflammatory treatment. RESULTS: The ureteropyeloscopic removal of a nephrolith from the left renal pelvis was completed. No complications were appreciated following the procedure, and the horse was able to return to athletic activity within 2 weeks. The horse had no further clinical signs referable to urinary dysfunction 7 months later. CONCLUSION: Ureteropyeloscopic removal of a nephrolith from the renal pelvis is technically feasible in the equine patient and preserves function of the affected kidney. The availability of a treatment that maintains renal function is a distinct benefit over unilateral nephrectomy, particularly when treating a condition that frequently involves both kidneys.

Preputial urethrostomy with preservation of the local anatomy in 4 dogs.

OBJECTIVE: To describe a novel modified preputial urethrostomy with preservation of the local anatomy in 4 dogs. STUDY DESIGN: Short case series. ANIMALS: Four client-owned male dogs. METHODS: Dogs presented for dysuria and urethral obstruction and underwent a modified preputial urethrostomy as a salvage procedure after the failure of previous treatments. Urethral stenosis or tear was confirmed by cysto-urethrography in all dogs. The preputial urethrostomy involved anastomosis of the pelvic urethra with the preputial mucosa after caudal laparotomy, without dissection of the prepuce or amputation of the penis. Owner follow up was obtained by telephone interview. RESULTS: Urinary obstruction was due to urethral stenosis in 3 dogs and severe complications following perineal urethrostomy in 1 dog. The urinary obstruction was resolved in all dogs by the modified preputial urethrostomy. None of the dogs had signs of dysuria, urinary tract infection, or dermatitis immediately postoperatively. Two dogs showed signs of urinary incontinence from 15 days to 1 month postoperatively, which persisted throughout the follow-up period. CONCLUSION: A functional urethral stoma was obtained in all dogs. This technique may be an alternative to prepubic urethrostomy in male dogs.

Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats.

OBJECTIVE: To describe the procedure, complications, and long-term outcome of cats that underwent a modified prepubic urethrostomy (mPPU) technique for the management of proximal urethral obstructions. ANIMALS: Eight male cats. STUDY DESIGN: Short case series. METHODS: Medical records were reviewed for signalment, diagnostic investigation, details of the surgical procedure, and complications of cats that underwent mPPU. RESULTS: mPPU was well tolerated by all patients, and no intraoperative complications were reported. The duration of follow-up ranged from 13 to 84 months (median 19 months). Early postoperative skin scalding around the stoma associated with mild urinary incontinence during recumbency occurred and was self-limiting in all patients. Two cats required surgical revision at 5 and 6 months, respectively, due to a progressive weight gain and accumulation of abdominal fat around the stoma, causing a partial stomal obstruction. Resolution of clinical signs was reported in both patients. CONCLUSIONS: mPPU was easy to perform and offered favorable outcomes in this cohort of cats.

Irreversible Electroporation Balloon Therapy for Palliative Treatment of Obstructive Urethral Transitional Cell Carcinoma in Dogs.

Progression of transitional cell carcinoma (TCC) in dogs often leads to urinary obstruction. This observational pilot study aimed to evaluate the safety and efficacy of irreversible electroporation (IRE) balloon therapy for the palliative treatment of TCC with partial urethral obstruction. Three client-owned dogs diagnosed with TCC causing partial urethral obstruction were enrolled. After ultrasonographic and cystoscopic examination, IRE pulse protocols were delivered through a balloon catheter device inflated within the urethral lumen. After the procedure, the patients were kept overnight for monitoring and a recheck was planned 28 days later. No complication was observed during the procedure and postprocedural monitoring. After 28 days, one dog had a complete normalization of the urine stream, one dog had stable stranguria, and one dog was presented with a urethral obstruction secondary to progression of the TCC. On recheck ultrasound, one dog had a 38% diminution of the urethral mass diameter whereas the other two dogs had a mass stable in size. IRE balloon therapy seems to be a feasible and apparently safe minimally invasive novel therapy for the palliative treatment of TCC causing urethral obstruction. Further studies are needed to better characterize the safety, efficacy, and outcome of this therapy.

Effect of intermittent bladder flushing on recurrence rate in feline urethral obstruction: 72 cases.

Objective: To evaluate the effect of intermittent bladder flushing on recurrent urethral obstruction (rUO) at 7 d and 30 d after discharge and the risk of bacteriuria as a result of indwelling urethral catheterization. Animals: There were 72 cats with suspected obstructive feline idiopathic cystitis admitted to the hospital. Procedures: Cats were randomly assigned to either intermittent bladder flushing (n = 34) or no-flush (control) groups (n = 38). Bladder flushing was performed with 5 mL/kg of sterile 0.9% saline, q8h during indwelling urinary catheterization. Urine was tested for bacteriuria by a point-of-care test at the time of urinary catheterization and via cystocentesis following catheter removal before discharge. Risk of rUO by groups and its association with other variables were evaluated. Results: The age (median: 3.0 years) in the flush group was younger (P = 0.01), and the length of hospitalization (> 24 hours) was longer (P < 0.01) than that of the control group. Overall rUO was 6.6% on Day 7 and 21.8% on Day 30 after discharge, but there was no significant difference between groups. A shorter duration of catheterization (< 24 hours) was associated with higher risk of rUO (odds ratio: 6.0). The incidence of catheter-related bacteriuria was 14.5% and was not significantly different between groups (13.8% and 15.2% in the flush and control, respectively). Conclusion and clinical relevance: Intermittent bladder flushing during hospitalization appears safe but did not decrease the incidence of rUO. The incidence of bacteriuria following catheterization was not affected by intermittent bladder flushing.

Effet des rinçages intermittents de la vessie sur le taux de récidive de l'obstruction urétrale féline: 72 cas. Objectif: Évaluer l'effet du rinçage intermittent de la vessie sur l'obstruction urétrale récurrente (rUO) à 7 jours et 30 jours après le congé et le risque de bactériurie résultant d'un cathétérisme urétral à demeure. Animaux: Il y avait 72 chats suspects de cystite idiopathique féline obstructive admis à l'hôpital. Procédures: Les chats ont été assignés au hasard à des groupes avec rinçage intermittent de la vessie (n = 34) ou sans rinçage (témoin) (n = 38). Le rinçage de la vessie a été effectué avec 5 mL/kg de solution saline stérile à 0,9 %, toutes les 8 heures pendant le cathétérisme urinaire à demeure. L'urine a été testée pour la bactériurie par un test au point de service au moment du cathétérisme urinaire et par cystocentèse après le retrait du cathéter avant le congé. Le risque de rUO par groupes et son association avec d'autres variables ont été évalués. Résultats: L'âge (médiane: 3,0 ans) dans le groupe rinçage était plus jeune (P = 0,01) et la durée d'hospitalisation (> 24 heures) était plus longue (P < 0,01) que celle du groupe témoin. La rUO globale était de 6,6 % au jour 7 et de 21,8 % au jour 30 après le congé, mais il n'y avait pas de différence significative entre les groupes. Une durée de cathétérisme plus courte (< 24 heures) était associée à un risque plus élevé de rUO (rapport de cotes: 6,0). L'incidence de la bactériurie liée au cathéter était de 14,5 % et n'était pas significativement différente entre les groupes (13,8 % et 15,2 % dans le rinçage et le témoin, respectivement). Conclusion et pertinence clinique: Le rinçage intermittent de la vessie pendant l'hospitalisation semble sans danger mais n'a pas diminué l'incidence de rUO. L'incidence de la bactériurie après cathétérisme n'a pas été affectée par le rinçage intermittent de la vessie.(Traduit par Dr Serge Messier).

Case report laparoscopy-assisted pre-pubic urethrostomy as a palliative procedure for resection of distal urethral tumor in a female dog.

BACKGROUND: This paper presents the first described case of laparoscopy-assisted prepubic urethrostomy and laparoscopic resection of a tumor of the distal part of the urethra in a female dog as a palliative treatment. CASE PRESENTATION: An intact, 11 -year-old, mixed breed female dog, weighing 15 kg, was admitted with signs of urinary obstruction and difficulty with catheterization. Vaginal, rectal, and endoscopic examinations revealed a firm mass in the pelvic cavity at the level of the pelvic urethra. Ultrasound and computed tomography examination showed enlargement of the urethral wall (5.5 cm width and 3 cm thick), which was significantly restricting the patency of the urethra. The lesion affected only the distal part of the urethra without the presence of local or distant metastatic changes. The affected portion of the urethra was laparoscopically removed while performing pre-pubic urethrostomy with laparoscopy. The patient regained full consciousness immediately after the end of anesthesia, without signs of urinary incontinence. Histopathological examination of the removed urethra revealed an oncological margin only from the side of the bladder. In the period of 2.5 months after the procedure, the owner did not notice any symptoms that could indicate a postoperative recurrence, which was diagnosed three months after the procedure. CONCLUSIONS: Pre-pubic urethrostomy can be successfully performed with the assistance of laparoscopy. The use of minimally invasive surgery will allow, in selected cases, removal of the urethral tumor, and in inoperable cases, to perform a minimally invasive palliative pre-pubic urethrostomy.

Penile urethral resection and anastomosis augmentation with regional tissue tension relieving technique: A cadaveric mechanical study and clinical outcome in two dogs.

OBJECTIVE: To describe penile urethral augmentation anastomosis (PURAA) for resection anastomosis (RA) of the canine penile urethra by using autogenous tissue in two dogs and to determine the mechanical properties of the augmentation technique in cadaveric specimens. STUDY DESIGN: Cadaveric study and two case reports. ANIMALS: Sixteen canine cadavers and two dogs with urethral obstruction. METHODS: The lower urogenital system was harvested from cadavers and randomized into two groups: simple (S) and augmented (AUG) RA of the urethra. Tensile strength and peak load were compared between the two groups. Two dogs were treated with PURAA for urethral obstruction secondary to juxtaurethral neoplasms. RESULTS: Minimal tensile strength (MITS) and maximal tensile strength (MATS) were greater in the AUG group (MITS, 54.36 ± 24.0 N; MATS, 75.37 ± 34.79 N) compared with the S group (MITS, 11.78 ± 4.93 N, P = .0014; MATS, 13.74 ± 3.89 N, P = .0015). Both dogs recovered without complications. Histopathological examinations were consistent with a lipomatous mass in both cases. Both dogs had good medium-to-long-term outcomes. CONCLUSION: The augmentation technique improved the tensile properties of penile RA in normal cadavers and was associated with successful outcomes in two dogs. CLINICAL SIGNIFICANCE: Penile urethral augmentation anastomosis may help prevent stricture or leakage secondary to tension at the surgical site after penile urethral RA.

Combined tube cystostomy and urethrotomy for the treatment of urethral obstruction due to urolithiasis in goats.

OBJECTIVE: To describe the treatment of goats with urethral obstruction secondary to urolithiasis by combining tube cystostomy and urethrotomy. ANIMALS: Eight male goats. STUDY DESIGN: Short case series. METHODS: Medical records (September 2012-September 2017) of male goats treated for obstruction secondary to urolithiasis with tube cystostomy and urethrotomy were reviewed. Data collected included signalment, history, physical examination findings, diagnostic results, perioperative treatments, operative details, hospitalization duration, intraoperative and postoperative complications, urolith analysis, and time to restoration of urethral patency. Long-term follow-up (>12 months) was obtained by email or telephone interviews of owners or by clinical examination. RESULTS: Seven of eight goats were castrated males of various of breeds. All goats were tachycardic with urethral pulsation at admission. Uroliths were composed of calcium carbonate in four goats and silica in one goat. All goats regained urethral patency during hospitalization, and all were discharged alive from the hospital. Seven goats were alive at long-term follow-up. Postoperative complications included persistent urethral obstruction requiring a second urethrotomy 2 days postoperatively, premature dislodgement of the bladder catheter and jejunal obstruction secondary to adhesions, and recurrence of obstructive urolithiasis within the proximal perineal urethra requiring a second surgery 8 months later (1 each). Long-term outcome was good, with urethral patency beyond 12 months in six of eight goats. CONCLUSION: Combining tube cystostomy and urethrotomy restored urethral patency in goats with urethral obstruction from uroliths. Although none of the complications seemed directly related to the urethrotomy, formation of abdominal adhesions and recurrence of urolithiasis affected long-term outcomes. CLINICAL SIGNIFICANCE: Uroliths that do not dissolve in acidic urine may be more frequent in some practices. The combined approach of tube cystostomy and urethrotomy appears to successfully restore urethral patency with promising long-term outcomes.

Pubic fractures secondary to extended transpelvic urethrostomy in a cat.

OBJECTIVE: To report the occurrence and describe the management of pubic fractures after the use of an extended transpelvic urethrostomy (TPU) to treat postprostatic intrapelvic urethral obstruction and laceration in a cat. ANIMAL: One 6-year-old domestic short-haired cat. STUDY DESIGN: Case report. METHODS: A cat was presented with urethral obstruction and laceration confirmed by positive contrast retrograde urethrography. Temporary urinary diversion was performed. An attempt was made to perform perineal urethrostomy, but the cranial location of the laceration precluded this technique. An extended TPU was performed, which required removal of 30% to 60% greater length of pelvic bone than has been previously described. RESULTS: Bilateral pubic ramus fractures occurred 1 week after surgery, from which the cat clinically improved with cage rest, and exhibited evidence of healing according to computed tomography after 8 weeks. CONCLUSION: Extended TPU used to treat postprostatic intrapelvic urethral laceration may lead to pubic fractures postoperatively. CLINICAL SIGNIFICANCE: It may be prudent to rest any cat that has had a TPU or extended TPU to reduce fracture risk.

Intermittent urethral obstruction secondary to caudal sliding of a pelvic bladder in 3 dogs.

Three Yorkshire terrier dogs (2 males and 1 female) were presented for investigation of chronic dysuria and stranguria. Physical examination was unremarkable except for a poorly filled bladder. Biological tests, urinalysis, ultrasound, and routine radiography detected no significant abnormality, except for intermittent displacement of the bladder in the pelvis. Manual voiding cysto-urethrography showed marked caudal displacement of the bladder without perineal hernia and revealed intermittent, dynamic urethral obstruction. Obstructive kinking of the membranous urethra was observed in male dogs, and the marked caudal displacement of the bladder in the female dog was suspected to induce similar urethral obstruction, although this was not clearly visualized because of the absence of contrast filling of the obstructed urethra. All dogs showed resolution of the clinical signs following cystopexy. Key clinical message: This report documents the diagnostic value of manual voiding cysto-urethrography for the investigation of dynamic voiding disorders, especially in dogs with a pelvic bladder.

Obstruction urétrale intermittente secondaire au glissement caudal d'une vessie pelvienne chez trois chiens. Trois chiens de race Yorkshire (2 mâles et 1 femelle) furent présentés pour un problème de dysurie chronique et de strangurie. L'examen physique ne révéla rien d'anormal sauf une vessie pauvrement remplie. Des tests biologiques, une analyse d'urine, une échographie et des radiographies de routine ne détectèrent aucune anormalité, sauf pour le déplacement intermittent de la vessie dans le pelvis. Une cysto-urétrographie avec vidange manuelle a montré un déplacement caudal marqué de la vessie sans hernie périnéale et a révélé une obstruction urétrale dynamique et intermittente. Une plicature obstructive de l'urètre membraneuse fut observée chez les chiens mâles, et le déplacement caudal marqué de la vessie chez la chienne fut soupçonné d'induire une obstruction urétrale similaire, bien que ceci n'était pas clairement visualisé étant donné l'absence de remplissage par le milieu de contraste de l'urètre obstruée. La résolution des signes cliniques fut observée chez tous les chiens suite à la cystopexie.Message clinique important :Ce rapport documente la valeur diagnostique d'une cysto-urétrographie avec vidange manuelle pour l'étude de désordres de vidange dynamiques, spécialement chez les chiens avec une vessie pelvienne.(Traduit par Dr Serge Messier).

In-hospital medical management of feline urethral obstruction: A review of recent clinical research.

Evidence-based medical practice requires that clinical research be conducted to help guide veterinary recommendations. Unfortunately, clinical research on the treatment of feline urethral obstruction (UO) is limited. Over the past decade, a body of clinically relevant scientific literature related to the in-hospital management of feline UO has been published. This review of the literature from December 2007 to February 2019 encompasses management options, stabilization, anesthetic considerations, unblocking procedures, urinary bladder lavage, intravesical treatments, post-obstructive diuresis, urinary catheter management, catheter-associated bacterial complications, and oral medications. Studies are briefly summarized with respect to their main findings and limitations. Common recurring limitations observed include small sample sizes leading to insufficient power and potential type II errors, lack of standardized treatment protocols, and assessment of multiple inter-related confounding variables. The authors' intent is for this article to inform practitioners and inspire future clinical research initiatives which address these limitations, possibly with large-scale multicenter studies, standardized treatment protocols, and multivariate regression modeling.

Gestion médicale en hôpital d'obstruction urétrale féline : Revue descriptive de la recherche clinique. La pratique médicale factuelle nécessite que de la recherche clinique soit menée afin d'aider à guider les recommandations vétérinaires. Malheureusement, la recherche clinique sur le traitement de l'obstruction urétrale féline (UO) est limitée. Au cours de la dernière décennie, un ensemble de publications cliniques scientifiquement pertinentes à la gestion en hôpital d'UO féline a été publié. Cette recension de la littérature de décembre 2007 à février 2019 incluait les options de gestion, la stabilisation, les considérations anesthésiques, les procédures de déblocage, le lavage de la vessie urinaire, les traitements intravésical, la diurèse post-traitement, la gestion des cathéters urinaires, les complications bactériennes associées aux cathéters et les médications orales. Les études sont résumées brièvement en lien avec leurs trouvailles principales et leurs limitations. Les limitations récurrentes observées fréquemment incluaient les petites tailles d'échantillonnage entrainant une puissance insuffisante et des erreurs de type II potentielles, un manque de standardisation des protocoles de traitement et l'évaluation de multiples variables confondantes interreliées. L'intention des auteurs est que le présent article informe les praticiens et inspire de futures initiatives de recherche clinique qui vise ces limitations, possiblement avec des études multicentres de grande envergure, des protocoles de traitement standardisés et de la modélisation de régression multivariée.(Traduit par Dr Serge Messier).

Urethrotomy in combination with or after temporary tube cystostomy for treatment of obstructive urolithiasis in male goats.

OBJECTIVE: To report the clinical findings, outcome, and complications associated with urethrotomy performed in combination with or after temporary tube cystostomy for treatment of obstructive urolithiasis in male goats. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Castrated male goats (n = 15). METHODS: The medical records of male goats admitted for obstructive urolithiasis were reviewed. Goats that underwent aurethrotomy performed in combination with or after a temporary tube cystostomy were included in the study population. Follow-up information was obtained through hospital records and telephone communication. RESULTS: Thirteen of 15 goats were discharged from the hospital a median of 13 days (range, 7-25) after urethrotomy. Complications related to the urinary system occurred in 5 goats and included recurrent obstruction, urination from open urethrotomy, uroabdomen and intra-abdominal adhesions after removal of the Foley catheter, and incisional infection. Five of 7 goats with long-term follow-up (2-24 months after surgery) were healthy, with normal urinary function. The remaining 2 goats returned to the hospital with signs of reobstruction that were attributed to uroliths at necropsy in 1 goat. CONCLUSION: Goats treated with urethrotomy for persistent urethral obstruction after temporary tube cystostomy generally survived the procedure. Normal long-term urinary function was obtained in some goats, although recurrence was the most common complication. CLINICAL SIGNIFICANCE: Urethrotomy is a surgical option for male goats with persistent urethral obstruction due to urethral calculi after temporary tube cystostomy.

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).

Urethral intussusception following traumatic catheterization in a male cat.

An 8-year-old, European male shorthair cat was presented with lower urinary tract obstruction. He was catheterized and referred. Retrograde cysto-urethrography suggested a urethral mass. Intussusception of the urethra with a partial rupture of the urethra was visualized. A perineal urethrostomy was performed. The cat was clinically normal at 15 months' follow-up.

Invagination urétrale secondaire à un cathétérisme traumatique chez un chat mâle. Un chat européen male de 8 ans présentant des signes d'obstruction du bas appareil urinaire a été cathéterisé et référé. L'urétrographie rétrograde suggérait une masse urétrale. Une intussusception de l'urètre avec une rupture partielle de l'urètre a été visualisée. Une urétrostomie périnéale a été réalisée. Le chat était cliniquement normal 15 mois après l'intervention.(Traduit par les auteurs).

ASSOCIATIONS BETWEEN ULTRASOUND AND CLINICAL FINDINGS IN 87 CATS WITH URETHRAL OBSTRUCTION.

Urethral obstruction is a life-threatening form of feline lower urinary tract disease. Ultrasonographic risk factors for reobstruction have not been previously reported. Purposes of this retrospective cross-sectional study were to describe urinary tract ultrasound findings in cats following acute urethral obstruction and determine whether ultrasound findings were associated with reobstruction. Inclusion criteria were a physical examination and history consistent with urethral obstruction, an abdominal ultrasound including a full evaluation of the urinary system within 24 h of hospitalization, and no cystocentesis prior to ultrasound examination. Medical records for included cats were reviewed and presence of azotemia, hyperkalemia, positive urine culture, and duration of hospitalization were recorded. For medically treated cats with available outcome data, presence of reobstruction was also recorded. Ultrasound images were reviewed and urinary tract characteristics were recorded. A total of 87 cats met inclusion criteria. Common ultrasound findings for the bladder included echogenic urine sediment, bladder wall thickening, pericystic effusion, hyperechoic pericystic fat, and increased urinary echoes; and for the kidneys/ureters included pyelectasia, renomegaly, perirenal effusion, hyperechoic perirenal fat, and ureteral dilation. Six-month postdischarge outcomes were available for 61 medically treated cats and 21 of these cats had reobstruction. No findings were associated with an increased risk of reobstruction. Ultrasonographic perirenal effusion was associated with severe hyperkalemia (P = 0.009, relative risk 5.75, 95% confidence interval [1.54-21.51]). Findings supported the use of ultrasound as an adjunct for treatment planning in cats presented with urethral obstruction but not as a method for predicting risk of reobstruction.