Right-sided ureteral hemangiosarcoma in a paraplegic dog.

BACKGROUND: This study aims to describe a rare case of primary ureteral hemangiosarcoma, in which surgical intervention preserved the kidney and ureter after tumor removal. CASE PRESENTATION: A 13-year-old, neutered male dog, weighing 14 kg, mixed-breed, presented with apathy, anorexia, acute-onset vomiting, and abdominal discomfort during the physical examination. Ultrasonography and pyelography revealed a right-sided dilation of the renal pelvis and ureter due to complete obstruction in the middle third of the ureter. A mass obstructing the lumen of the right ureter was completely resected, and ureteral suturing was performed, preserving the integrity of the involved structures. Histopathology confirmed primary ureteral hemangiosarcoma. Due to the local and non-invasive nature of the mass, chemotherapy was not initiated. The patient's survival was approximately two years, and normal renal function was preserved throughout this period. CONCLUSIONS: Considering this type of tumor in the differential diagnosis of upper urinary tract obstructive disorders. Furthermore, the preservation of the ureter and kidney is a suitable therapeutic option after surgical resection of non-invasive tumors.

Receiver operating characteristics of computed tomography (CT) compared to cystoscopy in diagnosis of canine ectopic ureters: Thirty-five cases.

OBJECTIVE: The aim of the study was to determine receiver operating characteristics (ROC) of computed tomographic excretory urography (CTEU) in predicting cystoscopic findings of ureteral anatomy. STUDY DESIGN: Retrospective cohort study. ANIMALS: Thirty-five client-owned dogs. METHODS: The medical records of dogs referred for suspected ectopic ureters were reviewed. Inclusion criteria included CTEU findings reported by board-certified radiologists, followed by rigid cystoscopy with or without ureteral cystoscopic laser ablation (CLA). Data included signalment, urinary incontinence degree, body condition score, weight, degree of colon distension, CTEU and cystoscopy findings. ROC analysis was used to compare CT-predicted ureteral orthotopia/ectopia to cystoscopy findings. Additionally, ROC of CT predicted ureteral orifice locations was analyzed. Regression covariate analysis was performed to identify factors that may have influenced accuracy of diagnosis. RESULTS: The ability of CT to identify a normal and intra-or extramural ectopic ureters conclusively and correctly was 13/26 (50%) and 32/41(78%), respectively. Sensitivity and specificity of identifying extramural versus intramural ureters was 2/7 versus 30/46 (29 vs. 65%) and 61/63 versus 17/24 (97 vs. 71%), respectively. Ectopic orifice determination sensitivity and specificity varied widely depending on location from 0% to 76% and 67% to 97%, respectively. Covariate analysis failed to identify interfering factors. CONCLUSIONS: CT did not accurately predict anatomy of ureters; CT findings may need confirmation by cystoscopy and possibly intraoperative fluoroscopy prior to determining if CLA is indicated or not. CLINICAL SIGNIFICANCE: Our results may be of importance for surgeons interpreting the CTEU findings. CTEU prediction of the location of the ureteral orifice shows low sensitivity especially in or close to the urethral sphincter area.

Bilateral neoureterocystostomy with distal ureteral tapering in a dog with severe bilateral hydroureteronephrosis.

A 3.5-year-old intact male Labrador retriever was seen for hematuria. The results of clinical pathology tests were unremarkable. However, urinalysis revealed dark, cloudy, alkalotic, and isosthenuric urine containing red and white blood cells, epithelial cells, and struvite crystals. Severe bilateral enlargement of ureters and markedly enlarged kidneys were identified on abdominal radiographs. Computerized tomography revealed extensive bilateral hydroureteronephrosis with no definitive cause of obstruction. The dog underwent bilateral ureteral tapering with bilateral neoureterocystostomy and placement of temporary bilateral ureteral stents and a cystostomy tube. The dog was monitored in the intensive care unit for 7 d after surgery and was discharged 9 d after surgery and after the stent and cystostomy tube were removed. The dog remained clinically normal and was reported to have been euthanized at 11 y of age (2021) due to unspecified causes. Key clinical message: There are several potential causes of severe bilateral hydroureteronephrosis in animals. Based on this case report, dogs with severe bilateral hydroureteronephrosis that are clinically asymptomatic may have favorable outcomes following bilateral ureteral reconstruction and neoureterocystostomy, even if a definitive cause is not identified.

Néourétérocystostomie bilatérale avec effilement urétéral chez un chien avec hydrourétéronéphrose bilatérale sévère. Un labrador mâle non-castré âgé de 3,5 ans a été vu pour hématurie. Les résultats des tests de pathologie clinique ne présentaient pas d'anomalie. Toutefois, l'analyse d'urine a mis en évidence une urine foncée, trouble, alcaline et isosthénurique, contenant des globules rouges et blancs, des cellules épithéliales et des cristaux de struvite. Une augmentation bilatérale sévère de la taille des urètres ainsi qu'une augmentation de la taille des reins ont été notées lors des radiographies abdominales. Un examen par tomodensitométrie a révélé une hydrourétéronéphrose bilatérale marquée sans cause identifiable d'obstruction. On procéda à un effilement urétéral bilatéral avec néourétérocystostomie bilatérale et mise en place de stents urétéraux bilatéraux temporaires et un tube à cystotomie. Le chien a été sous surveillance à l'unité des soins intensifs pendant 7 j après la chirurgie et a obtenu son congé 9 j après la chirurgie, après que les stents et le tube à cystotomie aient été retirés. Le chien est demeuré cliniquement normal jusqu'à son euthanasie à l'âge de 11 ans (2021) pour des raisons non-spécifiées.Message clinique clé :Il y a plusieurs causes potentielles d'hydrourétéronéphrose bilatérale chez les animaux. Sur la base de ce rapport de cas, les chiens avec hydrourétéronéphrose bilatérale sévère qui sont cliniquement asymptomatique un résultat favorable peut être obtenu à la suite d'une reconstruction urétérale bilatérale et une néourétérocystostomie même si une cause définitive n'est pas identifiée.(Traduit par Dr Serge Messier).

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).

Extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques for feline proximal ureteral obstruction: A retrospective study.

OBJECTIVE: To describe the surgical technique for extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques (ETSUTT) for feline proximal ureteral obstruction and report clinical outcomes. STUDY DESIGN: Retrospective case series. ANIMALS: Ten privately-owned cats with ureteral obstruction near the ureteropelvic junction (UPJ). METHODS: Medical records were retrospectively reviewed for cats with ureteral obstruction close to the UPJ that underwent ETSUTT (2018-2021). The ETSUTT procedure consisted of a modified extravesicular technique (two-layer, side-to-side ureteroneocystostomy) and tension-relieving techniques (renal descensus, ureterocystopexy, and nephrocystopexy). RESULTS: All cats survived through discharge. In all cats, postoperative blood urea nitrogen and creatinine concentrations were decreased, compared with preoperative concentrations. Perioperative complications included ureteral catheter dislodgement (3), transient pollakiuria (2), and dysuria (1), but no specific treatments were required. Urinary tract infection was observed postoperatively in three of the 10 cats. The median follow-up was 648 days (min-max: 86-1229 days). Seven of the 10 cats were alive without recurrent ureteral obstruction at the end of this retrospective study. CONCLUSION: The ETSUTT procedure was successfully performed without major complications in cats with ureteral obstruction occurring near the UPJ. Use of ETSUTT provided a fair-to-good, long-term prognosis in cats that were otherwise difficult to manage. CLINICAL SIGNIFICANCE: This novel procedure, ETSUTT, was feasible, safe, and could be a viable treatment option for feline proximal ureteral obstruction, including the UPJ, especially for obstructions caused by stricture.

Feline ureteral rupture with para-ureteral urinomas following blunt trauma: clinical presentation and long-term outcome after treatment by urinary diversion for five cases from 2012 to 2019.

CASE HISTORY: Medical records were reviewed for cats that underwent surgical treatment of traumatic ureteral rupture (TUR) using urinary diversion procedures between 2012 and 2019. CLINICAL FINDINGS AND TREATMENT: Five cats had presented with injuries associated with road traffic accidents. These included three cats with abdominal hernias that required surgical management. At a median of 15 days after the accident, cats represented with lethargy, the presence of an abdominal mass or with lower urinary tract symptoms and in all cats contrast diagnostic imaging showed proximal unilateral TUR with associated para-ureteral urinoma. Four cats received subcutaneous ureteral bypass (SUB) device placement and one had ureteral anastomosis over a stent. Unilateral cyst-like retroperitoneal fluid consistent with para-ureteral urinoma was observed in all cats and a diffuse retroperitoneal haematoma was noticed in four cats. No immediate major complications occurred, and all cats had post-operative serum creatinine concentration within the reference interval. The cat that had received a ureteral stent subsequently required placement of a SUB following stent encrustation 15 months after surgery. Median follow-up time was 34 (min 28, max 58) months and renal function was normal in all cats at the last follow-up. CLINICAL RELEVANCE: Urinary diversion procedures provided long-term stable renal function following proximal TUR in these five cats. Delayed, subtle non-specific clinical signs subsequent to high-energy blunt trauma causing abdominal hernia and associated diffuse retroperitoneal haematoma, should raise suspicion of TUR. ABBREVIATIONS: AFAST: Abdominal focused assessment with sonography for trauma; SUB: Subcutaneous ureteral bypass; TUR: Traumatic ureteral rupture.

Rapport de cas Suspected congenital unilateral ureteral atresia and hydronephrosis in a 6-year-old dog.

A 6-year-old neutered male giant schnauzer dog was presented to an emergency clinic with stranguria and pollakiuria. On physical examination, the abdomen was generally and non-painfully distended. Diagnostic imaging revealed several large, anechoic, fluid-filled, space-occupying lesions from the cranial to caudal abdomen placing extramural pressure on the bladder and urethra and apparently causing the clinical signs. Unilateral ureteral atresia with secondary ipsilateral hydronephrosis and hydroureter were diagnosed on post-mortem examination. Due to a lack of history of abdominal surgery or trauma and the absence of scarring or stenosis of the ureter, the condition was suspected to be congenital. Key clinical message: Although rare, hydronephrosis and hydroureter secondary to a congenital ureteral defect should be considered when a dog is presented with abdominal distension and several peritoneal and retroperitoneal space-occupying lesions on diagnostic imaging.

Atrésie urétérale unilatérale congénitale suspectée et hydronéphrose chez un chien de 6 ans. Un chien schnauzer géant mâle castré âgé de 6 ans a été présenté à une clinique d'urgence avec une strangurie et une pollakiurie. À l'examen physique, l'abdomen était distendu de manière générale et non-douloureuse. L'imagerie diagnostique a révélé plusieurs grandes lésions anéchoïques, remplies de liquide et occupant de l'espace de l'abdomen crânien à caudal, exerçant une pression extra-murale sur la vessie et l'urètre et causant apparemment les signes cliniques. Une atrésie urétérale unilatérale avec hydronéphrose ipsilatérale secondaire et hydro-uretère ont été diagnostiqués lors de l'autopsie. En raison d'un manque d'antécédents de chirurgie abdominale ou de traumatisme et de l'absence de cicatrices ou de sténose de l'uretère, la condition a été suspectée d'être congénitale.Message clinique clé :Bien que rares, l'hydronéphrose et l'hydro-uretère secondaires à une anomalie urétérale congénitale doivent être envisagées lorsqu'un chien présente une distension abdominale et plusieurs lésions péritonéales et rétropéritonéales occupant de l'espace à l'imagerie diagnostique.(Traduit par Dr Serge Messier).

Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation.

OBJECTIVE: To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic-guided laser ablation (CLA) in female dogs. STUDY DESIGN: Retrospective study from 2011 to 2018. ANIMALS: Twenty-five female dogs. METHODS: Data collected included signalment, clinicopathologic data, procedural data, complications, and short-term and long-term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent). RESULTS: Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One-month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05). CONCLUSION: Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy. CLINICAL SIGNIFICANCE: Cystoscopic-guided laser ablation should be preferred to correct iEU to prevent short-term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.

Successful Treatment of Ureteral Obstructive Lithiasis by Ureterotomy in a Domestic Hen.

A 2-year-old domestic hen was presented for a 15-day history of intermittent left leg lameness. The owners also observed a decrease in egg quality during that period. Physical examination of the bird revealed a generalized weakness with a flattened pale comb. Neurological evaluation of the left leg found a proprioceptive deficit with no loss of pain sensitivity. Whole body radiographic images showed a marked reduction of abdominal detail, a large amount of "grit" (mineral opacity) in the ventriculus, intestinal dilation, and a metallic foreign body (nail) in the digestive tract. Abnormal results from a plasma biochemistry panel were hypercalcemia, hypertriglyceridemia, hyperglobulinemia, hypophosphatemia, increased creatine kinase, and decreased uric acid. After initial stabilization of the patient, a computed tomographic scan was obtained, which revealed multiple right-sided ureteral calculi, the largest of which measured 10 mm in diameter, and changes compatible with cystic right renal nephrosis. Suspected compensatory enlargement of the left kidney was also observed. Considering the renal lesion and associated neurological limb impairment, surgery was recommended and approved by the owner. A right lateral approach was used for the coeliotomy, and a ureterotomy was performed to remove all calculi. Analysis of the ureteral stones confirmed they were 100% uric acid salts. The hen fully recovered left leg function 1 week postsurgery. Urolithiasis is well described in hens, but surgical treatment is uncommon. This report describes the successful removal of ureteral stones by ureterotomy in a domestic hen.

A case of congenital ureteral atresia causing rare upper and lower urinary tract manifestations in a puppy: a case report.

BACKGROUND: Ureteral atresia is the congenital absence of a ureteral opening, resulting in a blind-ended ureter that fails to terminate at the urinary bladder. Consequently, severe hydroureter and hydronephrosis occur ipsilateral to the atresic ureter. However, hydronephrosis contralateral to severe hydroureter, although reported in humans, is not documented in the dog. Additionally, ureteral atresia has not been reported as a cause for lower urinary tract signs directly related to extramural urinary bladder compression. This report aims to describe these unique manifestations of this congenital urinary tract disease, as well as follow-up findings after successful treatment. CASE PRESENTATION: A 4-month-old male Husky puppy was evaluated for pollakiuria, stranguria, and urine dribbling of 1-month duration. During the physical examination, a mass was palpated in the mid-abdomen. Diagnostic imaging and cystoscopy findings were diagnostic for right-sided ureteral atresia with secondary hydroureter and hydronephrosis. The severe right hydroureter caused lower urinary tract signs and contralateral hydronephrosis secondary to regional compression of the left distal ureter and urinary bladder. A right-sided ureteronephrectomy was performed, resolving the stranguria and pollakiuria. Significant reduction in the contralateral (left) hydronephrosis also occurred. CLINICAL RELEVANCE: Ureteral atresia should be considered as a differential diagnosis for lower urinary tract signs and/or bilateral hydronephrosis in a young dog. Reporting this case expands our knowledge of congenital lower urinary tract disease and the etiology of their manifestations in dogs. Surgical resolution of the congenital ureteral abnormality can result in preservation of renal function in the contralaterally obstructed kidney.

Long-term outcome of female dogs treated for intramural ectopic ureters with cystoscopic-guided laser ablation.

OBJECTIVE: To report the complications and long-term outcome of female dogs with intramural ectopic ureter(s) (iEU) undergoing cystoscopic-guided laser ablation (CLA) and determine the effect of post-CLA neutering on urinary continence. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Thirty-four client-owned dogs. METHODS: Medical records of female dogs that had iEU-CLA were reviewed. A 10-point continence score was assigned before, immediately after, and at a minimum of 12 months postprocedure via owner telephone contact. Neutering status prior to and postprocedure was recorded. RESULTS: Continence scores increased in all dogs after CLA (p < .0001, mean duration of follow-up: 63.9 ± 5.7 months) with an increase of the median score from 2 (preprocedure) to 10 (postprocedure). A urethral tear occurred in 2/34 dogs immediately after the procedure, successfully managed conservatively. Mild hematuria was present in 2/34, lasting less than 48 h. Postoperative urinary tract infections were documented in 6/34 dogs. Two dogs died of urinary-related issues at 1 and 5 months after CLA. Complete and near-complete urinary continence (scores 9 and 10/10) was achieved in 26/32 dogs including 3 dogs requiring medical (2) or surgical interventions (1). Post-CLA neutering did not affect continence scores (p = .44). CONCLUSION: A large proportion of dogs regained and maintained full continence after CLA alone. Subsequent medical or surgical therapy allowed further improvements when needed. Post-CLA neutering did not negatively impact urinary continence score. CLINICAL SIGNIFICANCE: The beneficial effect of iEU-CLA in female dogs is long standing and not affected by postprocedural neutering.

Postoperative outcomes of 12 cats with ureteral obstruction treated with ureteroneocystostomy.

OBJECTIVE: To report complications and long-term outcomes of cats with benign ureteral obstruction treated with ureteroneocystostomy and to determine the effects of double pigtail catheter (DPT) placement on postoperative outcomes. STUDY DESIGN: Retrospective study. ANIMALS: Twelve client-owned cats with ureteral urolithiasis treated with ureteroneocystostomy. METHODS: Records were reviewed for signalment, location of the obstruction, diagnostic tests, surgical technique, perioperative complications, long-term measurements of kidney function, and survival. Cats were divided into two groups; in one group, a DPT was placed at the time of ureteroneocystostomy, and, in the other group, a DPT was not placed at the time of ureteroneocystostomy (NDPT). RESULTS: A DPT was placed in six of 12 cats. The NDPT group included four cats with temporary catheters and two cats with no catheter. Median creatinine concentration decreased from 10.4 mg/dL (range, 1.6-20.3) to 2.2 mg/dL (range, 1.1-3.6) at the time of discharge (P = .015) in all cats. Two cats in the NDPT group required revision surgery for uroabdomen. Eleven cats were discharged from the hospital. Long-term complications (hematuria, pollakiuria, urinary tract infections) were more common in the DPT group (P = .047). Seven cats were alive a median of 329 days (range, 8-1772) after surgery. Median creatinine concentration was 2.0 mg/dL (range, 0.6-6.4) at a median of 157 days (range, 43-1772) after surgery. CONCLUSION: Ureteroneocystostomy resulted in acceptable long-term outcomes in 11 of 12 cats. The placement of a DPT did not influence the long-term outcome in this small population. CLINICAL SIGNIFICANCE: Ureteroneocystostomy with or without intraoperative placement of a DPT should be considered to relieve benign ureteral obstructions in cats.

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).

Inhibition of SIRT2 Alleviates Fibroblast Activation and Renal Tubulointerstitial Fibrosis via MDM2.

BACKGROUND/AIMS: Renal tubular epithelial cells and fibroblasts are the main sources of myofibroblasts, and these cells produce the extracellular matrix during tubulointerstitial fibrosis (TIF). Histone deacetylases (HDAC) inhibitors exert an antifibrogenic effect in the skin, liver and lung. Sirtuin 2 (SIRT2), which is a class III HDAC, is an important member of NAD+-dependent protein deacetylases. The current study evaluated the role of SIRT2 in renal TIF. METHODS: Immunohistochemical staining and Western blot were performed to evaluate SIRT2 expression in TIF patients and unilateral urethral obstruction (UUO) mice. Western blot was used to assess the protein levels of SIRT2, α-SMA, collagen III, fibronectin, and MDM2 in tubular epithelial cells and fibroblasts. The specific inhibitor AGK2 was used to inhibit SIRT2 activity, and targeted siRNA was used to suppress SIRT2 expression. RESULTS: SIRT2 expression increased in the tubulointerstitium of TIF patients and UUO mice. SIRT2 inhibition ameliorated TIF in UUO mice. SIRT2 expression in tubular cells was unchanged after exposure to TGF-ß1. The SIRT2-specifc inhibitor AGK2 did not attenuate TGF-ß1-induced tubular epithelial-mesenchymal transition. However, SIRT2 was upregulated in fibroblasts, and fibroblasts were activated after TGF-ß1 treatment. Genetic knockdown and chemical inhibition of SIRT2 attenuated TGF-ß1-induced fibroblast activation. We also explored the downstream signaling of SIRT2 during fibroblast activation. Genetic knockdown and chemical inhibition of SIRT2 suppressed TGF-ß1-induced increase in MDM2 expression, and inhibition of the MDM2-p53 interaction using Nutlin-3 did not suppress SIRT2 upregulation. CONCLUSION: Our results suggest that SIRT2 participates in the activation of fibroblasts and TIF, which is mediated via regulation of the MDM2 pathway, and the downregulation of SIRT2 may be a therapeutic strategy for renal fibrosis.

Exogenous H2S Inhibits Autophagy in Unilateral Ureteral Obstruction Mouse Renal Tubule Cells by Regulating the ROS-AMPK Signaling Pathway.

BACKGROUND/AIMS: The induction of excessive autophagy by increased levels of oxidative stress is one of the main mechanisms underlying unilateral ureteral obstruction (UUO)-induced vascular endothelial cell dysfunction. Hydrogen sulfide (H2S) has been shown to have an anti-oxidative effect, but its mode of action on excessive autophagy in vascular endothelial cells is unclear. METHODS: Surgery was used to induce UUO in male C57BL/6 mice as an in vivo model. Human renal epithelial cells (HK-2) were treated with H2O2 as an in vitro model. NaHS was used as an exogenous H2S donor. Transmission electron microscopy was applied to observe the structure of renal autophagosomes. The expression of proteins related to autophagy and apoptosis was detected by western blot analysis in vivo and in vitro. Flow cytometry (DCFH-DA) was used to examine the levels of intracellular reactive oxygen species (ROS). The terminal deoxynucleotidyl transferase dUTP nick end labeling assay was used to detect cell apoptosis. Compound C was used to analyze the association of AMPK with autophagy. RESULTS: Compared with the sham group, in which the ureter was exposed but not ligated, the cell apoptosis index, number of autophagosomes, protein expression of microtubule-associated protein 1 light-chain 3 (LC3)-II/I, beclin-1, and p-AMPK/AMPK were significantly increased in the UUO group. On the other hand, p62, cystathionine ß-synthase, and cystathionine γ-lyase protein expression levels and H2S concentration were significantly decreased (p < 0.05). These alterations were ameliorated by the addition of NaHS (p < 0.05). Similar results were observed in vitro. By using the AMPK inhibitor compound C, it was indicated that AMPK was involved in ROS-induced autophagy. In addition, using tissue from patients with obstructive nephropathy, excessive autophagy was observed by an increased LC3-II/LC3-I ratio. CONCLUSION: NaHS-treatment may exert a protective effect on mouse kidney against UUO by suppressing the ROS-AMPK pathway. ROS-AMPK-mediated autophagy may represent a promising therapeutic target for obstructive nephropathy.

Validation of a model of feline ureteral obstruction as a tool for teaching microsurgery to veterinary surgeons.

OBJECTIVE: To assess the content and face validity of a model of an obstructed feline ureter as a tool for teaching ureteral microsurgery. STUDY DESIGN: Prospective, experimental study. SAMPLE POPULATION: Seven expert and 11 novice microsurgeons. METHODS: The model was created from latex rubber with an inner diameter of 0.8 mm and an outer diameter of 5 mm. The "ureter" was created with an inner compartment, a thin wall, and a soft, outer layer mimicking periureteral fat. A "ureterolith" 0.8-1.2 mm in diameter was placed inside the inner compartment by using a blunt-tipped cannula. A standardized "ureterotomy" was performed by 7 expert and 11 novice microsurgeons. Both groups completed questionnaires evaluating the content and face validity of the model using subjective measures and a 5-point Likert scale. Reliability was analysed by calculation of Cronbach's α for all questions to ensure α ≥ .7. The median responses to each question were compared between groups with a nonparametric independent samples median test. P < .05 was considered significant. RESULTS: The Cronbach's α for the experts and the novices for content validity questions was .7 and .9, respectively, and for the face validity questions it was .7 and .8, respectively. The model was rated to have excellent content validity and very good face validity. CONCLUSION AND IMPACT: The model elicited positive responses from expert and novice microsurgeons and can be recommended as a tool for teaching ureteral microsurgery. A model validated by face and content measures should next be scrutinized by determination of construct, concurrent, and predictive validity by using objective measures.

Use of a modified Boari flap for the treatment of a proximal ureteral obstruction in a cat.

OBJECTIVE: To describe the use and long term outcome of a novel surgical technique developed to treat a proximal ureteral obstruction in a cat. STUDY DESIGN: Case report. ANIMALS: A 3-year-old female spayed Russian blue cat. METHODS: A 3-year-old female spayed Russian blue cat presented with a fever, decreased appetite, vomiting, and abdominal discomfort. A proximal left ureteral obstruction was noted on ultrasonographic examination. No filling defect was noted on antegrade pyelography. Due to the proximal location of the obstruction, a modification of a Boari flap was performed. In the current technique, the ureter was cut proximal to the level of obstruction, and the distal ureter was resected. A flap was created on the ventral surface of the bladder, the cut end of the ureter was pulled through the flap, and a ureteroneocystostomy was performed. The bladder was closed in a simple interrupted pattern. RESULTS: At re-evaluation 2 and 4 weeks after surgery, azotemia had resolved. According to ultrasonography, the ureteroneocystostomy site appeared to be healing, and pelvic dilation had resolved. One year later, the cat continued to do well, with no lower urinary tract signs and no abnormality noted on blood tests or ultrasonography. CONCLUSION: The tubularized bladder flap originally described by Boari was modified to create a tension-free ureteroneocystostomy, without complication. This technique relied on surrounding native tissues and resulted in long-term resolution of the ureteral obstruction. CLINICAL SIGNIFICANCE: A modified Boari flap can lead to long-term resolution of proximal ureteral obstruction in cats, without requiring stents or permanent implants.

Role of Stat3 Signaling in Control of EMT of Tubular Epithelial Cells During Renal Fibrosis.

BACKGROUND/AIMS: Transforming growth factor ß 1 (TGFß1) plays a critical role in the epithelial-to-mesenchymal transition (EMT) of renal tubular epithelial cells (TECs) during renal injury, a major cause of acute renal failure, renal fibrosis and obstructive nephropathy. However, the underlying molecular mechanisms remain ill-defined. Here, we addressed this question. METHODS: Expression of TGFß1, Snail, and phosphorylated Stat3 was examined by immunohistochemistry in the kidney after induction of unilateral ureteral obstruction (UUO) in mice. In vitro, primary TECs were purified by flow cytometry, and then challenged with TGFß1 with/without presence of specific inhibitors for phosphorylation of SMAD3 or Stat3. Protein levels were determined by Western blotting. RESULTS: We detected significant increases in Snail and phosphorylated Stat3, an activated form for Stat3, in the kidney after induction of UUO in mice. In vitro, TGFß1-challenged primary TECs upregulated Snail, in a SMAD3/Stat3 dependent manner. CONCLUSION: Our study sheds light on the mechanism underlying the EMT of TECs after renal injury, and suggests Stat3 signaling as a promising innovative therapeutic target for prevention of renal fibrosis.

Ureteral obstruction secondary to disseminated penicilliosis in a German shepherd dog.

Abdominal ultrasonographic evaluation of a 2-year-old male German shepherd dog evaluated for weight loss demonstrated a right ureteral mass with ipsilateral hydronephrosis, hypoechoic splenic nodules, and hypoechoic and rounded lymph nodes. A fungal mat extending from the renal pelvis into the ureter secondary to disseminated Penicillium was confirmed at necropsy.

Obstruction urétérale secondaire à une infection disséminée àPenicilliumchez un chien Berger allemand. L'évaluation abdominale par échographie d'un chien Berger allemand mâle âgé de 2 ans qui était évalué pour une perte de poids a révélé une masse urétrale droite avec de l'hydronéphrose ipsilatérale, des nodules spléniques hypoéchogènes et des ganglions lymphatiques arrondis et hypoéchogènes. Une masse fongique s'étendant du pelvis rénal jusqu'à l'urètre secondaire à une infection disséminée à Penicillium a été confirmée à la nécropsie.(Traduit par Isabelle Vallières).