Characteristics associated with bacterial growth in urine in 451 proteinuric dogs (2008-2018).

BACKGROUND: Urine cultures are frequently recommended to rule out infection as a postrenal cause of proteinuria. OBJECTIVE: Identify characteristics associated with bacterial growth in urine in proteinuric dogs. ANIMALS: Four hundred and fifty-one dogs admitted to a teaching hospital between January 2008 and January 2018 with urine protein-to-creatinine ratios (UPCs) >0.5. METHODS: Retrospective study included dogs with a UPC, urinalysis, and quantitative urine culture (QUC) performed within a 72-hour period by searching electronic records. Dogs with recent antimicrobial therapy, urine collected by methods other than cystocentesis, or UPC ≤0.5 were excluded. Signalment, comorbidities, serum BUN and creatinine concentrations, urinalysis findings, and QUC results were recorded. The association between these characteristics and presence of bacterial growth in urine was assessed by univariable and multivariable analysis. RESULTS: Thirty of four hundred fifty-one dogs (6.7%) had bacterial growth in urine. Of these, 18 (60.0%) had active urine sediment. Bacterial growth in urine was associated with pyuria (odd ratio [OR] 25.1, 95% confidence interval [CI] 7.9-79.6, P < .001), bacteriuria (OR 11.1, 95% CI 3.2-39.1, P < .001), and lower urinary tract disease (OR 6.7, 95% CI 1.9-23.0; P = .0028). If QUC was prompted based on these criteria, 8/451 (1.8%) of proteinuric dogs would have had undetected bacterial growth. CONCLUSIONS AND CLINICAL IMPORTANCE: The proportion of proteinuric dogs with both inactive urine sediment and bacterial growth in urine was low, suggesting that QUC might not be necessary in the evaluation of all proteinuric dogs. An active urine sediment or lower urinary tract disease should prompt QUC for proteinuric dogs.

Jejunal Lesion Identified at a Previous Anastomosis Site in a Dog Using Capsule Endoscopy.

A 3 yr old spayed female French bulldog was evaluated for a progressive regenerative anemia of unknown origin that was unresponsive to empiric immunosuppressive and gastroprotective therapy. The patient had a history of previous resection and anastomosis of a small intestinal diverticulum ∼2 yr prior to evaluation for her anemia. Capsule endoscopy revealed a focal abnormality in the distal jejunum at the site of a previous bowel resection and anastomosis. This lesion was suspected to be the cause of ongoing gastrointestinal bleeding and anemia. Exploratory laparotomy combined with endoscopy was performed to further investigate and localize the jejunal lesion. The lesion was resected, and a primary end-to-end jejunal anastomosis was performed. Histopathology of the specimen revealed jejunal suture granulomas with focal ulceration. The patient recovered well from surgery with significant improvement of the anemia and resolution of clinical signs at recheck examinations 1 and 2 wk postoperatively. Complete resolution of the anemia was noted at a 6 wk follow-up. The case report demonstrates how, in cases of unknown causes of anemia, capsule endoscopy is a noninvasive method of identifying the presence of gastrointestinal bleeding as a result of lesions that might otherwise not be detectable with abdominal ultrasound or conventional endoscopy. The report also documents a long-term complication to a resection and anastomosis surgery.

Description and Biomechanical Comparison of a Percutaneous Radiologic Gastropexy Technique in a Canine Cadaver Model.

OBJECTIVE: To describe a novel percutaneous radiologic gastropexy (PRG) technique in a canine model and to biomechanically compare this technique to open incisional gastropexy (OIG) and laparoscopic-assisted incisional gastropexy (LAG). STUDY DESIGN: Randomized ex vivo biomechanical study. ANIMALS: Canine cadavers. METHODS: Fifteen cadavers were randomized to 1 of 3 surgical interventions: OIG, LAG, and PRG. For the PRG procedure, the stomach was distended with air, and a preloaded T-fastener device was utilized to attach the stomach to the body wall with fluoroscopic-guidance. The procedural times of the 3 techniques were recorded. After completion of the procedure, the stomach and body wall overlying the stomach wall were harvested and the maximum tensile strength of the gastropexies was determined. RESULTS: The maximal tensile strength was not significantly different between groups. The total procedural time for the PRG procedure (5 minutes) was significantly shorter than both OIG (28 minutes) and LAG (20 minutes) procedures. CONCLUSION: The PRG technique described in this study demonstrated a similar maximal tensile strength to commonly employed gastropexy techniques (OIG and LAG) in an acute canine model. Additionally, the PRG procedure was significantly faster to perform. The clinical relevance of this technique will be determined by further study to assess the applicability and efficacy of this procedure in clinical patients by determining the likelihood of adhesion development and the ability of the adhesion to prevent gastric volvulus.

Efficacy of Two Radiologic-Assisted Prophylactic Gastropexy Techniques.

OBJECTIVE: To describe the technique and clinical outcome of prophylactic percutaneous radiologic-assisted gastropexy (PRG) and radiologic-assisted incisional gastropexy (RIG) in client-owned dogs. STUDY DESIGN: Prospective, nonrandomized clinical trial. ANIMALS: Fourteen client-owned, large, and giant breed dogs. METHODS: Four dogs underwent PRG with fluoroscopic guidance to place 2 T-fasteners into the pyloric antrum and secure it to the right body wall. Ten dogs underwent RIG, which was a modification of PRG. For RIG, the T-fasteners were first used to approximate the pyloric antrum and body wall, then a full thickness incision through the body wall was made and the pyloric antrum was sutured to the internal abdominal wall. The duration and complications of each procedure were recorded. The gastropexy was assessed by abdominal ultrasound at day 1, week 2, and week 8 postoperative and by barium gastrogram at week 8 postoperative. RESULTS: No dogs undergoing PRG had a gastropexy present at week 2. All dogs undergoing RIG had ultrasonographic evidence of gastropexy at day 1, week 2, and week 8 postoperative. Gastrograms in 9/9 dogs were consistent with an intact gastropexy, appropriate gastric positioning and appropriate gastric emptying began. No major complications were noted. CONCLUSION: The PRG was unsatisfactory and did not result in a permanent gastropexy. The RIG was safe and created a gastropexy that remained intact at 8 weeks postoperative. The RIG should be considered as a minimally invasive option for prophylactic gastropexy in dogs of at-risk breeds.