Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012-2018).

OBJECTIVES: The aim of the study was to describe renal pelvis (RP) and ureteral ultrasonographic measurements in a population of cats with confirmed benign ureteral obstruction (UO) by antegrade pyelography. The secondary objective was to further describe clinical findings associated with minimally dilated obstructed kidneys in an attempt to better understand its occurrence. METHODS: Retrospective case series of cats diagnosed with benign UO were confirmed by antegrade pyelography. Medical records were reviewed and signalment, diagnostic imaging results, serum creatinine (SCr) concentration and urine culture results were recorded. Each obstructed kidney was categorized into two groups: group 1 included all RP measurements ⩽4 mm and group 2 included all RP measurements >4 mm. RESULTS: A total of 82 cats with 114 obstructed ureters met the inclusion criteria. Fifty (61%) cats had a unilateral UO and 32 (39%) had a bilateral UO. Thirty (26%) kidneys were included in group 1 while 84 (74%) were included in group 2. Nine (8%) kidneys had an RP dilation ⩽2 mm. Median RP and ureteral diameters were 6.6 mm (range 1.1-37.0 mm) and 3.2 mm (range 0.0-11.0 mm), respectively. RP size correlated positively with ureteral diameter in the study population (P <0.0001), but not in group 1 when analyzed separately (P = 0.47). UO was secondary to stones in 80 (70%) ureters. Seventeen (21%) cats had a positive urine culture. At admission, 79 (96%) cats were azotemic with a median preoperative SCr concentration of 444 µmol/l (range 108-1326 µmol/l). The mean (95% confidence interval [CI]) preoperative SCr concentration was significantly higher in group 1 (762 µmol/l [498-1165 µmol/l]) than in group 2 (409 µmol/l [333-502 µmol/l]). RP size in the two groups correlated negatively with preoperative SCr concentration (P = 0.0002). CONCLUSIONS AND RELEVANCE: Feline UO may be associated with minimal RP dilation and the severity of RP and ureteral dilation can be highly variable. Absence of significant RP dilation does not rule out UO in cats.

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).

Thrombectomy and thrombolysis: the interventional radiology approach.

OBJECTIVE: To present interventional therapeutic options for patients with thrombosis. ETIOLOGY: Thrombosis in small animals results from an unbalance in the normal hemostatic mechanisms leading to vessel occlusion. In veterinary medicine, thrombosis is recognized as a common complication of many acquired diseases, including cardiac, endocrine, immunological, inflammatory, and neoplastic disorders. DIAGNOSIS: Clinical signs are variable depending on the location of the thrombus and various laboratory and imaging modalities can aid in its identification and localization. THERAPY: Once identified, a decision must be made to whether or not intervene and which method is most appropriate. A number of minimally invasive approaches for dealing with thrombosis are available and offer veterinarians a choice of therapeutic options when dealing with a thrombotic patient. In the presence of thrombosis, a combined approach of vessel balloon dilatation, catheter-directed thrombolysis and stenting may be most appropriate. Percutaneous mechanical thrombectomy, if available, may also be appropriate. Embolic trapping devices can be used with vena cava thrombosis to help prevent pulmonary embolism. Anticoagulant therapy may be indicated in the postoperative period to prevent further thrombus formation while the patient's fibrinolytic system breaks the clot down. PROGNOSIS: Outcome is variable depending on the site of the thrombus formation. Arterial thrombosis can be life-threatening while venous thrombosis tends to be less life-threatening but may lead to pulmonary embolism.

Nonsurgical resolution of gallbladder mucocele in two dogs.

CASE DESCRIPTION: A gallbladder mucocele was diagnosed in 2 dogs. In both dogs, the mucocele resolved with medical treatment but without the need for surgical intervention. CLINICAL FINDINGS: A 12-year-old spayed female Miniature Schnauzer had a history of signs of gastrointestinal tract disease and high serum liver enzyme activities. Gallbladder mucocele and hypothyroidism were diagnosed. A 6-year-old neutered mixed-breed dog had chronic intermittent diarrhea and recurrent otitis; gallbladder mucocele and hypothyroidism were diagnosed. TREATMENT AND OUTCOME: The first dog was treated with S-adenosyl-methionine, omega-3 fatty acids, famotidine, ursodiol, and levothyroxine. Substantial improvement in the gastrointestinal tract condition and complete resolution of the gallbladder mucocele within 3 months were evident, but the dog was not available for further follow-up monitoring. The second dog was treated with fenbendazole, ursodiol, and levothyroxine and fed a hypoallergenic diet. One month after evaluation, abdominal ultrasonography revealed that the gallbladder mucocele was resolving, and treatment was continued. Ultrasonographic evaluation 2 and 4 months later revealed complete resolution of the mucocele. CLINICAL RELEVANCE: Review of the clinical course of 2 dogs in which there was nonsurgical resolution of gallbladder mucocele revealed that surgery is not necessary in all dogs with gallbladder mucocele. Hypothyroidism may have resulted in delayed gallbladder emptying, and its role in the pathogenesis of gallbladder mucocele merits investigation. Despite this information, until further prospective trials with a control group and standardized treatments and follow-up monitoring can be performed, the authors recommend surgical intervention for treatment of dogs with gallbladder mucocele.