RESUMO
A 3-year-old spayed female rabbit (Oryctolagus cuniculus) was referred with mineralizations in the left kidney. Despite medical management, 8 months after the initial examination, a 5.3-mm obstructive nephrolith with dilatation of the renal diverticuli was observed with abdominal ultrasonography. Surgical removal by endoscopy-assisted nephrolithotomy was completed. A flexible endoscope was introduced into the renal pelvis through a puncture incision in the lateral aspect of the kidney. The nephrolith was removed with endoscopic grasping forceps through the same orifice and the renal pelvis and diverticula were flushed to extract the smaller mineralized particles. The nephrotomy site was closed and the kidney was sutured to the abdominal wall. The rabbit recovered uneventfully. Six months after surgery, a non-obstructive stone was identified; however, 2 years later the rabbit remains asymptomatic. To the authors' knowledge, this is the first report on the use of endoscopy-assisted nephrolithotomy to extract a complicated nephrolith in a rabbit.
L'utilisation de la néphrolithotomie assistée par endoscopie pour l'élimination unilatérale des néphrolithes chez un lapin ( Oryctolagus cuniculus ). Une lapine stérilisée de 3 ans (Oryctolagus cuniculus) a été référée avec des minéralisations dans le rein gauche. Malgré la prise en charge médicale, 8 mois après l'examen initial, un néphrolithe obstructif de 5,3 mm avec dilatation des diverticules rénaux a été observé à l'échographie abdominale. L'ablation chirurgicale par néphrolithotomie assistée par endoscopie a été réalisée. Un endoscope flexible a été introduit dans le pelvis rénal par une incision de ponction dans la face latérale du rein. Le néphrolithe a été retiré avec une pince à préhension endoscopique par le même orifice et le bassinet et les diverticules rénaux ont été rincés pour extraire les plus petites particules minéralisées. Le site de néphrotomie a été fermé et le rein a été suturé à la paroi abdominale. Le lapin a récupéré sans incident. Six mois après la chirurgie, une pierre non obstructive a été identifiée; cependant, 2 ans plus tard, le lapin reste asymptomatique. À la connaissance des auteurs, il s'agit du premier rapport sur l'utilisation de la néphrolithotomie assistée par endoscopie pour extraire un néphrolithe compliqué chez un lapin.(Traduit par Dr Serge Messier).
Assuntos
Parede Abdominal , Cálculos Renais , Feminino , Animais , Coelhos , Nefrotomia/veterinária , Endoscopia/veterinária , Cálculos Renais/veterinária , RimRESUMO
CASE DESCRIPTION: A captive adult sexually intact female Asian small-clawed otter (Aonyx cinereus) was evaluated because of diarrhea and signs of abdominal discomfort on arrival at the quarantine area of a zoological park. CLINICAL FINDINGS: Radiographic and ultrasonographic examinations revealed the presence of a large nephrolith in the left kidney. Mild nephrolithiasis was detected in the right kidney. Results of hematologic and serum biochemical analyses were within references intervals. Intravenous pyelography was used for functional assessment of the urinary system and revealed normal renal excretory function bilaterally. TREATMENT AND OUTCOME: Unilateral (left-sided) pyelotomy was selected as a treatment option to preserve maximal functional renal tissue. Pyeloscopy was successfully used for detection of some small nephroliths that were not removed by repeated flushing of the renal pelvis. Surgical treatment of the right kidney was not considered necessary. The otter recovered fully from anesthesia and surgery. Renal function was considered normal when assessed at 3 and 7 days and at 1 and 12 months after surgery. CLINICAL RELEVANCE: To the authors' knowledge, pyelonephrotomy in otters has not been reported and may be considered as a potential surgical solution for nephrolithiasis. Pyeloscopy allowed the identification of small uroliths that were not removed by repeated flushing of the left renal pelvis following removal of the large nephroliths.