Stone-induced urethral fistula treatment with microfragmented adipose tissue containing mesenchymal stem cells: a case report from veterinary medicine with potential application in humans.

We report on a case of a two-year-old male dog, breed chow-chow, who suffered from urethral fistula as a result of ureterolithiasis. The urethral defect was identified intraoperatively with methylene blue. An autologous regenerative approach was combined with surgical closure of the defect, due to the well-known healing issues of the urethral wall in such conditions. A part of abdominal fat tissue was dissected to produce microfragmented adipose tissue containing mesenchymal stem cells, which was combined with platelet-rich plasma. The final product was applied in the area around the urethral defect closure. One month after the procedure, healing was confirmed with positive-contrast cystography. This therapeutic approach yielded success, and the follow-up period of one year was uneventful. The observed positive outcome of this approach in the canine model may be considered as a starting point for investigating the translational potential of the treatment in human medicine.

Assessment of Combined Resection-Anastomosis and Urethropexy in Dogs with Urethral Prolapse.

The literature regarding surgical repair of urethral prolapse in dogs is limited and associated with a high recurrence rate. We hypothesized that combined resection and anastomosis (R&A) with urethropexy would be associated with less recurrence of urethral prolapse compared with R&A alone. Medical records of dogs managed surgically for urethral prolapse were reviewed (2013-2023) from three tertiary care hospitals. Inclusion criteria included complete medical records, including surgery reports, short-term postoperative complications, and longer-term follow-up. Forty-six male dogs successfully met the inclusion criteria (16 castrated; 30 intact). Brachycephalic breeds were overrepresented (37/46, 80%). Surgical repair by R&A alone (n = 27), urethropexy alone (n = 6), or a combined R&A and urethropexy (n = 13) was performed. Recurrence rates for these techniques were 13/27 (48%), 2/6 (33%), and 1/13 (8%), respectively. The recurrence rate of urethral prolapse treated by a combined R&A and urethropexy was significantly lower (P < .05) than R&A alone, despite more dogs being overweight and less surgeon experience (each P < .05). Interestingly, dogs neutered before initial diagnosis may be more likely to have postoperative recurrence. Considering general anesthesia risks, an initial combination procedure for urethral prolapse may help prevent recurrence.

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).

Risk factors of enterococcal bacteriuria in cats: A retrospective study.

Objective: To determine if factors associated with urothelial damage and inflammation, including urinary catheterization, urinary obstruction, and urolithiasis are associated with the presence of enterococcal bacteriuria in cats. Animals: Thirty-one cats with Enterococcus spp. bacteriuria and 31 cats with Escherichia coli bacteriuria. Procedure: A retrospective case-control study with cases and controls identified by records search for Enterococcus spp. (case) and E. coli (control) bacteriuria from August 1, 2014 to July 31, 2019. Cases and controls were balanced with respect to average age. Binary logistic regression was used to estimate and test whether the odds of having Enterococcus spp. bacteriuria (instead of E. coli) were associated with the presence of any characteristic. Results: Urinary catheterization, urinary obstruction, and urolithiasis were not observed more often in Enterococcus cases versus E. coli controls (19% versus 25%, P = 0.543; 19% versus 32%, P = 0.244; and 16% versus 16%, P = 1, respectively). Signs of lower urinary tract disease were significantly less common in Enterococcus cases than in E. coli controls (OR: 0.30; 95% CI: 0.10 to 0.83, P = 0.02). Hematuria was significantly less common in cases than controls (P = 0.048). Conclusion: No association was identified between urinary catheterization, urolithiasis, or any other comorbidities (hyperthyroidism, chronic kidney disease) and enterococcal bacteriuria in cats. Clinical relevance: Unlike in humans and dogs, urothelial damage and inflammation caused by factors such as urinary catheterization and urolithiasis may not be the mechanism for enterococcal bacteriuria in cats.

Facteurs de risque de bactériurie à entérocoque chez le chat : une étude rétrospective. Objectif: Déterminer si les facteurs associés aux lésions et à l'inflammation urothéliales, y compris le cathétérisme urinaire, l'obstruction urinaire et les lithiases urinaires, sont associés à la présence de bactériurie à entérocoque chez le chat. Animaux: Trente et un chats avec bactériurie à Enterococcus spp. et 31 chats atteints de bactériurie à Escherichia coli. Procédure: Une étude cas-témoins rétrospective avec des cas et des témoins identifiés par la recherche de dossiers pour bactériurie à Enterococcus spp. (cas) et à E. coli (témoin) du 1er août 2014 au 31 juillet 2019. Les cas et les témoins étaient équilibrés par rapport à l'âge moyen. La régression logistique binaire a été utilisée pour estimer et tester si la probabilité d'avoir une bactériurie à Enterococcus spp. (au lieu d'E. coli) était associée à la présence de n'importe quelle caractéristique. Résultats: Le cathétérisme urinaire, l'obstruction urinaire et la lithiase urinaire n'ont pas été observés plus souvent chez les cas avec Enterococcus spp. par rapport aux témoins avec E. coli (19 % vs 25 %, P = 0,543; 19 % vs 32 %, P = 0,244; et 16 % vs 16 %, P = 1, respectivement). Les signes de maladie des voies urinaires inférieures étaient significativement moins fréquents chez les cas à Enterococcus que chez les témoins à E. coli (OR : 0,30; IC à 95 % : 0,10 à 0,83, P = 0,02). L'hématurie était significativement moins fréquente chez les cas que chez les témoins (P = 0,048). Conclusion: Aucune association n'a été identifiée entre le cathétérisme urinaire, la lithiase urinaire ou toute autre comorbidité (hyperthyroïdie, maladie rénale chronique) et la bactériurie à entérocoque chez le chat. Pertinence clinique: Contrairement aux humains et aux chiens, les lésions urothéliales et l'inflammation causées par des facteurs tels que le cathétérisme urinaire et la lithiase urinaire peuvent ne pas être le mécanisme pour la bactériurie à entérocoque chez les chats.(Traduit par Dr Serge Messier).

Urethrorectal fistula ligation and transection in a dog with a history of unilateral abdominal cryptorchidism and misdiagnosed anal gland disease.

A 10-month-old unilaterally cryptorchid male labradoodle dog was presented to a specialty surgery referral center with a reported history of persistent anal sac leakage that was unresponsive to conservative management. The dog underwent castration and left anal sacculectomy but was witnessed urinating from the anus postoperatively. A contrast urethrogram was performed, and a urethrorectal fistula located between the distal portion of the pelvic urethra and the caudal aspect of the rectum was diagnosed. One week later, the dog underwent ligation and transection of the fistula. Surgery was successful and the dog recovered unremarkably with complete resolution of clinical signs. A contrast urethrogram 1 mo after surgery confirmed the successful ligation and transection of the fistula. Key clinical message: To the authors' knowledge, this is the first clinical report of urethrorectal fistula ligation and transection in a dog with unilateral abdominal cryptorchidism and misdiagnosed anal sac disease. Our findings underscore the importance of a thorough physical examination, history taking, and clinical workup for appropriate diagnosis and treatment of multiple congenital abnormalities.

Ligature et transection de la fistule urétrorectale chez un chien ayant des antécédents de cryptorchidie abdominale unilatérale et de maladie des glandes anales mal diagnostiquée. Un chien Labradoodle mâle unilatéralement cryptorchide âgé de 10 mois a été présenté à un centre de référence en chirurgie spécialisée avec des antécédents signalés de fuite persistante du sac anal qui ne répondait pas à une prise en charge conservatrice. Le chien a subi une castration et une sacculectomie anale gauche, mais a été vu en train d'uriner par l'anus après l'opération. Un urétrogramme de contraste a été réalisé et une fistule urétrorectale située entre la partie distale de l'urètre pelvien et la face caudale du rectum a été diagnostiquée. Une semaine plus tard, le chien a subi une ligature et une section de la fistule. La chirurgie a été un succès et le chien s'est rétabli sans particularité avec une résolution complète des signes cliniques. Un urétrogramme de contraste 1 mois après la chirurgie a confirmé la réussite de la ligature et de la section de la fistule.Message clinique clé :À la connaissance des auteurs, il s'agit du premier rapport clinique de ligature et de transection de fistule urétrorectale chez un chien atteint de cryptorchidie abdominale unilatérale et d'une maladie du sac anal mal diagnostiquée. Nos résultats soulignent l'importance d'un examen physique approfondi, d'une anamnèse et d'un bilan clinique pour un diagnostic et un traitement appropriés des anomalies congénitales multiples.(Traduit par Dr Serge Messier).

Traumatic Rectovesicular Fistula in a Dog.

A 7 mo old intact male Australian cattle dog presented for evaluation of a suspected urethrorectal fistula after being examined by the primary veterinarian for leaking of urine from the rectum at rest and when posturing to urinate. Advanced imaging identified a caudally retroflexed urinary bladder, several healing pelvic fractures, and a rectovesicular fistula. Primary surgical repair of the fistula was performed. The dog recovered well from surgery and was urinating and defecating normally as of 5 mo after the operation. This is the first report of a traumatic rectovesicular fistula in the veterinary literature.

Surgical treatment and outcome of sterile prostatic cysts in dogs.

OBJECTIVE: To describe the surgical treatment and outcome of a large cohort of dogs with sterile prostatic cysts (PCs). STUDY DESIGN: Retrospective study. ANIMALS: Forty-four client-owned dogs. METHODS: Dogs with sterile PCs with at least 6 months of follow-up were included. Clinical variables, type of surgery, complications, recurrences, and outcomes (telephonic interviews or rechecks) were recorded. RESULTS: Extra- and intraparenchymal cysts were diagnosed in 29 and 11 dogs, respectively. Four dogs had both types. Extraparenchymal cysts were treated by partial resection and omentalization (n = 22) and complete resection (n = 7). Drainage and intracapsular omentalization were performed in all dogs with intraparenchymal cysts. The four dogs with both types of cyst were treated by omentalization. Resolution was documented in 39/44 dogs (88.6%). Intraoperative complications occurred in one dog (urethral tear). Major complications resulting in death occurred in three dogs (oliguric kidney injury, cardiac arrhythmia, and persisting urinary tract obstruction). Minor complications (n = 10) consisted of temporary urinary incontinence (n = 2), permanent urinary incontinence (n = 5), urinary retention (n = 2), and dysuria (n = 1). Recurrence occurred in two dogs with extraparenchymal cysts. Median long-term follow-up was 528 days (range, 250-730 days). Thirty-nine dogs had no signs associated with prostatic disease at long-term follow-up. CONCLUSION: Partial or complete resection and/or omentalization of sterile PCs led to resolution of clinical signs in most dogs, although postoperative urinary incontinence was frequent. IMPACT: This study is the largest case series relative to canine sterile PCs treated surgically and provides evidence on the prognosis and rate of complications.

Long-term outcome of the transobturator vaginal tape inside out for the treatment of urethral sphincter mechanism incompetence in female dogs.

OBJECTIVE: To evaluate the long-term efficacy of the transobturator vaginal tape inside out (TVT-O) in female dogs with urethral sphincter mechanism incompetence (USMI). STUDY DESIGN: Retrospective study. ANIMALS: Incontinent spayed female dogs (n = 12). METHODS: TVT-O tape was inserted in 12 incontinent bitches diagnosed with USMI. Follow-up information was evaluated by a telephone questionnaire, and a continence score was attributed. RESULTS: One year after surgery, 7 of 12 (58%) dogs were completely continent. Two dogs were removed from the long-term analysis (1 dead and 1 lost). At a median follow-up time of 85 months (range, 28-95), 4 of 10 dogs were completely continent without medical treatment. Incontinence recurred in 6 dogs at a median time of 2 months after surgery (range 1-20). Among these 6 dogs, 4 regained continence, and 2 had sporadic episodes of incontinence with additional medical treatment. No postoperative complications were encountered. CONCLUSION: TVT-O alone was successful in maintaining long-term continence in 40% of the dogs. Additional postoperative medical treatment was effective in restoring continence in another 40% of the dogs. CLINICAL SIGNIFICANCE: TVT-O provides an alternative treatment of USMI in female dogs that is safe and less invasive than standard surgical techniques.

Long term use of hydraulic artificial urethral sphincters in nine dogs from New Zealand with urethral sphincter mechanism incompetence.

AIMS: To report on the long-term outcomes of hydraulic artificial urethral sphincter (HAUS) placement for the correction of urethral sphincter mechanism incompetence (USMI) in New Zealand dogs. METHODS: Retrospective data were obtained from cases of dogs which had a HAUS placed after failed medical and/or surgical management of USMI between August 2012 and November 2016. Owner assessment of urinary incontinence was evaluated by an online survey in May 2017 using a visual analogue scale (0 being normal, 100 being severely affected) for the frequency, volume and severity of any straining to urinate, immediately prior to the placement of the HAUS and at the time of the survey. The number of days between surgery and the completion of survey were recorded. RESULTS: Seven females and two male dogs, which were all desexed except for one female, were eligible for inclusion in the study. The period of follow-up following HAUS placement ranged from 206-1,685 days. Following HAUS placement, frequency and volume of urinary incontinence decreased for six dogs and were practically unchanged for three dogs. The median frequency score decreased from 70 to 13 and the volume score decreased from 73 to 12. There was no consistent change in the perceived degree of straining to urinate. Complications occurred in three dogs; one required repositioning of a dislodged injection port, one required management for haematuria and a hypoplastic bladder, and one required surgical removal of fibrous tissue around the HAUS cuff. CONCLUSIONS AND CLINICAL RELEVENCE: HAUS placement was an effective method for the treatment of persistent USMI in most dogs and provided good clinical results based on owner assessment. The technique was associated with few complications and allowed successful long-term control of urinary incontinence without the need for medical management.

Suspected congenital urethral diverticulum in a dog.

A 2-year-old neutered male dog with a history of urinary incontinence, recurrent urinary tract infections, and unilateral cryptorchidism was presented with an acute onset of perineal swelling. Urinary contrast studies revealed a urothelial lined structure in the perineum. Surgical resection of 80% to 90% of this structure, suspected to be a congenital urethral diverticulum, was successful.

Diverticule urétral congénital soupçonné chez un chien. Un chien mâle stérilisé âgé de 2 ans ayant une anamnèse d'incontinence urinaire, d'infections des voies urinaires récurrentes et de cryptorchidie unilatérale a été présenté suite à l'apparition aiguë d'enflure périnéale. Des épreuves de contraste urinaire ont révélé une structure urothéliale recouverte dans le périnée. Une résection chirurgicale de 80 % à 90 % de cette structure, soupçonnée d'être un diverticule urétral congénital, a été réalisée avec succès.(Traduit par Isabelle Vallières).

IMAGING DIAGNOSIS-RADIOGRAPHY AND ULTRASONOGRAPHY OF BILATERAL CONGENITAL URETEROVESICAL JUNCTION STENOSIS CAUSING HYDRONEPHROSIS AND HYDROURETER IN A FERRET (MUSTELA PUTORIUS FURO).

An 8-month-old neutered male ferret was presented for vaccination and preventive treatment for adrenal gland disease. Abdominal ultrasound revealed severe bilateral hydronephrosis and hydroureter. Excretory urography and negative contrast cystography showed bilateral ureterovesical junction stenosis. Positive retrograde cystography demonstrated right ureteral reflux. A subcutaneous ureteral bypass was placed in the left kidney; however, it had to be removed 3 months later due to an obstruction and persistent urinary tract infection. Bilateral ureteroneocystotomy was performed. Although congenital strictures are uncommon in veterinary patients, they should be included in the differential diagnosis in ferrets presenting with hydronephrosis and hydroureter of undetermined cause.

Urethral prolapse in dogs: a retrospective study.

OBJECTIVE: To evaluate the signalment, clinical signs, treatment, and outcome of dogs with urethral prolapse and identify risk factors associated with prolapse or treatment. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 48) with urethral prolapse. METHODS: Medical records (May 1995-June 2010) from 2 referral centers were reviewed. Retrieved data included signalment, clinical signs, laboratory findings, treatment, complications, results of long-term follow-up. Records from Veterinary Medical Data Base (VMDB) were evaluated to determine odds ratios. RESULTS: Odds ratio for urethral prolapse in English bulldogs compared to all breeds was 366.99 (95% CI: 265.83, 506.65). Of 48 affected dogs, 46 had either resection and anastomosis (43 dogs) or urethropexy (3 dogs). The most common early postoperative complication was hemorrhage (39%); postoperative hemorrhage was less common when a simple continuous pattern was used for resection and anastomosis. Prolapse recurred in 57% of dogs available for long-term follow-up; recurrence was less common in dogs that were administered postoperative butorphanol or acepromazine. Gender was not associated with urethral prolapse or postoperative complications. CONCLUSIONS: Urethral prolapse occurs most commonly in English bulldogs. Postoperative hemorrhage and prolapse recurrence may be reduced with use of a simple continuous pattern for urethral anastomosis and by administration of postoperative sedation, respectively. Castration status did not appear to affect prolapse development or outcome.

Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum.

BACKGROUND: Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. HYPOTHESIS/OBJECTIVES: Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). ANIMALS: Eight client-owned dogs with UD treated with an AUS. METHODS: Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. INCLUSION CRITERIA:  diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow-up. Urinary continence score (UCS) was attributed retrospectively. RESULTS: Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). CONCLUSION: Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.

Application of buccal mucosal graft to establish a new urination passage in male cats with penile traumatic injury.

Two male cats were presented with penile part of urethra injury due to dog attacks to the perineum and genitalia area. Chronic wound around a remained penile part of urethra due to the dog bite and perineal area was evident due to urine irritation. The buccal mucosa was harvested and subsequently placed on the granulation tissue of the wound to reconstruct the urinary passage. The buccal mucosal graft completely attached to the skin and urethra without any complications. From the follow-up at 3 months, the cats were able to urinate normally and the skin irritation from urine was resolved. In summary, the buccal mucosa is a good graft source and is suitable for the reconstruction of the urinary passage in severe and complicated cases of penile part of urethra injury in male cats.

Transobturator vaginal tape inside out for treatment of urethral sphincter mechanism incompetence: preliminary results in 7 female dogs.

OBJECTIVES: To evaluate the clinical efficacy of the transobturator vaginal tape inside-out (TVT-O) in incontinent female dogs affected with urethral sphincter mechanism incompetence (USMI) and to determine its urodynamic and morphologic effects. STUDY DESIGN: Case series. ANIMALS: Incontinent spayed female dogs (n=7). METHODS: TVT-O tape was inserted in 7 incontinent female dogs diagnosed with USMI. Urethral pressure profilometry (UPP) and vaginourethrograms were performed preoperatively, and 1 and 3 months postoperatively. Clinical efficacy of the technique was evaluated and complications reported. Follow-up information was evaluated by a telephone questionnaire. RESULTS: All dogs were continent immediately after the procedure. Incontinence recurred 2 months after surgery in 1 dog and was treated by phenylpropanolamine administration. At mean follow-up time of 11.3 months, 6 of 7 dogs were continent. An iatrogenic urethral tear occurred intraoperatively in 1 dog. No postoperative complications were encountered. The postoperative UPPs showed significantly increased maximal urethral closure pressure and integrated pressure. Postoperative vaginourethrograms were unremarkable. The surgical procedure did not modify the location of the urinary bladder neck in dogs with a "pelvic urinary bladder" preoperatively. CONCLUSIONS: TVT-O was efficient in maintaining short term continence in 6 of 7 dogs affected with USMI.

Creation of a urethral conduit from a preputial indirect flap in a dog with perineal hypospadias.

OBJECTIVE: To report a surgical technique for creation of a urethral conduit using a preputial indirect flap. STUDY DESIGN: Case report. ANIMALS: Male Doberman Pinscher (6 weeks old). METHODS: A urethral conduit was constructed using a multistage preputial indirect flap in a dog with severe perineal hypospadias. RESULTS: Successful transfer of a perineal located urethral meatus to a more anatomically normal inguinal location was achieved with a preputial flap. The procedure was performed to aid control of recurrent urinary tract infections after anal and urethral separation in a dog with imperforate anus, urethrorectal fistula, and proximal perineal hypospadias. CONCLUSIONS: Creation of a urethral conduit from a tubed bipedicle flap using redundant preputial tissue eliminated fecal contamination of the urethral meatus, aiding control of urinary tract infection. A good functional and cosmetic outcome was achieved. CLINICAL RELEVANCE: This technique should be considered in aiding control and prevention of urinary tract infections in dogs with proximal perineal hypospadias where a preputial remnant exists.

Prepubic urethrostomy and vaginoplasty in a female cat.

A 1-year-old, intact female, domestic shorthaired cat was presented for dysuria resulting from perineal scarring subsequent to injuries incurred during a cat fight. A prepubic urethrostomy was performed to manage the dysuria. Eleven months later, the cat was re-presented with a 3-day history of pyrexia and inappetence. A pinpoint opening extending 0.5 cm ventral to the anus on midline, exuding a clear discharge, was noted in the perineal region. A contrast fistulogram was performed, and a vaginoperineal fistula was diagnosed. The fistulous tract was a result of vulvar stricture from the trauma of the cat fight. A vaginoplasty was performed to create an opening for vaginal secretions. This is the first published report of a prepubic urethrostomy performed in a female cat.

Ultrasonography and Surgical Treatment of an Unusual Case of Urethral Calculus in an Arabian Horse.

This case report records an obstructive urolithiasis due to a large calcium carbonate urethral stone in an 11-year-old Arabian stallion. The stallion had colicky pain, anuria, and reduction in food and water intakes. Palpation of the penis revealed rhythmic contractions of the urethra, a hard mass in the penile urethra at the level of the ischial arch, and a dilated urethra proximal to the mass. Rectal examination revealed a distended and turgid urinary bladder. Passing a urethral catheter revealed a complete urethral obstruction at the level of the ischial arch. Ultrasonography revealed a calculus that appeared as an irregular, hyperechoic arch-like thick line with acoustic shadowing. Subischial urethrotomy was conducted under epidural anesthesia. Uneventful recovery was seen with no recurrence or complications for 12 months of available follow-up. In conclusion, clinical, rectal, and ultrasound examinations are valuable for definite diagnosis of urethral calculi in horses and the subischial urethrotomy appears to be successful in correcting this condition in horses.

Efficacy and safety of laser lithotripsy in fragmentation of urocystoliths and urethroliths for removal in dogs.

OBJECTIVE: To characterize the efficacy and safety of laser lithotripsy in the fragmentation of urocystoliths and urethroliths for removal in dogs. DESIGN: Prospective case series. ANIMALS: 100 dogs with naturally occurring urocystoliths and urethroliths. PROCEDURES: Via cystoscopy, laser lithotripsy was performed to fragment uroliths. Basket retrieval and voiding urohydropropulsion were used to remove fragments. Postprocedural contrast cystography was performed to assess efficacy and safety. In 40 dogs, midstream urine samples were collected just prior to laser lithotripsy (day 0) and on days 1, 3, and 11 after laser lithotripsy to assess inflammation. RESULTS: Urolith removal was complete in 82% of dogs (52/66 with only urocystoliths, 17/17 with only urethroliths, and 13/17 with urocystoliths and urethroliths). Urolith removal was incomplete in 18 dogs; of these dogs, 9, 6, and 3 had urolith fragments >or= 3 mm, 1 to < 3 mm, and < 1 mm in diameter, respectively. Sex (female) was the most significant predictor for success. Median procedure time was 72 minutes. Two dogs developed urinary tract obstruction following laser lithotripsy. Hematuria was detected in 53% of dogs on day 0 and in 84%, 13%, and 3% of dogs on days 1, 3, and 11, respectively. Leukocyturia was detected in 13% of dogs on day 0 and in 47%, 0%, and 3% of dogs on days 1, 3, and 11, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that use of laser lithotripsy was a safe and effective alternative to surgical removal of urocystoliths and urethroliths in dogs.

Use of a rectus abdominis muscle flap to repair urinary bladder and urethral defects in a dog.

CASE DESCRIPTION: An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria. CLINICAL FINDINGS: Rectal and vaginal examination and abdominal radiography revealed a large (4 x 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon. TREATMENT AND OUTCOME: Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 x 2.0 x 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 x 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 x 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture. CLINICAL RELEVANCE: Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.