[Uroperitoneum in a heifer]. / Uroperitoneum bei einem weiblichen Jungrind.

Uroperitoneum is a rarely documented finding in heifers. More frequently uroperitoneum is described in male youngstock suffering from obstructive urolithiasis, or abscesses of the urachus. This report describes a case of uroperitoneum most likely as a result of a traumatic rupture of the urinary bladder in an 8.5 months old heifer. The animal was presented with a severely dilated abdomen and an undulating wave was evident upon palpation. The heifer exhibited physiologic urination. Additionally, left displacement of the abomasum was evident. In consequence to findings of the ultrasonographic examination and abdominocentesis, diagnostic laparotomy was performed. Urine was evacuated from the abdominal cavity in fractions and the damaged cranial pole of the urinary bladder was excised followed by the suture of the urinary bladder. The abomasum was replaced in its physiologic position and an omentopexy was performed. The heifer was discharged from hospital and was still in the herd 5 years after discharge.

Computed tomography of a canine omental torsion secondary to a chronic abdominal gossypiboma and concurrent incidental broad ligament torsion.

A 5-year-old female spayed Dogue de Bordeaux was referred for concerns of an abdominal mass and peritoneal effusion. Abdominal radiographs identified a mid-ventral abdominal soft tissue opaque mass containing a radiopaque marker consistent with a gossypiboma. Contrast-enhanced abdominal CT identified two whirl signs associated with the abdominal gossypiboma. Exploratory laparotomy confirmed an omental torsion with encapsulated gossypiboma and concurrent incidental torsion of the remnant of the right broad ligament. Based on a literature review, omental torsions are an unreported complication of gossypibomas in canids.

Management of uroperitoneum through combination of conservative and surgical treatments in two colts.

Background: Ruptures of the urinary bladder and urachus are the most frequent cause of uroperitoneum in foals. Surgical correction is often the first treatment choice, however, nonsurgical methods, such as urine removal via urinary catheters and abdominal drains, have been successfully performed in foals. Case Description: Two foals were referred to the Equine Perinatology Unit for suspicion of uroperitoneum. The diagnosis was confirmed by hematobiochemical and ultrasound examinations, thus cystorrhaphy and cystoplasty were attempted. Surgeons found a lesion in the dorsocranial margin of the bladder (Case 1) and a tear in the pelvic urethra (Case 2); in the first case, the defect was routinely repaired, while the last lesion was impossible to repair due to its localization. A urinary catheter was left in place in both cases. Uroperitoneum recurred 72 hours after the surgery in both foals: a second surgical correction was not recommended due to the localization of the tears and conservative treatment, with the placement of a 32F chest tube in the most ventral part of the abdomen, was preferred. Abdominal drains were removed 5-7 days after surgery, while urinary catheters were left in place for up to 7-8 days. Colts' conditions improved during hospitalizations. Two months after bladder surgery, Case 1 was euthanized due to multiple adhesions between the small intestine and the abdominal wall. Case 2 was still alive one year postoperatively. Conclusion: Although it cannot be considered the first choice for the treatment of uroperitoneum in the foal, nonsurgical treatment was successful in both cases in the short-term follow-up. However, the prognosis should be cautious due to the risk of long-term complications. Conservative management may be used to manage bladder/urethral tears that cannot be solved by surgery.

Complications and Comorbidities in Foals Undergoing Surgical Repair for Uroperitoneum.

Surgical repair is frequently effective at resolving uroperitoneum in foals, though complications occur. Despite their occurrence, management strategies used to address these complications, and their impact on survival are not clearly defined. To better describe the complications following surgical correction of uroperitoneum and to document treatment strategies and outcomes after intervention, a multi-center retrospective case series was performed. Medical record data of foals undergoing surgical treatment for uroperitoneum were retrieved from three surgical centers, and cases identified with complications or comorbidities were reviewed. Long-term follow-up was obtained through owner contact. Of 45 foals with uroperitoneum, 13 (29%) had complications or comorbidities following surgical repair. Uroperitoneum recurred in 9 (20%) foals 12-264 hours after surgery. Foals with recurrence were managed medically with an indwelling urinary catheter, repeat celiotomy, or were euthanized. Other comorbidities following repair included sepsis and persistent azotemia. One horse developed cystic calculi 14 months later. Urinary catheters maintained for 3-7 days in combination with medical and surgical interventions successfully resolved uroperitoneum. The decision to debride bladder tear edges or the selection of suture material or pattern did not impact recurrence or survival. Six (67%) foals with recurrent uroperitoneum survived to hospital discharge; 86% survived if treatment was attempted. Four (80%) of cases treated for recurrent uroperitoneum were alive without active medical problems >2 years later. Despite recurrence, medical or surgical treatment of recurrent uroperitoneum enables short-term survival, and maintenance of long-term health. Indwelling urinary catheters should be considered in select cases with recurrent uroperitoneum.

[Uroperitoneum in neonatal foals - a review of the literature]. / Uroperitoneum beim Fohlen ­ eine Literaturübersicht.

Uroperitoneum is a typical disease in newborn foals. An accumulation of urine develops in the abdominal cavity in consequence to a congenital or acquired leakage in the urinary tract. Colts are more frequently affected than fillies. The most common cause of uroperitoneum is a rupture of the dorsal urinary bladder wall. The urinary bladder is affected in 73.1 %, the urachus in 21.6 % and the ureter in 5.2 % of cases. Typical clinical signs occur 2-5 days postpartum, and encompass reduced general condition, abdominal distention, mild colic symptoms and unphysiologic micturition. Ultrasound examination in conjunction with abdominocentesis is considered as the gold standard of diagnostics. Typical laboratory findings are azotemia, metabolic acidosis as well as electrolyte imbalances, particularly hyperkalemia, hyponatriemia and hypochloridemia. Surgical treatment is the only reasonable therapy. Preoperative metabolic disorders and electrolyte abnormalities should be corrected prior to surgery. Especially hyperkalemia leads to a high potential for complications during general anesthesia. Following effective perioperative stabilization, the presence of a defect in the bladder wall or the urachus carries a good prognosis. In total, 63.6 % of the affected foals are healed. Most common complication is a recurrence of uroperitoneum caused by disruption of the suture line or an incomplete closure of the defect.

Ultrasonographic features of mesenteric cysticercosis in a domestic rabbit (Oryctolagus cuniculus).

A 5-year-old, 0.92-kg (2-lb), spayed female Dwarf Hotot rabbit was evaluated for a 1-day duration of lethargy and anorexia. Survey radiographs revealed evidence of gastrointestinal stasis. Abdominal ultrasonography characterized multiple small, round, anechoic structures embedded in the mesentery. These structures were thin walled with hyperechoic strands/septations. Most of the structures contained a well-defined, eccentric, hyperechoic nodule adherent to the intraluminal wall. Mesenteric cysticercosis was confirmed via exploratory laparotomy and histopathology. To the authors' knowledge, this is the first description of the ultrasonographic features of mesenteric cysticercosis in a domestic rabbit.

Acute and Chronic Outcomes of Gas-Bubble Disease in a Colony of African Clawed Frogs (Xenopus laevis).

Gas-bubble disease occurs in aquatic species that are exposed to water that is supersaturated with gases. In February 2007, municipal water supersaturated with gas was inadvertently pumped into the vivarium's aquatic housing systems and affected approximately 450 adult female Xenopus laevis. The inflow of supersaturated water was stopped immediately, the holding tanks aggressively aerated, and all experimental manipulations and feeding ceased. Within the first 6 h after the event, morbidity approached 90%, and mortality reached 3.5%. Acutely affected frogs showed clinical signs of gas-bubble disease: buoyancy problems, micro- and macroscopic bubbles in the foot webbing, hyperemia in foot webbing and leg skin, and loss of the mucous slime coat. All of the frogs that died or were euthanized had areas of mesenteric infarction, which resulted in intestinal epithelial necrosis and degeneration of the muscular tunic. Over the subsequent 2 wk, as gas saturation levels returned to normal, the clinical symptoms resolved completely in the remaining frogs. However, 3 mo later, 85% of them failed to lay eggs or produce oocytes, and the remaining 15% produced oocytes of low number and poor quality, yielding cytosolic extracts with poor to no enzymatic activity. Histology of the egg mass from a single 2- to 3-y-old frog at 3 mo after disease resolution revealed irregularly shaped oocytes, few large mature oocytes, and numerous small, degenerating oocytes. At 6 mo after the incident, the remaining frogs continued to fail to produce eggs of sufficient quantity or quality after hormonal priming. The researchers consequently opted to cull the remainder of the colony and repopulate with new frogs.

Aberrant peritoneal localization of Dirofilaria repens in a dog.

Subcutaneous dirofilariosis is a widely spread vector-borne zoonotic disease caused by Dirofilaria repens. In the last years, a rise of human and animal cases of infection by D. repens has been reported in different European countries. The disease may be subclinical or characterized by different skin conditions. This report describes an unusual ectopic localization of D. repens in a naturally infected dog. The six-year old Pit Bull mixed breed dog presented dysorexia, exercise intolerance, orchialgia and moderate abdominal effusion. The abdominal ultrasound examination revealed multiple linear tubular structures with writhing and undulating movements within the peritoneal effusion. The microscopic examination of the peritoneal effusion revealed many larvae microscopically and molecularly identified as D. repens. This is the first case of peritoneal localization of D. repens in a dog. Epidemiological implications are discussed.

Computed tomographic excretory urography features of intramural ectopic ureters in 10 dogs.

OBJECTIVES: To describe the morphologic and morphometric computed tomographic excretory urography features of intramural ectopic ureters in dogs. METHODS: Retrospective evaluation of computed tomographic excretory urography studies in 10 dogs with surgical and/or cystoscopically confirmed intramural ectopic ureters. All studies were assessed for ureteral ectopia, dilatation, tortuosity, ureterovesicular junction morphology and ureteral orifice location. RESULTS: A total of 14 intramural ectopic ureters were confirmed at surgery/cystoscopy with reviewers correctly identifying 100% (14/14). Abnormalities on computed tomographic excretory urography included ureteral dilatation (7), ureteral tortuosity (3), lack of a normal ureterovesicular junction (14), urethral ureteral orifice location (14) and lack of ureteral divergence (14). CLINICAL SIGNIFICANCE: Lack of a normal ureterovesicular junction, a urethral-ureteral orifice location and lack of ureteral divergence are common computed tomographic excretory urography findings in dogs with intramural ectopic ureters. This technique requires further investigation to determine whether it might allow differentiation of intramural and extramural ectopic ureters.

Urinary bladder retroversion and neourethrocystostomy for treatment of inadvertent prostatectomy and urethrectomy in a dog.

CASE DESCRIPTION A 15-month-old male Newfoundland was examined because of an inability to urinate, lethargy, inappetence, and intermittent vomiting that first became evident after bilateral cryptorchidectomy 2 days previously. The patient was referred for further evaluation and treatment. CLINICAL FINDINGS Results of physical examination, serum biochemical analysis, and abdominocentesis led to a diagnosis of uroperitoneum. Retrograde cystography indicated urinary tract obstruction. In view of the history of recent elective cryptorchidectomy, a diagnosis of uroperitoneum with urethral obstruction secondary to iatrogenic prostatectomy and urethrectomy was made. TREATMENT AND OUTCOME During a ventral midline celiotomy, the inadvertent prostatectomy and urethrectomy were found to have resulted in insufficient urethral length for primary repair. Surgical repair of the urethral defect was achieved by means of a novel technique of bladder retroversion and neourethrocystostomy at the apex of the bladder. A urethral stricture evident 1.5 months after surgery was initially treated with balloon dilatation, followed by temporary and then permanent placement of a self-expanding metallic stent. At the last follow-up 6.6 years after stent placement, the dog remained continent while receiving phenylpropanolamine and the owner was highly satisfied with the outcome. CLINICAL RELEVANCE Caudal intraabdominal bladder retroversion with apex neourethrocystostomy may be a viable alternative to more complex urethral lengthening procedures in dogs and can potentially preserve lower urinary tract function. This treatment might be considered for patients with urethral trauma or malignant neoplasia necessitating extensive urethral resection. Urethral strictures may be effectively managed with stenting.

The first report of peritoneal tetrathyridiosis in squirrel monkey (Saimiri sciureus).

This report describes a case of peritoneal larval cestodiasis caused by tetrathyridia of Mesocestoides sp. in an adult female squirrel monkey. The monkey had lived in a zoological garden in Japan and had a clinical history of wasting. At necropsy, numerous whitish oval masses were found in the liver and peritoneal cavity. These masses contained larval cestodes. Morphological observation and molecular analyses of the mitochondrial 12S ribosomal RNA gene and cytochrome c oxidase subunit 1 gene sequences allowed us to identify the larva as the tetrathyridium of Mesocestoides sp. This is the first report of Mesocestoides larvae in a squirrel monkey in Japan.

Abdominal chronic expanding hematoma causing iron-deficiency anemia in a dog.

A 2 yr old spayed female mixed-breed Irish wolfhound was referred for assessment of anemia and slowly progressing abdominal distention. At the time of admission, the dog had marked anemia and thrombocytosis, a decreased serum iron concentration, and a normal coagulation profile. An ultrasound examination showed a massive fluid-filled cavitated structure in the abdominal cavity. Paracentesis of that structure yielded a large amount of hemorrhagic fluid with an iron concentration >24 times greater than the serum iron concentration, consistent with chronic sequestration of iron, leading to iron-deficiency anemia. Blood transfusions and incomplete surgical removal of the structure allowed short-term stabilization of the patient, but the dog was euthanized 17 days postsurgery for lethargy and continued abdominal distention. Histopathological evaluation of the structure was consistent with a chronic expanding hematoma. To the authors' knowledge, this is the first reported case of intra-abdominal chronic expanding hematoma in a dog. It is also unique given its features of iron-deficiency anemia caused by internal blood loss.

Constrictive pericarditis following surgical repair of a peritoneopericardial diaphragmatic hernia in a cat.

A 4-year-old female spayed domestic longhair cat was referred for dyspnea. Further diagnostics revealed severe pleural effusion and a peritoneopericardial diaphragmatic hernia (PPDH). Following surgical correction of the PPDH the pleural effusion persisted. Re-check echocardiogram 4 weeks after initial evaluation revealed leftward deviation of the interventricular septum and interatrial septum occurring with inspiration. There were also exaggerated phasic changes in trans-tricuspid flow velocities suggestive of constrictive pericardial disease. Cardiac catheterization was performed and revealed elevated pressures in the right atrium and right ventricle. Constrictive pericarditis (CP) and epicarditis was confirmed at surgery, where subtotal pericardiectomy was performed with epicardial decortication. The cat continued to develop recurrent pleural effusion after surgery, although the volume and frequency of recurrence slowed over time. This is the first reported case of CP following PPDH repair in a cat.

Omental torsion in a captive polar bear (Ursus maritimus).

This is the first case report of an omental torsion in a polar bear (Ursus maritimus). A captive, 23-yr-old, 250-kg, intact female polar bear presented to the University of Minnesota Veterinary Medical Center with a 2-day history of lethargy, depression, and vomiting. Abdominal ultrasound identified large amounts of hyperechoic free peritoneal fluid. Ultrasound-guided abdominocentesis was performed and yielded thick serosanguinous fluid compatible with a hemoabdomen. An exploratory laparotomy revealed a large amount of malodorous, serosanguineous fluid and multiple necrotic blood clots associated with a torsion of the greater omentum and rupture of a branch of the omental artery. A partial omentectomy was performed to remove the necrotic tissue and the abdomen was copiously lavaged. The polar bear recovered successfully and is reported to be clinically well 6 mo later. This condition should be considered as a differential in bears with clinical signs of intestinal obstruction and hemoabdomen.

Herniation of the gravid uterus through a mesoduodenal defect and concurrent omental hernia in a cow.

OBJECTIVES: To describe surgical treatment of herniation of the gravid uterus through the mesoduodenum, displacement of the descending duodenum around the gravid uterus, and concurrent herniation of the small and large intestines into the omental bursa in a cow. STUDY DESIGN: Clinical report. ANIMAL: Three-year-old, five-month-pregnant Swiss Braunvieh cow. METHODS: Repositioning of the displaced uterus and descending duodenum without transection and anastomosis of the duodenum was performed through a right flank laparotomy. Concurrent displacement of a large portion of the small and large intestines into the omental bursa was not associated with intestinal strangulation and was corrected manually. The defects in the omentum and mesoduodenum were sutured. RESULTS: There were no postoperative complications, and the cow was healthy at discharge from the clinic 1 week after surgery. Telephone follow-up revealed that the cow had delivered a live calf and was producing a normal amount of milk. The cow was slaughtered 14 months after the surgery because of an udder problem. CONCLUSIONS: Herniation of the gravid uterus through a tear in the mesoduodenum with subsequent displacement of the descending duodenum around the uterus combined with internal omental herniation caused nonspecific clinical signs and no ileus. Exploratory laparotomy in an early stage of pregnancy facilitated reduction of the displaced uterus without transection of the descending duodenum.

Ectopic spleen presenting with anemia and an abdominal mass in a dog.

An 11.5-year-old, neutered male, golden retriever dog that had previously had a splenectomy for benign disease 2 years prior to presentation was diagnosed with anemia and a large abdominal mass. Necropsy and histopathology identified the abdominal mass as ectopic splenic tissue.

Présentation d'un cas de rate ectopique avec de l'anémie et une masse abdominale chez un chien. Un chien Golden retriever castré âgé de 11,5 ans ayant subi une splénectomie pour une maladie bénigne 2 ans avant la présentation a été diagnostiqué avec l'anémie et une grande masse abdominale. La nécropsie et l'histopathologie ont identifié la masse abdominale comme des tissus spléniques ectopiques.(Traduit par Isabelle Vallières).

Ultrasound criteria and guided fine-needle aspiration diagnostic yields in small animal peritoneal, mesenteric and omental disease.

Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.

Peritoneal inflammatory response to surgical correction of left displaced abomasum using different techniques.

The objective of this study was to compare the inflammatory response within the abdominal cavity between three surgical methods. The study comprised 45 cows with left displacement of the abomasum, which were allocated into three groups (n = 15). Right flank laparotomy and omentopexy (group R), left flank laparotomy and omentopexy (group L), and laparoscopic abomasopexy (group J) have been applied. Laparoscopic abomasopexy was the only technique that requires perforation of the abomasal wall. Blood and peritoneal fluid (PF) samples were obtained before, and on days 1, 2 and 3 after surgery. Macroscopic and microscopic evaluation of PF were performed. Cytological and biochemical parameters were analysed in blood and PF. No bacteria were present in PF after surgery. The number of PF leukocytes increased in all groups on day 1 after surgery with the highest value after laparoscopy (median, 1st quartile, 3rd quartile, R: 13.1, 6.4, 16.0; L: 13.6, 9.9, 17.4; J: 33.7, 21.1, 46.9 G/l). Laparotomy resulted in an increase of blood and PF CK on day 1 after surgery, whereas, laparoscopy caused an increased PF CK only. All groups had elevated PF D-dimer concentrations before surgery, with further increase in groups R and L on day 1 after surgery.