An international survey on canine urinary incontinence: case frequency, diagnosis, treatment and follow-up.

Introduction: Urinary incontinence (UI) consists of involuntary leakage of urine during the storage phase of urination. Methods: An anonymous survey was given to Spanish and Italian veterinarians about canine UI treated cases, diagnosis, treatment, follow-up, and professional interest. Results and discussion: Most veterinarians treated ≤3 cases/quarter, resulting in the percentage of incontinence males being lower than that of females (1-4% vs 0-24%). The percentage of spayed incontinent females was lower in Spain (0-24%) than in Italy (75-100%). Most diagnoses were based on a diagnostic algorithm (Spain: 88.7%; Italy: 65.3%); patient report and history, blood work, urinalysis and abdominal ultrasound. Urethral/bladder pressure measurement was unusual (Spain: 0.2%; Italy: 2.4%). In Spain, radiology with contrast medium and CT urography (26.3% and 34.4%, respectively) were more frequent than in Italy (11.6% and 22.7%, respectively). When suspecting urethral sphincter mechanism incompetence pharmacological trial (Spain: 93.2%; Italy: 78.9%). The first-choice medical treatment was Phenylpropanolamine, followed by Ephedrine and Deslorelin. When pharmacotherapy failed, the most frequent option was drug change, followed by increased drug dosage/frequency of administration, surgical therapy and colposuspension. A review was completed after the first week of treatment followed by periodic reviews. Most of the respondents participated in continuing education only if UI occurred in their everyday practice (Spain: 63.0%; Italy: 55.4%) and about 30% responders did it regardless of the number of UI cases treated (Spain: 30.5%; Italy: 37.4%). Conclusion: Some recommendations in clinical practice were made. UI can be underestimated by owners; therefore, a complete history should be obtained by veterinarians. Veterinarians should carefully evaluate if spaying is advisable considering it could increase UI risk. A step-by-step approach is recommended and a specific diagnostic-therapeutic algorithm for UI in dogs is provided. Conservative approaches (regular exercise, weight loss in overweight dogs and observing an "incontinence diary" to identify abnormal patterns of urination) are advisable.

Resection of vaginal septum using endoscopic-guided sealing devices in female dogs: 8 cases (2015-2018).

OBJECTIVES: Vestibulovaginal septal remnants are congenital anomalies that are often concurrent with ectopic ureters in bitches. During endoscopic laser ablation of the ectopic ureter, the vaginal septum should be cut in the same surgical session. However, sometimes, the septal length and thickness make the procedure extremely long and challenging with lasers. This study aimed to describe the use of sealing devices for septal cuts. MATERIALS AND METHODS: We searched medical records for female dogs presented for ectopic ureters with endoscopic laser ablation that had a vaginal septum equal or longer than 4 cm in length that were treated using vesseal-sealing devices. RESULTS: Medical records of 37 patients were retrieved. Of those, 8 patients were eligible for inclusion in the case series. Weight of included dogs ranged from 10 to 27 kg, and age ranged from 3 to 60 months. Three of these patients had the septum resected using the LigaSure™ device, and five of them using the ENSEAL® device. The median time of septum resection using the vessel-sealing devices was 100 seconds (range 60 to 130s). No obvious complications were detected when using the described technique. CLINICAL SIGNIFICANCE: The sealing devices used by the authors allowed a rapid and uneventful resection of the vaginal septum in the cases described herein.

Nissen fundoplication and combined procedures to reduce recurrence of gastroesophageal reflux disease in neurologically impaired children.

Neurologically impaired children account for almost half of the fundoplication procedures performed for gastroesophageal reflux disease. Aim of the present study was to report results of antireflux surgery in neurologically impaired children. A retrospective study of neurologically impaired children who underwent fundoplication over a 13-year period (1999-2012) was performed. Recurrence rate, major complications and parents/caregivers perceptions of their child's quality of life following antireflux surgery were analyzed. A total of 122 children (median age: 8 years 9 months; range: 3 months to 18 years) had open "tension-free" Nissen fundoplication, gastrostomy + /- pyloroplasty. Gastroesophageal reflux disease was in all cases documented by at least two diagnostic exams. Median duration of follow-up was 9.7 (1.9-13) years. Three (2.4%) recurrences were documented and required surgery re-do. Major complications were 6%. Seventy-nine of 87 (90%) caregivers reported that weight gain was improved after fundoplication with a median score of 1 (IQR: 1-2). Significant improvement was perceived in postoperative overall quality of life. In this series of fundoplication recurrence incidence was low, serious complications were uncommon and caregivers' satisfaction with surgery was high. Accurate patient's selection and creating a "low-pressure" surgical system are mandatory to obtain these results.

Obalon intragastric balloon in the treatment of paediatric obesity: a pilot study.

BACKGROUND: Lifestyle interventions are often ineffective in the treatment of pediatric obesity. Weight loss devices have been introduced for the temporary nonsurgical treatment of morbid obesity. OBJECTIVE: The aim of the study is to evaluate the efficacy of Obalon Intragastric Balloon on weight loss and on metabolic and cardiovascular parameters in a pediatric population with severe obesity. METHODS: We enrolled 10 children with severe obesity. In all patients anthropometric parameters, biochemical tests, ultrasound liver examination and blood pressure monitoring were evaluated at the time of insertion and after removal of device. RESULTS: The Obalon had a positive effect on decrease of weight, body mass index and percentage of excess body weight within 3 months from placement. Moreover, this safe minimally invasive device improves the cardio-metabolic profiles of obese children. CONCLUSIONS: The Obalon could be a useful tool in the difficult management of pediatric patients with morbid obesity, inducing in short-term a meaningful weight loss.

[Experience with cadexomer iodine (Iodosorb) in the treatment of skin ulcers]. / Esperienze con cadexomero iodico (Iodosorb) nel trattamento delle ulcerazioni cutanee.

Ten patients with cutaneous ulcers were treated with cadexomer iodine, powder and ointment. Cadexomer iodine was evaluated as reduction of ulcers area, pain, removal of pus and debris, exudate, stimulation to granulation, biohumoral tests and side effects. Cadexomer iodine was resulted, as ointment like as powder, a very efficacious drug for the treatment of cutaneous ulcers.