Investigation of preinguinal approach for removal of urachal abscess in three Japanese black cattle older than 18 months of age.

This study investigated the diagnostic and surgical management of urachal abscessation involving the urinary bladder in three cattle aged >18 months. While the abdominal floor or paralumbar fossa are typically considered for accessing the urachus and bladder in calves and heifers, the distance is too great to perform the procedure under direct vision in adult cows. Therefore, a novel preinguinal approach was used for access in cows with urachal abscesses after 18 months. Access was successfully achieved in all the three cows through a preinguinal incision to the urachal abscess at the apex of the bladder. However, in cases wherein the abscess and adhesions are severe, removal may be challenging or may necessitate a combined median or paramedian approach.

The use of agitated saline as contrast agent in a contrast-enhanced cystosonography for detection of urinary bladder rupture in animal cadavers.

OBJECTIVE: To determine the value of microbubble contrast cystosonography in the diagnosis of bladder rupture in animals. DESIGN: Prospective, method comparison study from November 2019 to October 2020. SETTING: University teaching hospital. ANIMALS: Thirty-four ethically sourced cadavers of dogs, rats, and rabbits. INTERVENTIONS: In a prospective and blinded study, the cadavers were divided into 2 randomized groups: with bladder rupture (CR), and without bladder rupture (SR). Urinary catheterization was performed in all cadavers. Through the urethral catheter, bladders in CR group were ruptured using a rigid stainless steel guide wire. Microbubble contrast was infused into the bladder through the urethral catheter, while a single, blinded observer sonographically assessed the bladder. The time to diagnosis and the number of attempts needed for diagnosis were recorded. MEASUREMENTS AND MAIN RESULTS: The study included cadavers of 16 female Wistar rats, 6 female dogs, 11 male dogs, and 1 male rabbit. Time to diagnosis in dogs (2.25 ± 0.91 min) was statistically higher when compared to rats (1.15 ± 0.75 min; P = 0.03). Of the 34 cases, incorrect diagnosis of bladder rupture was made in only 2 dogs (6%), indicating a diagnostic sensitivity of 88.88%, specificity of 100%, and an accuracy of 94%. The positive predictive value was 1 and the negative predictive value was 0.9. CONCLUSIONS: Our study showed that the described method is accurate, sensitive, and specific for the detection of bladder rupture in animal cadavers of different species, size, and sex.

Urinary Incontinence and Urinary Tract Infections.

Urinary incontinence results from disorders of the lower urinary tract or neurologic diseases either of the nerve supply to the bladder/urethra or within the central nervous system. Congenital causes include patent urachus and ectopic ureter. Coordination of lower urinary tract function involves the interaction of both the sympathetic and parasympathetic system as well as somatic branches of the central nervous system. Well-recognized causes of incontinence include equine herpes virus 1 myeloencephalopathy, polyneuritis equi (neuritis of the cauda equina), and sacral/coccygeal trauma. Idiopathic bladder paralysis is characterized by bladder paralysis and sabulous cystitis in the absence of overt neurologic deficits.

Malakoplakia of the urinary bladder in a young French Bulldog.

CASE DESCRIPTION: A 4-month-old 5.9-kg sexually intact female French Bulldog was presented because of recurrent urinary tract infections in combination with pollakiuria, hematuria, and urinary incontinence. CLINICAL FINDINGS: A diagnosis of malakoplakia was made on the basis of results of hematologic and serum biochemical testing, abdominal ultrasonography, bacterial culture, and cystoscopic biopsies of the urinary bladder wall. Biopsy samples were sent for routine histologic examination and fluorescence in situ hybridization to confirm the presence of intracellular and subendothelial bacteria. TREATMENT AND OUTCOME: Treatment with enrofloxacin was started after the diagnosis of malakoplakia was confirmed. During treatment, polypoid changes in the urinary bladder decreased dramatically but did not disappear. On follow-up ultrasonography after 12 weeks of treatment, marked improvement was visible and results of repeated bacterial culture and fluorescence in situ hybridization of bladder wall samples were negative. The patient was free from clinical signs and had an ultrasonographically normal urinary bladder 59 weeks after antimicrobial treatment was discontinued. CLINICAL RELEVANCE: Malakoplakia, a granulomatous disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria, is a very rare disease in dogs, but early suspicion of the condition is essential to allow timely diagnosis and avoid disease progression and the need for prolonged treatment. Malakoplakia should be considered in young dogs with chronic urinary tract infections; the diagnosis can be made through a combination of histologic examination and fluorescence in situ hybridization of bladder wall biopsy samples.

Association between case signalment and disease diagnosis in urinary bladder disease in Australian cats and dogs.

Urinary bladder diseases are common in dogs and cats; however, there is little published work on urinary bladder disease in Australian pets. We identified pathology records of Australian dogs and cats with urinary bladder tissue submitted to the University of Queensland Veterinary Laboratory Service during 1994-2016 (n = 320). We described the proportion of bladder diseases in dogs and cats, and applied the less-commonly used logistic regression procedure to quantify associations between signalment variables and disease diagnosis that were evident using descriptive statistics alone. After preliminary analysis, both species were combined because of similar results. Spayed/castrated animals were 74% less likely to be diagnosed with cystitis compared with intact animals. Animals 4-11 y old were also at lower risk of being diagnosed with cystitis compared with younger or older animals. Male animals were at increased risk of neoplasia compared to females, which contrasts with reports from North America and Europe. There was increased risk for developing neoplasia with progressive age, with up to 20 times higher odds in the > 11-y age group. Logistic regression modeling provided unique insight into proportionate morbidity of urinary bladder diseases in Australian dogs and cats.

Successful Management of Urinary Bladder Clot with Intravesical Tissue Plasminogen Activator Infusion in a Cat.

A 5 yr old male neutered domestic shorthair with intermittent signs of urinary tract obstruction was suspected of having a blood clot in the urinary bladder secondary to trauma. The cat was hospitalized and received standard supportive therapy for urinary tract obstruction with urinary catheterization, with the addition of intravesical saline flushes in an attempt to promote bladder clot lysis. The cat was subsequently discharged after voluntary urination was observed. The cat was represented 28 hr after discharge because of clinical signs consistent with urinary tract obstruction. The cat was hospitalized and intravesical tissue plasminogen activator (tPA) infusions (0.5 mg of tPA in 10 mL of saline with 2 hr dwell time q 8 hr) were administered to break down the bladder clot (2.78 × 4.46 cm). Thirty-two hours after starting tPA, the clot was no longer visible on ultrasound. The cat was discharged with no recurrent symptoms in the subsequent 11 mo. This is the first report of tPA being used for dissolution of bladder clot in a cat. There were no observed complications, suggesting that intravesical instillation of tPA may be a safe and efficacious therapy in cats, similar to the previously reported successes in dogs and humans.

Urinary capillariasis: Case report of Pearsonema (syn. Capillaria) plica infection in a dog in Greece.

Pearsonema (syn. Capillaria) plica is a nematode that resides in the urinary bladder of canids, felids and mustelids (definitive hosts) and is classified in the same class as Trichuris spp. Epidemiological and clinical data on Pearsonema plica infection in domestic animals are limited. The nematode has an indirect lifecycle that involves earthworms as intermediate hosts. A six-year-old crossbred dog from Greece, presented a history of intermittent pollakiuria and hematuria. At urine analysis, P. plica eggs were found in the urine sediment. The dog was successfully treated with a double dose of milbemycin. To the best of our knowledge this is the first case of urinary capillariasis diagnosed in a domestic animal in Greece.

Intermittent urethral obstruction secondary to caudal sliding of a pelvic bladder in 3 dogs.

Three Yorkshire terrier dogs (2 males and 1 female) were presented for investigation of chronic dysuria and stranguria. Physical examination was unremarkable except for a poorly filled bladder. Biological tests, urinalysis, ultrasound, and routine radiography detected no significant abnormality, except for intermittent displacement of the bladder in the pelvis. Manual voiding cysto-urethrography showed marked caudal displacement of the bladder without perineal hernia and revealed intermittent, dynamic urethral obstruction. Obstructive kinking of the membranous urethra was observed in male dogs, and the marked caudal displacement of the bladder in the female dog was suspected to induce similar urethral obstruction, although this was not clearly visualized because of the absence of contrast filling of the obstructed urethra. All dogs showed resolution of the clinical signs following cystopexy. Key clinical message: This report documents the diagnostic value of manual voiding cysto-urethrography for the investigation of dynamic voiding disorders, especially in dogs with a pelvic bladder.

Obstruction urétrale intermittente secondaire au glissement caudal d'une vessie pelvienne chez trois chiens. Trois chiens de race Yorkshire (2 mâles et 1 femelle) furent présentés pour un problème de dysurie chronique et de strangurie. L'examen physique ne révéla rien d'anormal sauf une vessie pauvrement remplie. Des tests biologiques, une analyse d'urine, une échographie et des radiographies de routine ne détectèrent aucune anormalité, sauf pour le déplacement intermittent de la vessie dans le pelvis. Une cysto-urétrographie avec vidange manuelle a montré un déplacement caudal marqué de la vessie sans hernie périnéale et a révélé une obstruction urétrale dynamique et intermittente. Une plicature obstructive de l'urètre membraneuse fut observée chez les chiens mâles, et le déplacement caudal marqué de la vessie chez la chienne fut soupçonné d'induire une obstruction urétrale similaire, bien que ceci n'était pas clairement visualisé étant donné l'absence de remplissage par le milieu de contraste de l'urètre obstruée. La résolution des signes cliniques fut observée chez tous les chiens suite à la cystopexie.Message clinique important :Ce rapport documente la valeur diagnostique d'une cysto-urétrographie avec vidange manuelle pour l'étude de désordres de vidange dynamiques, spécialement chez les chiens avec une vessie pelvienne.(Traduit par Dr Serge Messier).

Prevalence and chemical composition of uroliths in fattening pigs in Belgium.

The present study investigated the prevalence of uroliths in fattening pigs and assessed the composition of these urinary tract concrements. In total, 2,432 urinary bladders were sampled in the slaughterhouse and checked for abnormal content. Urinary samples were analysed microscopically, and samples of the urinary bladder wall were tested for histological signs of inflammation. The composition of the concrements was examined by infrared spectrophotometry. Macroscopic and microscopic abnormalities were detected in 8.4% and 52.8% of the samples respectively. Magnesium ammonium phosphate (struvite), calcium oxalate dihydrate (COD), calcium carbonate (calcite), calcium oxalate monohydrate (COM) and amorphous crystals were detected. Analysis of stones showed COD in all samples in different proportions. The calcium content of examined stones was always considerable (up to 34%), in contrast to the magnesium content which represented max 1.9%. Struvite was found in one third of the samples, but was never part of stones and grit. COD crystals were the second most common microscopic crystal. These COD crystals and some COD stones had a rectangular shape, and therefore, they can be harmful to the bladder mucosa. In conclusion, uroliths are present in a large proportion of male fattening pigs, and consequently, urinary concrements pose a life-threatening risk for urethra obstruction in male pigs. Further research is warranted to identify potential risk factors for urolithiasis and microscopic crystals.

Malakoplakia of the Bladder in a 4-Month-Old Puppy.

A 4 mo old female Staffordshire bull terrier puppy was presented with chronic Escherichia coli cystitis. Ultrasound and cystoscopic examination revealed innumerable, intraluminal, finger-like proliferations arising from the dorsal urinary bladder (UB) wall. Histological examination of mucosal biopsies obtained by cystoscopy was suggestive of granulomatous cystitis. The proliferative lesions were removed surgically and submitted for histological examination. The UB submucosa was heavily infiltrated by macrophages with periodic acid-Schiff-positive cytoplasm exhibiting rare Michaelis-Gutmann bodies, leading to the diagnosis of malakoplakia. The puppy was prescribed with sulfamethoxazole-trimethoprim. The urinary signs disappeared despite the persistent UB wall thickening revealed by abdominal ultrasound. Urine culture performed during the ninth week of treatment showed a persistent infection by E coli resistant to sulfamethoxazole-trimethoprim. The dog was switched to doxycycline but was then lost to follow-up. Malakoplakia is a chronic granulomatous inflammation well documented in humans. Its pathophysiology is not fully understood, but bacterial infection, immunodepression, and a defective lysosomal function may lead to the intracytoplasmic accumulation of partially degraded bacteria that can subsequently mineralize to form the Michaelis-Gutmann bodies. Malakoplakia should be suspected when UB mass lesions are identified in a young dog with bacterial cystitis.

Urine retention in cattle putatively associated with injection of an ivermectin and closantel anthelmintic formulation into the ischiorectal fossa.

CASE HISTORY: A group of 39, 19-22-month-old Friesian bulls were administered an ivermectin/closantel anthelmintic via intended S/C injection in the ischiorectal fossa on 15 June 2017 (Day 0). Over the next 50 days, 22 affected bulls presented various degrees of anorexia, abdominal pain and urine dribbling. Seventeen bulls were examined by transrectal ultrasonography which revealed urinary bladder distension in all 17, and peritoneal fluid accumulation in some. Overall, eight bulls died or were subjected to euthanasia. On-farm postmortem examination of three bulls revealed urinary bladder rupture. CLINICAL FINDINGS: On Day 50 one affected live bull was admitted to Massey University for further investigation. This bull continuously dribbled urine and had an overtly distended urinary bladder as determined by rectal palpation and ultrasonography. PATHOLOGICAL FINDINGS: Postmortem examination of this bull revealed a markedly distended urinary bladder, massive subcapsular and pericapsular renal oedema with retroperitoneal fluid accumulation, minimal hydronephrosis and no evidence of mechanical urinary outflow obstruction. The right ischiorectal fossa contained multifocal areas of tissue fibrosis that extended into areas innervated by the distal cutaneous branch of the pudendal nerve and the pelvic nerve. Histopathological changes consisted of extensive fibrosis, myonecrosis and neurodegeneration, and evidence of granulation tissue and inflammation at the putative injection site and in surrounding tissues. DIAGNOSIS: A local inflammatory reaction at the presumed injection site together with localised peripheral neurodegeneration and myelopathy may have led to detrusor-sphincter dyssynergia causing urine retention. CLINICAL RELEVANCE: These cases of urine retention and bladder rupture in cattle were of putative iatrogenic origin. Veterinarians should be aware of this rare complication after S/C injections in the ischiorectal fossa.

Urinary incontinence associated with Mesocestoides vogae infection in a dog.

Peritoneal larval cestodiasis caused by Mesocestoides spp. is a rare infection in dogs. A 6-year-old female dog was presented for veterinary care with urinary incontinence which started 1 year earlier. After performing hematology, ultrasound, and computerized tomography, an exploratory laparotomy revealed canine peritoneal larval cestodiasis (CPLC) with the presence of Mesocestoides vogae (syn. Mesocestoides corti) tetrathyridia confirmed by morphological identification and PCR and DNA sequencing. Parasitic cysts were found around the urinary bladder and appeared to inhibit its normal function. An initial treatment with 5 mg/kg praziquantel subcutaneously every 2 weeks for four treatments failed to alleviate the clinical signs, and only treatment with fenbendazole at 100 mg/kg P.O. twice daily for 28 days was associated with the disappearance of ascites and regaining of urinary control. This is the first report of CPLC associated with urinary incontinence in dogs and the first description of this cyclophyllidean cestode in dogs in Israel.

Urinary bladder herniation through inguinal ring in a female cat.

A 7-month-old spayed female domestic shorthair cat was referred for lethargy, stranguria, and a fluctuant mass of varying size in the right inguinal region. Computed tomographic imaging revealed the urinary bladder partially herniated through the right inguinal canal. Primary herniorrhaphy was performed and re-placement of the urinary bladder was confirmed via laparotomy.

Herniation de la vessie urinaire par le trou inguinal chez une chatte. Une chatte domestique stérilisée âgée de 7 mois a été recommandée pour de l'abattement, de la strangurie et une masse fluctuante de taille variable dans la région inguinale droite. Une imagerie obtenue par tomodensitométrie a révélé une vessie urinaire partiellement herniée dans le canal inguinal droit. Une herniographie primaire a été réalisée et le replacement de la vessie urinaire a été confirmé via laparotomie.(Traduit par Isabelle Vallières).

Computed tomographic features of urinary bladder torsion in two dogs.

Urinary bladder torsion is rare in dogs. It is characterised by rotation of the organ along its longitudinal axis and is potentially life-threatening because of urinary flow obstruction with subsequent urine retention, hydroureter, hydronephrosis and azotaemia. This report describes the computed tomographic features of urinary bladder torsion in two dogs. In both cases, the hallmark indicative of torsion was the "whirl sign," originating from the twisted pelvic urethra and urinary bladder neck encircling the ureters, blood vessels and bladder ligaments in a characteristic spiral pattern. The imaging features correlated well with surgical findings, demonstrating high sensitivity of computed tomography in the preoperative diagnosis of urinary bladder torsion.

Transurethral urinary bladder eversion and prolapse in a castrated male pet rabbit.

A 7-year-old castrated male rabbit was presented with a red oedematous mass at the prepuce. The tissue was identified as the urinary bladder, and the condition was diagnosed as complete transurethral urinary bladder eversion. Exploratory laparotomy was performed, the prolapse was successfully reduced and the bladder was secured to the body wall with cystopexy. The surgery was successful and the bladder remained in place without complications until the time of this report (three years after surgery). Transurethral bladder prolapse is a very rare condition previously reported only in women, mares, cows, bitches, queens, and rabbit does. The case herein is the first reported case of transurethral bladder prolapse in a male of any species.

Survey of ferns and clinico-pathological studies on the field cases of Enzootic bovine haematuria in Himachal Pradesh, a north-western Himalayan state of India.

Enzootic bovine haematuria (EBH) in cattle occurs in upland areas of the world. In India, the disease is present in isolated pockets in the Himalayas and in the Nilgiri Hills. The variation in the disease incidence has been attributed to different environmental conditions and animal rearing practices followed in the different regions. The aim of the study was to conduct field surveys in parts of EBH endemic regions of Himachal Pradesh, a north-western Himalayan state of India. Out of the total 103 plant samples collected, a total of 95 samples were identified as ferns. The major ferns identified included, Onychium japonicum (Thunb.) Kunze, Polystichum piceopaleaceum Tagawa, Dryopteris juxtaposita Christ, Pseudocyclosorus canus (Baker) Holttum and J.W. Grimes, Onychium contiguum C. Hope, Dryopteris nigropaleacea (Fraser-Jenk.), Pteridium aquilinum (L.) Kuhn, Diplazium esculentum (Retz.) Sw., Allantodia maxima (D. Don) Ching, Woodwardia unigemmata (Makino) Nakai, Pteris cretica L., Pteris vittata L., Asplenium trichomanes L., Thelypteris phegopteris (L.) Sloss. ex Rydb, Adiantum venustum D. Don and Paraceterach vestita (Hook.) R.M. Tryon. The concentration of ptaquiloside (PTA) and pterosin B (PtB) in some of the ferns collected from Kullu and Chamba regions ranged from 0 to 358.6 ± 70.5 µg/g and 0 to 652.4 ± 50.0 µg/g, respectively. In addition, field cases of the disease in cattle were also studied in the EBH endemic districts. A total of sixteen cattle urine samples and one urinary bladder of EBH affected cattle were collected. On physical, chemical (benzidine test) and microscopic examination of urine sediment, all the sixteen field samples were found to be positive for erythrocytes and the cases were diagnosed as macrohaematuria. The clinico-pathological studies on the field cases and the presence of PTA and PtB in the ferns indicated that EBH is a prevalent disease and there is an association between chronic fern ingestion and EBH in cattle. On the basis of gross pathology, histopathology and immunohistochemistry (p53 and H-ras nuclear expression in the urothelial cells) of the urinary bladder tissue, the field case was diagnosed as transitional cell adenocarcinoma with chronic lymphocytic cystitis.

The use of intravesicular alteplase for thrombolysis in a dog with urinary bladder thrombi.

OBJECTIVE: To describe the use of alteplase for intravesicular thrombolysis in a dog after development of urinary tract obstruction from a blood clot in the urinary bladder. CASE SUMMARY: A 5.8 kg, 6.5-year-old female neutered Bichon Frise was presented for signs of acute hematuria. A complete blood count (CBC) revealed marked thrombocytopenia and leukopenia, and nonregenerative anemia. Bone marrow aspirate cytology revealed mild hypercellularity, mild megakaryocytic hyperplasia, mildly left-shifted erythroid maturation, and moderately left-shifted myeloid maturation, suggesting ongoing recovery from an acute bone marrow insult. Thrombocytopenia and hematuria resolved concurrently; however, stranguria and oliguria developed acutely. Ultrasonography identified two large presumed thrombi within the urinary bladder. A urinary catheter was placed and 4 doses of 0.5 mg of alteplase diluted in 10 mL of 0.9% sodium chloride were instilled into the bladder with a 4-hour dwell time at 12-hour intervals. Prothombin and activated partial thromboplastin times were monitored during therapy and remained within normal limits. One thrombus was successfully dissolved after 48 hours of therapy and the remaining thrombus was reduced in size and was voided upon removal of the urinary catheter. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the use of alteplase in a dog for thrombolysis of intravesicular thrombi. In patients that develop intravesicular thrombi, intravesical instillation of alteplase can be considered as a method for dissolution of these thrombi.

IMAGING DIAGNOSIS-A LUMINAL LAMINATED DEBRIS BALL IN THE URINARY BLADDER OF A DOG.

A 5-year-old dog presented with pollakiuria and urinary incontinence. Abdominal radiographs revealed an oval, multilayered structure with soft tissue opacity and gas lucency in the urinary bladder. Ultrasonography showed an oval luminal structure with hyper- and hypoechoic layers and internal reverberation artifacts. Following cystotomy, the hemisected plane showed a layered, pale whitish matrix with a gas layer around the core. Histopathological examination showed no evidence of cells, bacteria, or fungi. The core and laminae comprised fibrinous and mineral debris. A final diagnosis of a freely floating, gas-filled laminated debris ball was made.

Rigid urethrocystoscopy via a percutaneous fluoroscopic-assisted perineal approach in male dogs: 19 cases (2005-2014).

OBJECTIVE To describe the technique and outcome for male dogs undergoing rigid urethrocystoscopy via a novel percutaneous, fluoroscopic-assisted perineal approach. DESIGN Retrospective case series. ANIMALS 19 client-owned male dogs. PROCEDURES Medical records of male dogs that underwent urethrocystoscopy via a percutaneous perineal approach for treatment of a variety of conditions from 2005 through 2014 were reviewed. Signalment, history, pertinent diagnostic imaging results, endourologic and postprocedure details, duration of hospitalization, complications, and outcome (short-term, < 1 month; long-term, ≥ 1 month) were recorded. After flexible urethrocystoscopy, direct percutaneous perineal needle puncture and guidewire placement by means of fluoroscopic guidance (with or without ultrasonography) allowed access to the urethral lumen. The perineal tract was subsequently serially dilated to accommodate a peel-away sheath and rigid endoscope. Rigid urethrocystoscopy was performed, and on completion of endourologic procedures, the access site was left to heal by second intention. RESULTS 19 male dogs successfully underwent 20 procedures. No intraoperative complications were reported. Short-term outcome was good (ie, mild perineal urine leakage) for 3 dogs and excellent (ie, no abnormalities with urination) for 16. Long-term outcome was excellent for the 17 dogs for which follow-up information was available. CONCLUSIONS AND CLINICAL RELEVANCE A percutaneous fluoroscopic-assisted perineal approach (with or without ultrasonography) allowed access to the pelvic urethra with no major complications in the present series of patients. This minimally invasive approach may be a valuable tool for endourologic procedures in male dogs.

Practical Use of Ultrasound Scan in Small Ruminant Medicine and Surgery.

Modern portable ultrasound scan machines provide the veterinary clinician with an inexpensive and noninvasive method to further examine sheep on farms, which should take no more than 5 minutes with the results available immediately. Repeat examinations allow monitoring of the disease process and assessment of therapy. 5 MHz linear array scanners can be used for most organs except the heart and right kidney. Transthoracic ultrasonography is particularly useful for critical evaluation of lung and pleural pathologies. Transabdominal ultrasonographic examination can readily identify distended urinary bladder and advanced hydronephrosis.