Neutering is not associated with early-onset urethral obstruction in cats.

OBJECTIVES: The purpose of this study was to evaluate the correlation between clinical aspects and urethral lesions with reproductive status and age at neutering in obstructed male cats. METHODS: All cats with compatible signs of urethral obstruction (UO) treated at the Veterinary Hospital of the Federal Rural University of Pernambuco from 2019 to 2021 were divided into three groups according to their reproductive status: intact; prepubertal neutered; and post-pubertal neutered. Cats with compatible signs of UO were selected for further analysis. Age, clinical signs, age at neutering and age of the first obstructive event were documented. Cats with recurrent obstructive urinary signs or urethral trauma that made catheterization impossible were referred for perineal urethrostomy. The morphology of the excised penises was assessed by histopathological analysis. RESULTS: Of 84 cats with signs of UO included in this study, 28.6% were classified as intact, 28.6% as prepubertal neutered and 42.8% as post-pubertal neutered. Intact cats had a significantly earlier onset of UO compared with prepubertal and post-pubertal neutered cats, as seen by the age at obstruction (3.6 vs 5.7 and 5.5 years, respectively). Similar clinical signs and histopathological lesions were observed in all groups. The main clinical signs observed were stranguria, hematuria and pollakiuria. All cats had some degree of injury in the penile urethra. The most common lesions were hemorrhage, fibrosis and congestion. CONCLUSIONS AND RELEVANCE: It appears that intact cats had an earlier onset of UO than neutered cats, regardless of age at neutering. Urethral histopathological lesions and clinical signs were similar in both groups. Pediatric neutering represents a useful tool in the control of abandoned and stray animals and the consequent dissemination of zoonoses, thus having a positive impact on public health.

Adaptation to partial urethral obstruction in healthy aging LOU rats and the role of nerve growth factor signaling pathway in the bladder.

AIM: Aging is associated with poor ability to adapt to stress and abnormal nerve growth factor (NGF) profile. Lower urinary tract symptoms frequently disturb the quality of life of the aging population with no optimal treatment for both genders. The aim of the study was to compare the bladder response to bladder outflow obstruction in young and old LOU rats, a model of healthy aging that does not develop insulin resistance, and its relation to proNGF/NGF imbalance. METHODS: 6- and 36-month-old female LOU rats were subjected to partial bladder urethral obstruction (PUO) for 2 weeks. Morphometric parameters (body and bladder weight) and glycemia were evaluated. Cystometry was carried out to measure functional parameters followed by ex vivo assessment of muscle strip contractile characteristics. Tissue proteins were examined by immunoblotting and morphology was examined by microscopy. RESULTS: Body weight and glycaemia were not affected by surgery. PUO increases significantly bladder weight with increased thickness and fibrosis of the bladder wall as revealed by histological examination in both age groups. Cystometry showed that old PUO rats had a significant reduction in the intercontraction interval and the bladder capacity, a pattern opposite to young rats with PUO. Contractile properties of bladder strip were not affected by age or PUO. On the molecular level, the old rats had lower abundance of the mature NGF relative to proNGF, with signs of p75NTR activation suggested by the higher expression of TNF-α and JNK phosphorylation in the bladder tissue. CONCLUSION: Bladder adaptation to PUO occurs only in young LOU rats to maintain efficient bladder contractility. Old LOU rats display proNGF/NGF imbalance and the associated p75NTR activation. This can further induce tissue damage and degeneration through activation of JNK pathway and release of TNF-α which in turn interferes with the necessary bladder adaptation.

Bilateral aniridia and congenital ureteral valve: Role of genetic testing.

BACKGROUND: Congenital aniridia involves total or partial hypoplasia of the iris and is due to a deficiency in PAX6 gene expression. WAGR syndrome is comprised of Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. Numerous genitourinary pathologies may be associated with WAGR syndrome, necessitating an evaluation of the genitourinary anatomy. The WT1 is vital for the development of kidneys, ovaries in females, and testes in males. WT1 gene mutations result in a WT1 protein with a decreased ability to bind to DNA, leading to uncontrolled growth, and cell division in the kidney which permits the development of Wilms tumor. A congenital ureteral valve is an exceedingly rare cause of obstructive uropathy. RESULTS: A renal and bladder ultrasound demonstrated a renal cyst. A voiding cystourethrogram revealed grade 3 vesicoureteral reflux, and a MAG3 renal scan showed ureteropelvic junction obstruction and hydronephrosis. A ureteral stent was inserted at 3 months of age after which the renal cyst resolved. The patient was urinary tract infection-free at 27 months of age. Genetic testing confirmed a heterozygous alteration in PAX6 (c.495delG, p.Thr166Leufs*41) and no abnormalities of WT1, excluding WAGR syndrome. CONCLUSION: The genitourinary risks potentially associated with aniridia necessitate prompt genetic analysis to evaluate for WAGR syndrome.

Postmortem urinary tract changes in cats with urethral obstruction.

OBJECTIVE: To report the gross and histopathological postmortem findings of the urinary tract and compare them to clinical severity of disease in cats with urethral obstruction (UO). DESIGN: Retrospective, observational, descriptive study. SETTING: University teaching hospital. ANIMALS: Fourteen cats from 2000 to 2014 with UO that had a complete postmortem examination. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Bladder lesions were moderate-severe in 10 of 14 (71%) and mild in 4 of 14 (29%) cats. Bladder lesions were diffuse in 8 of 14 (57%), multifocal in 3 of 14 (21%), and focal in 3 of 14 (21%) cats. Lymphocytic cystitis was noted in 11 of 14 cats (78%), and neutrophilic cystitis was noted in 10 of 14 (71%) bladders. Urethral lesions were moderate-severe in 4 of 14 (29%), mild in 4 of 14 (29%), and no urethral lesions were identified in 6 of 14 (43%) cats. Ureteral lesions were mild in 1 of 14 (7%), and no ureteral lesions were identified in 13 of 14 (93%) cats. There were moderate-severe histopathological renal lesions in 5 of 14 cats (36%), mild renal lesions in 6 of 14 (43%), and no renal lesions were identified in 3 of 14 cats (21%). Renal lesions were multifocal in 10 of 14 (71%) and regional in 1 of 14 cats (7%). In the kidneys, the most common inflammatory infiltrate was lymphoplasmacytic. The severity of urethral lesions was not associated with the severity of bladder lesions (P = 1.0). Hyperkalemia paralleled the severity of bladder (P = 0.02) and renal lesions (P = 0.04). An association between the severity of bladder lesions and degree of azotemia could not be determined due to small sample size and removal of the most azotemic cats. CONCLUSIONS: Substantial renal and urinary bladder inflammatory lesions were found in cats with UO. The severity of these findings paralleled the severity of blood potassium concentrations.

Combined tube cystostomy and urethrotomy for the treatment of urethral obstruction due to urolithiasis in goats.

OBJECTIVE: To describe the treatment of goats with urethral obstruction secondary to urolithiasis by combining tube cystostomy and urethrotomy. ANIMALS: Eight male goats. STUDY DESIGN: Short case series. METHODS: Medical records (September 2012-September 2017) of male goats treated for obstruction secondary to urolithiasis with tube cystostomy and urethrotomy were reviewed. Data collected included signalment, history, physical examination findings, diagnostic results, perioperative treatments, operative details, hospitalization duration, intraoperative and postoperative complications, urolith analysis, and time to restoration of urethral patency. Long-term follow-up (>12 months) was obtained by email or telephone interviews of owners or by clinical examination. RESULTS: Seven of eight goats were castrated males of various of breeds. All goats were tachycardic with urethral pulsation at admission. Uroliths were composed of calcium carbonate in four goats and silica in one goat. All goats regained urethral patency during hospitalization, and all were discharged alive from the hospital. Seven goats were alive at long-term follow-up. Postoperative complications included persistent urethral obstruction requiring a second urethrotomy 2 days postoperatively, premature dislodgement of the bladder catheter and jejunal obstruction secondary to adhesions, and recurrence of obstructive urolithiasis within the proximal perineal urethra requiring a second surgery 8 months later (1 each). Long-term outcome was good, with urethral patency beyond 12 months in six of eight goats. CONCLUSION: Combining tube cystostomy and urethrotomy restored urethral patency in goats with urethral obstruction from uroliths. Although none of the complications seemed directly related to the urethrotomy, formation of abdominal adhesions and recurrence of urolithiasis affected long-term outcomes. CLINICAL SIGNIFICANCE: Uroliths that do not dissolve in acidic urine may be more frequent in some practices. The combined approach of tube cystostomy and urethrotomy appears to successfully restore urethral patency with promising long-term outcomes.

Preclinical Study of DNA-Recognized Peptide Compound Pyrrole-Imidazole Polyamide Targeting Human TGF-ß1 Promoter for Progressive Renal Diseases in the Common Marmoset.

Pyrrole-imidazole (PI) polyamides are novel gene silencers that strongly bind the promoter region of target genes in a sequence-specific manner to inhibit gene transcription. We created a PI polyamide targeting human TGF-ß1 (hTGF-ß1). To develop this PI polyamide targeting hTGF-ß1 (Polyamide) as a practical medicine for treating progressive renal diseases, we examined the effects of Polyamide in two common marmoset models of nephropathy. We performed lead optimization of PI polyamides that targeted hTGF-ß1 by inhibiting in a dose-dependent manner the expression of TGF-ß1 mRNA stimulated by PMA in marmoset fibroblasts. Marmosets were housed and fed with a 0.05% NaCl and magnesium diet and treated with cyclosporine A (CsA; 37.5 mg/kg/day, eight weeks) to establish chronic nephropathy. We treated the marmosets with nephropathy with Polyamide (1 mg/kg/week, four weeks). We also established a unilateral urethral obstruction (UUO) model to examine the effects of Polyamide (1 mg/kg/week, four times) in marmosets. Histologically, the renal medulla from CsA-treated marmosets showed cast formation and interstitial fibrosis in the renal medulla. Immunohistochemistry showed strong staining of Polyamide in the renal medulla from CsA-treated marmosets. Polyamide treatment (1 mg/kg/week, four times) reduced hTGF-ß1 staining and urinary protein excretion in CsA-treated marmosets. In UUO kidneys from marmosets, Polyamide reduced the glomerular injury score and tubulointerstitial injury score. Polyamide significantly suppressed hTGF-ß1 and snail mRNA expression in UUO kidneys from the marmosets. Polyamide effectively improved CsA- and UUO-associated nephropathy, indicating its potential application in the prevention of renal fibrosis in progressive renal diseases.

Variables of initial examination and clinical management associated with survival in small ruminants with obstructive urolithiasis.

BACKGROUND: Obstructive urolithiasis is a common disease associated with a guarded prognosis in small ruminants. HYPOTHESIS/OBJECTIVE: The results of physical examination, laboratory analyses, and clinical management of male small ruminants presented to 2 referral clinics were investigated to identify variables significantly associated with disease outcome, so as to provide better recommendations to animal owners regarding the management of these patients. ANIMALS: Two-hundred ten small ruminants (130 sheep and 80 goats) with confirmed diagnosis of obstructive urolithiasis. METHODS: Clinical findings (including diagnostic imaging) and laboratory results of the 210 animals were reviewed, and relevant information regarding clinical and laboratory variables recorded upon admission and clinical management was retrieved. The association of the different variables with nonsurvival was investigated by univariable and multivariable logistic regression models. RESULTS: Only 39% of all patients considered for treatment and 52% of those undergoing tube cystostomy survived to be released from the clinic. Nonsurvival was strongly associated with a very poor clinical condition upon presentation, obesity, castration, and evidence of uroperitoneum. Among blood variables, abnormal PCV, severely increased serum creatinine concentrations, and increased activity of the creatine kinase were associated with increased risk of nonsurvival. Presence of signs of colic or macroscopic appearance of urine was not significantly associated with outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: The prognosis of obstructive urolithiasis was guarded with survival rates of 39% (overall) to 52% (after tube cystostomy). Intact young males with normal body condition presented early in the course of disease had the best chances of survival.

Therapeutic effect of TAC-302, a cyclohexenoic fatty alcohol derivative, on bladder denervation-related storage and voiding dysfunctions in rats.

AIMS: To evaluate the therapeutic effect of TAC-302, a cyclohexenoic fatty alcohol derivative, on bladder denervation-related storage and voiding dysfunctions in rats with bladder outlet obstruction (BOO). METHODS: BOO was achieved by partial ligature of the proximal urethra in female rats. Two weeks later, BOO rats were divided into two groups and treated orally with vehicle or 10 mg/kg TAC-302 twice a day for 4 weeks. Urodynamic and immunohistochemical evaluation of the bladder muscle layer was performed. In another study, the BOO rats were treated with intravenous tamsulosin at cystometry. The detrusor contractility in each group was evaluated using the modified Shafer's nomogram. RESULTS: Two weeks after BOO, the rats showed significant increases in non-voiding contraction (NVCs) and residual urine volume (RUV) compared to the sham group. Moreover, 6 weeks after BOO, BOO vehicle rats showed significant increases in NVCs and RUV and decreases in detrusor contractility and in the nerve fiber density in the urinary bladder compared to the sham group. BOO-induced denervation of the urinary bladder was partially improved by oral treatment with TAC-302. Oral treatment with TAC-302 significantly reduced the amplitude and frequency of NVCs (P < 0.05) and increased detrusor contractility and tended to reduce RUV compared with the BOO vehicle group. In contrast, the intravenous administration of tamsulosin significantly reduced the frequency of NVCs, but not RUV. CONCLUSIONS: TAC-302 improved storage and voiding dysfunctions by improving bladder denervation and detrusor underactivity even when the treatment was started after storage and voiding dysfunctions had already occurred.

Nerve-sparing Mid-urethral Obstruction (NeMO) in Female Small Rodents.

Partial bladder outlet obstruction (pBOO) has a high prevalence, causes significant patient burden, and immense health care costs. The most common animal model to investigate bladder remodeling in pBOO are female rodents undergoing partial obstruction at the proximal urethra. Variability in the degree of obstruction and animal mortality are major concerns with proximal obstruction. Furthermore, dissecting around the proximal urethra and bladder neck jeopardizes bladder innervation. We developed a nerve-sparing mid-urethral obstruction (NeMO) model for pBOO avoiding the disadvantages of the traditional model. We approached the urethra just inferior to the pubic symphysis, which obviated the need for laparotomy as well as for dissection in this area; also, the striated urethral sphincter remained untouched. We performed NeMO in female Sprague-Dawley rats (12 obstructions, 6 sham animals) as well as in female C57/bl6 mice (20 obstructions, 18 sham animals). After two weeks, we evaluated bladder function, bladder mass, and body mass. We had no mortalities among obstructed- or sham-operated female rats; as described for the traditional proximal pBOO-method, we tied the suture around the proximal urethra and a temporarily placed 0.9 mm metal rod. NeMO induced an 85% increase in bladder mass after two weeks, average residual urine volume was 0.4 mL in partially obstructed rats while only 0.03 mL in sham animals. In mice, we tested 3 sizes of cannulas that we placed along the urethra when tying the suture. We found that using a 27-gauge cannula resulted in over 50% animal mortality; placing the 25-gauge cannula did not yield the desired response in increasing bladder mass; utilizing a 26-gauge cannula yielded favorable results with minimal animal mortality (1/8) yet a significant 2-fold increase in bladder mass.

Double knockout of Bax and Bak from kidney proximal tubules reduces unilateral urethral obstruction associated apoptosis and renal interstitial fibrosis.

Interstitial fibrosis, a common pathological feature of chronic kidney diseases, is often associated with apoptosis in renal tissues. To determine the associated apoptotic pathway and its role in renal interstitial fibrosis, we established a mouse model in which Bax and Bak, two critical genes in the intrinsic pathway of apoptosis, were deleted specifically from kidney proximal tubules and used this model to examine renal apoptosis and interstitial fibrosis following unilateral urethral obstruction (UUO). It was shown that double knockout of Bax and Bak from proximal tubules attenuated renal tubular cell apoptosis and suppressed renal interstitial fibrosis in UUO. The results indicate that the intrinsic pathway of apoptosis contributes significantly to the tubular apoptosis and renal interstitial fibrosis in kidney diseases.

p53 induces miR199a-3p to suppress SOCS7 for STAT3 activation and renal fibrosis in UUO.

The role of p53 in renal fibrosis has recently been suggested, however, its function remains controversial and the underlying mechanism is unclear. Here, we show that pharmacological and genetic blockade of p53 attenuated renal interstitial fibrosis, apoptosis, and inflammation in mice with unilateral urethral obstruction (UUO). Interestingly, p53 blockade was associated with the suppression of miR-215-5p, miR-199a-5p&3p, and STAT3. In cultured human kidney tubular epithelial cells (HK-2), TGF-ß1 treatment induced fibrotic changes, including collagen I and vimentin expression, being associated with p53 accumulation, p53 Ser15 phosphorylation, and miR-199a-3p expression. Inhibition of p53 by pifithrin-α blocked STAT3 activation and the expression of miR-199a-3p, collagen I, and vimentin during TGF-ß1 treatment. Over-expression of miR-199a-3p increased TGFß1-induced collagen I and vimentin expression and restored SOCS7 expression. Furthermore, SOCS7 was identified as a target gene of miR-199a-3p, and silencing of SOCS7 promoted STAT3 activation. ChIp analyses indicated the binding of p53 to the promoter region of miR-199a-3p. Consistently, kidney biopsies from patients with IgA nephropathy and diabetic nephropathy exhibited substantial activation of p53 and STAT3, decreased expression of SOCS7, and increase in profibrotic proteins and miR-199a-3p. Together, these results demonstrate the novel p53/miR-199a-3p/SOCS7/STAT3 pathway in renal interstitial fibrosis.

The profile of patients with obstructive uropathy in Cameroon: case of the Douala General Hospital.

INTRODUCTION: Obstructive uropathy can lead to irreversible kidney damage. The etiology largely determined by the patient's age can be benign or malignant. This study aimed at determining the profile and outcome of patients with obstructive uropathy in Cameroon. METHODS: A cross sectional study carried out in the urology unit of the Douala General Hospital, including patients with a diagnosis of obstructive uropathy seen from January 2004 to December 2013. Clinical profile, treatment and outcome data were obtained from patients records. RESULTS: Of the 229 patients included 69% were men, mean age 50 ±18 years. Associated comorbidities were hypertension, diabetes, and HIV. Mean haemoglobin 8,40±2,4g/dl, mean GFR 10,3 ±10ml/min, 94 (41%) patients needed emergency dialysis. Symptoms at presentation: asthenia (57%), anorexia (55%), loin pain (37%), vomiting (28%), oedema (20%), and anuria (15%). Urinary tract infection was present in 33 patients. Main aetiologies of obstruction: urolithiasis (35%), begnin prostatic hypertrophy (27%), prostatic cancer (12%), cervical cancer (16%), and congenital malformations (5%). Drainage was effective in 102 (45%) patients, 63 (28%) recovered completely, 91 (41%) were loss to follow up, 49 (22%) died and more women (p = 0.02). Mortality was associated with prostatic cancer (p = 0.000), cervical cancer (p = 0.004) and radiotherapy (p = 0.03). CONCLUSION: Patients with obstructive uropathy presented with significant impaired renal function. Main causes were urinary stones, prostatic hypertrophy, prostatic and cervical cancers. Renal recovery was poor, loss to follow up and mortality high. Specific strategies to target improvement in renal recovery and patient's survival are needed in this patient's group.

Outcome in fetal lower urinary tract obstruction: a prospective registry study.

OBJECTIVE: To describe influences on decision-making and prognostic variables in the prenatal management of fetal lower urinary tract obstruction (LUTO). METHODS: This was a prospective registry study of pregnant women with a male fetus with LUTO from centers within the British Isles and The Netherlands. Women and/or their clinicians were given the treatment option of either conservative management or vesicoamniotic shunting (VAS). Baseline characteristics of women in the registry, reasons for entry to the registry and pregnancy outcomes were assessed. The main study outcomes were survival to 28 days after delivery, further survival to 2 years and renal function. Logistic regression analysis was used to examine prognostic variables that affected outcome. Results were compared with those of women in a randomized controlled trial (RCT) who were allocated randomly to a treatment option. RESULTS: Forty-five women were registered, of whom 78% (35/45) underwent conservative management. Twenty-seven women entered the registry owing to their clinician's preference for management and 18 because of their own preference. Compared to the conservative-management group of the RCT, a higher proportion of women in the registry opting for conservative management had a normal amniotic fluid volume at diagnosis (P = 0.05) and a diagnosis of LUTO ≥ 24 weeks' gestation (P = 0.003). On multivariable logistic regression analysis, these variables showed a significant association with perinatal survival (P < 0.001). Survival to 28 days after delivery was higher in the conservative-management group, at 69% (24/35), compared to 40% (4/10) in the VAS group (P = 0.02) but this difference had limited statistical significance owing to small study size (relative risk, 0.58 (95% CI, 0.26-1.29); P = 0.14). CONCLUSION: In our prospective registry, the majority of fetuses with LUTO received conservative management, which was associated with better short- and long-term outcomes. A significant proportion of these pregnancies had normal amniotic fluid volume and a gestational age at diagnosis of ≥ 24 weeks, characteristics shown to be associated with improved survival.

Litiasis en divertículo uretral. Diagnóstico y tratamiento / Urethral diverticulum lithiasis. Diagnostic and therapeutic management

Introducción: la incidencia del divertículo uretral es menor en hombres, siendo más frecuentes los casos adquiridos. Es extraordinario encontrar una litiasis ocupando la totalidad del divertículo. Caso clínico: presentamos varón de 34 años con litiasis en divertículo uretral secundaria a intervención quirúrgica previa. Conclusión: mujeres el tratamiento de elección será la diverticulectomía con la técnica más simple posible

Introduction: the urethral diverticulum incidence is lower in men than in women. Acquired cases are more frequent. Is extremely rare to find a diverticulum lithiasis. Case report: we present a 34 years old male with urethral diverticulum lithiasis due to previous urethral surgery. Conclusion: treatment of choice is diverticulectomy with lithiasis removement

Can a pressure-limited V-A shunt for obstructive uropathy really protect the kidney?

BACKGROUND: In our fetal lamb model of lower urinary tract obstruction, a valved shunt preserves bladder function. This study investigates the effects on renal histology. METHODS: We created obstructive uropathy (OU) in 60-day gestation fetal lambs, ligating the urethra and urachus, and delivering them at term (130-145days). We compared renal histology in 4 groups: group A-OU without shunt, group B-low-pressure shunt (15-54mmH2O), group C-high-pressure shunt (95-150mmH2O). Shunts were inserted 3weeks post-obstruction. Group D were normal controls. RESULTS: We delivered 32 fetuses from 23 ewes: 13 fetuses in group A (9 survived), 6 fetuses in group B (5 survived), 7 fetuses in group C (5 survived), and 6 fetuses in group D. Histologically, we found renal tubular distention, vacuolated degeneration of tubular epithelial cells in 7 lambs, and cyst formation in 4 lambs in group A. There was renal tubular distention in two lambs, and cyst formation in one lamb in both groups B and C, with vacuolated degeneration of tubular epithelial cells observed in all but 1 lamb in each group. CONCLUSIONS: V-A shunting prevents multicystic dysplastic kidney (MCDK). Some lambs have renal tubular distention and vacuolated degeneration of renal tubular epithelial cells.

Urethral plugs in dogs.

BACKGROUND: Crystalline-matrix urethral plugs have not been previously reported in dogs. HYPOTHESIS/OBJECTIVES: To report the composition of urethral plugs in dogs, describe clinical features of the disease, and identify overrepresented breeds. METHODS: Retrospective case series. A Minnesota Urolith Center (MUC) record search was performed for urethral plugs in dogs submitted during a 6-year period. The composition of the plugs and signalment of affected dogs were recorded. Breed risk analysis was performed using a control group without plugs from the Veterinary Medical Center, University of Minnesota (VMC UMN). Breed risk was also calculated for a group of dogs with struvite (plugs and uroliths). Medical records for the subset of plug cases from the VMC UMN were reviewed and described. RESULTS: Between 2006 and 2011, 42 urethral plugs from dogs were submitted to the MUC. All came from male dogs, and the mineral component of the majority (83%) was struvite. Thirty (71%) samples were from Pugs. Pugs were overrepresented in plug submissions (OR 179; CI 88-389; P < .001), and for struvite in general (OR 14.3; CI 7.9-24.4; P < .001). Nine of the dogs were treated at VMC UMN; all were castrated male Pugs. None of these cases had bacteriuria or positive urine cultures, and no underlying cause of plug formation was identified. CONCLUSIONS AND CLINICAL IMPORTANCE: When evaluating dogs with urethral obstruction, plugs need to be considered, especially in male Pugs. Further investigation into the underlying cause of plug formation in dogs is warranted.

[Effect of coicis semen oil on renal interstitial fibrosis in rats with unilateral urethral obstruction].

OBJECTIVE: To study the effect and mechanism of Coicis Semen oil (Kanglaite injection, KLT) on renal interstitial fibrosis induced by unilateral ureteral obstruction (UUO). METHOD: Fifty-four male SD rats were randomly divided into 3 groups, 6 in each group, the sham operated group, the model group, and the KLT group. Renal interstitial fibrosis model was established in rats by UUO. After administration of KLT (15 mL x kg(-1) x d(-1)) for 3, 7 and 14 days, the dynamic histological changes of renal interstitial tissues were observed and renal damage including tubular impairment and interstitial fibrosis were quantified on HE and Masson stained tissue sections. The expression of alpha-smooth muscle actin (alpha-SMA) and transforming growth factor-beta1 (TGF-beta1) were measured by immunohistochemistry staining sections. The protein expression of p-Smad2 and Smad7 were detected by Western blot respectively. RESULT: The degree of tubular damage in KLT group was much lower than that in UUO group (P < 0.05). The expression of alpha-SMA and TGF-beta1 was decreased in both UUO group and KLT group, while it was significantly lower in KLT group at every time point. The protein expression of p-Smad2 was obviously decreased while the protein expressions of Smad7 was obviously increased in KLT group, compared with the UUO group (P < 0.05). CONCLUSION: Coicis Semen oil could attenuate the tubulo-interstitial fibrosis, probable by intervening the TGF-beta/Smads signal transduction pathway of UUO rats.

Initial treatment factors associated with feline urethral obstruction recurrence rate: 192 cases (2004-2010).

OBJECTIVE: To evaluate the association of treatment factors during initial urinary catheterization (IUC) of cats with recurrence of urethral obstruction at 24 hours and 30 days after catheter removal. DESIGN: Retrospective case series. ANIMALS: 192 male cats with urethral obstruction that were treated at an emergency and specialty center from 2004 through 2010. PROCEDURES: Data were obtained from the cats' medical records. Duration of indwelling catheterization, catheterization with a 5F versus 3.5F urinary catheter, treatment with phenoxybenzamine versus prazosin, consistent administration of pain medication, and treatment with meloxicam or antimicrobials during IUC were reviewed for association with rate of recurrent urethral obstruction (rUO). RESULTS: Overall rUO rates were 10.94% (21/192 cats) at 24 hours and 23.57% (37/157 cats) at 30 days after IUC. At 24 hours and 30 days after IUC, rUO developed in 10 of 140 (7.14%) and 20 of 110 (18.18%) prazosin-treated cats, respectively, compared with 10 of 46 (21.74%) and 16 of 41 (39.02%) phenoxybenzamine-treated cats, respectively. Reobstruction developed following use of a 5F or 3.5F urinary catheter in 11 of 58 (18.97%) and 7 of 105 (6.67%) cats, respectively, through 24 hours. There was no association between rUO and duration of urinary catheterization, administration of antimicrobials or meloxicam, or consistent administration of pain medication during IUC. CONCLUSIONS AND CLINICAL RELEVANCE: At 24 hours and 30 days after IUC, rUO rates in prazosin-treated cats were significantly lower than rates in phenoxybenzamine-treated cats. Reobstruction rate at 24 hours was significantly lower when a 3.5F versus 5F urinary catheter was used.

Microtomographic analysis of lower urinary tract obstruction.

Prenatal obstruction of the lower urinary tract may result in megacystis, with subsequent development of hydroureter, hydronephrosis, and renal damage. Oligo- or anhydramnios, pulmonary hypoplasia, and prune belly syndrome are lethal consequences. Causes and mechanisms responsible for obstruction remain unclear but might be clarified by anatomic study at autopsy. To this end, we employed 2 methods of tomographic imaging-optical projection tomography and contrast-enhanced microCT scanning-to elucidate the anatomy of the intact urinary bladder and urethra in 10 male fetuses with lower urinary tract obstruction. Images were compared with those from 9 age-matched controls. Three-dimensional images, rotated and sectioned digitally in multiple planes, permitted thorough examination while preserving specimens for later study. Both external and internal features of the bladder and urethra were demonstrated; small structures (ie, urethral crest, verumontanum, prostatic utricle, ejaculatory ducts) were seen in detail. Types of obstruction consisted of urethral atresia (n  =  5), severe urethral stenosis (n  =  2), urethral diaphragm (n  =  2), or physical kinking (n  =  1); classic (Young type I) posterior urethral valves were not encountered. Traditional light microscopy was then used to verify tomographic findings. The prostate gland was hypoplastic or absent in all cases; in 1, prostatic tissue was displaced inferior to the verumontanum. Findings support previous views that dissection may produce valve-like artifacts (eg, bisection of an obstructing diaphragm) and that deformation of an otherwise normal urethra may result in megacystis. The designation "posterior urethral valves" should not be used as a generic expression of urethral obstruction unless actual valves are demonstrated.