Retrospective study of proliferative urethritis in dogs: Clinical presentation and outcome using various treatment modalities in 11 dogs.

BACKGROUND: Proliferative urethritis (PU) is an uncommon inflammatory and infiltrative disease of the urethra in female dogs, often associated with urinary tract infection (UTI). It typically presents with evidence of urethral obstruction (UO). OBJECTIVES: Identify clinical features in dogs with PU and determine outcome after different treatment modalities. ANIMALS: Eleven client-owned dogs. METHODS: Medical records of dogs with histopathologic diagnosis of PU from 2011 to 2020 were retrospectively evaluated, including information on clinical pathology, imaging, and histopathology. Outcomes of various treatment modalities were recorded and compared. Long-term urethral patency (>6 months) was considered treatment success. RESULTS: All dogs were female and presented with UO. Eight (73%) had a history of UTI. Ten of 11 survived to discharge and were used for long-term data collection. Seven of 10 (70%) were treated using an effacement procedure (balloon dilatation [BD], stent, or both) and 6/7 (86%) achieved long-term urethral patency (>6 months). Seven of 10 had UO recurrence after their first procedure, including 3/3 (100%) that did not have effacement and 4/7 that did (57%), at a median of 101 days and 687 days, respectively. After effacement, the duration of patency was longer for those treated using a stent than BD alone (median, 843 days and 452 days, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Proliferative urethritis is a recurrent disease often associated with UTI. The best outcome of long-term urethral patency occurred after lesion effacement, either by BD or stenting. Future prospective studies should determine the impact of immunosuppressive treatment.

Chronic osteomyelitis in canine penile bone: case report / Osteomielite crônica em osso peniano canino: relato de caso

A 10-year-old male mixed-breed dog was admitted for recurrent signs of urinary tract infection (UTI). Urinary bladder ultrasonography revealed decreased thickness of its wall with floating hyperopic particles within its lumen. Ultrasonography revealed a structure invading the dorsal wall of the penile urethral lumen, located in a segment distal to the bladder. Radiographies showed bone resorption with proliferation at the caudal aspect of the penile bone, stricture of the final aspect of the penile urethra, and no radiopaque images compatible with a urethrolith. Computed tomography showed bone proliferation causing stricture of the urethral lumen at two different sites. Presumptive diagnosis of penile neoplasia was considered more likely and the dog underwent penectomy along with orchiectomy and scrotal urethrostomy. Enterobacter spp. was cultured from the urine sample and antibiotic sensitivity tests revealed that the bacterium was susceptible to amikacin, imipenem, and meropenem. Histopathology revealed severe suppurative urethritis, bone resorption, and hyperostosis, suggestive of osteomyelitis of the penile bone. Neoplastic cells were not observed at any part of the examined tissue. The findings in the present case suggest that osteomyelitis of the penile bone should be included in differential diagnosis for partial and complete urethral obstruction in dogs with recurrent UTI.(AU)

Um cão mestiço, com 10 anos, foi admitido por sinais recorrentes de infecção do trato urinário (ITU). A ultrassonografia da bexiga urinária revelou diminuição da espessura de sua parede com partículas flutuantes dentro de seu lúmen. A ultrassonografia demonstrou estrutura invadindo a parede dorsal do lúmen da uretra peniana, localizada em segmento distal à bexiga. Radiografias evidenciaram reabsorção óssea com proliferação no aspecto caudal do osso peniano, estenose do aspecto final da uretra peniana e ausência de imagens radiopacas compatíveis com uretrólito. Pela tomografia computadorizada, observou-se proliferação óssea causando estreitamento da luz uretral em dois locais diferentes. Diagnóstico presuntivo de neoplasia peniana foi considerado mais provável e o cão foi submetido à penectomia, juntamente com orquiectomia e uretrostomia escrotal. Enterobacter spp. foi cultivada da amostra de urina e testes de sensibilidade revelaram susceptibilidade ao amicacina, imipenem e ao meropenem. A histopatologia revelou uretrite supurativa grave, reabsorção óssea e hiperostose compatível com osteomielite do osso peniano. Células neoplásicas não foram observadas em nenhuma parte do tecido examinado. Os achados do presente caso sugerem que a osteomielite do osso peniano deve ser incluída no diagnóstico diferencial de obstrução uretral parcial e completa em cães com ITU recorrente.(AU)

Clinical, histopathologic, cystoscopic, and fluorescence in situ hybridization analysis of proliferative urethritis in 22 dogs.

BACKGROUND: Proliferative urethritis (PU) is a lower urinary tract disease of dogs characterized by frond-like lesions in the urethra. The etiology of PU is unknown, although an association with bacterial cystitis is reported. OBJECTIVES: Deep-seated bacterial cystitis is associated with PU, particularly in dogs with neutrophilic or granulomatous inflammation. ANIMALS: Twenty-two client-owned dogs with PU and 5 control dogs euthanized for non-urinary disease. METHODS: In retrospective analysis, medical records of dogs with PU from 1986 to 2016 were reviewed. Signalment, clinical signs, cystoscopic findings, antimicrobial use, and results of urine, bladder, or urethral tissue cultures, if available, were recorded. Histopathology was reviewed and classified as lymphocytic-plasmacytic (LP), neutrophilic, LP-neutrophilic (LPN), granulomatous, or pleocellular. Eubacterial fluorescence in situ hybridization (FISH) was performed on 18 tissue samples (13 cases, 5 controls), with subsequent evaluation of bacterial species. RESULTS: Of the 22 dogs, 9 had LP urethritis, 6 had LPN, 4 had pleocellular, and 3 had neutrophilic urethritis. Of note, 7 of 13 PU samples were FISH+ for adherent or invasive bacteria; 1 of 5 controls were FISH+ for adherent bacteria. Five dogs had negative urine and tissue cultures when FISH was positive. There was no association detected between the type of urethral inflammation and the results of urine and tissue culture or FISH. CONCLUSIONS AND CLINICAL IMPORTANCE: The type of inflammation varied widely in these 22 PU cases. Deep-seated bacterial urethritis could be contributing to the inflammatory process in some dogs, regardless of the inflammation type. Urine and tissue cultures likely underestimate bacterial colonization of the urethra in dogs.

The use of a low-profile cystostomy tube to relieve urethral obstruction in a dog.

A 10-year-old, spayed female Dalmatian was diagnosed with granulomatous urethritis causing urethral obstruction. Due to the extensive involvement of the urethra, a urethrostomy was not possible. A commercially available, silicone, low-profile gastrostomy tube was placed as a prepubic cystostomy tube to achieve urinary diversion. This tube is easy to use, has a one-way valve, and lies flush with the skin margin, thereby decreasing the likelihood of inadvertent removal. This tube should be considered to achieve long-term urinary diversion when urethral involvement is extensive.

Vaginourethroplasty for treatment of urethral obstruction in the bitch.

Vaginourethroplasty was performed in six bitches with infiltrative, obstructive urethral disease. The initial clinical signs included dysuria, hematuria, pollakiuria, and stranguria. Diagnosis was based on the clinical signs, plain radiography and contrast vagino-urethrogram examination, and urethral biopsy. Five dogs were diagnosed as having urethral neoplasia; the sixth dog had granulomatous urethritis. In all six dogs, up to 50% of the urethra and the urethral tubercle were resected to ensure adequate surgical margins. One dog was euthanatized 4 months after surgery for recurrence of a transitional cell carcinoma at the surgical site. Long-term resolution of the problem (minimum of 12 months) was achieved in the other five dogs. The frequency of serious complications, including urinary incontinence and ascending lower urinary tract infections, was low.

Management and complications following trigonal-colonic anastomosis in a dog: five-year evaluation.

Urinary diversion procedures in the dog have been described for both benign and malignant processes involving the bladder, urethra, or both. These procedures are performed rather infrequently, primarily because of the potential complications associated with urinary diversion into an intact gastrointestinal system. A case managed for five years following trigonal-colonic anastomosis for lymphocytic-plasmacytic urethritis is presented, along with a review of urinary diversion techniques. Postoperative management recommendations following urinary diversion are discussed.

Infiltrative urethral disease in female dogs: 41 cases (1980-1987).

Forty-one cases of infiltrative urethral disease in female dogs were reviewed. The cause was epithelial neoplasia in 29 dogs, granulomatous (chronic active) urethritis in 10 dogs, and leiomyoma in 2 dogs. Clinical signs of disease were similar in dogs with neoplastic and inflammatory disease and included strangury (36/41), hematuria (30/41), pollakiuria (20/41), vaginal discharge (16/41), and complete urinary obstruction (7/41). Results of aspiration biopsy of the urethra correlated with those of surgical biopsy in 11 of 15 dogs. In 4 of 15 dogs, results of cytologic and histologic examinations differed. Granulomatous (chronic active) urethritis is an infiltrative urethral disease in female dogs. Clinical findings are similar, but the prognosis is more favorable than that in dogs with urethral epithelial neoplasia.

Urethral infection of male monkeys by Mycoplasma hominis and Ureaplasma urealyticum.

Seven male Macaca nemestrina, eight male Macaca mulatta and three male Papio hamadrias were infected with M. hominis or U. urealyticum separately or simultaneously into the urethra. Animals of the first two species exhibited moderate infection and mild clinical urethritis characterized by increased number of PMNL in the urethral discharge and colonization and lymphocytic infiltration of the mucous membrane of the urethra and urinary bladder. Animals of the third species proved to be less sensitive.

Effects of prolonged distention of retention catheters on the urethra of dogs and cats.

The effects of inflation of a balloon-tipped catheter in the distal part of the urethra of clinically healthy male and female dogs and cats were evaluated. Tissues were evaluated at 1 and 14 days after balloon inflation. Macroscopic and microscopic lesions were limited to the distal part of the urethra occupied by the inflated balloon in animals which were euthanatized 1 day after balloon inflation. The lesions were characterized by submucosal urethral hemorrhage. This investigation indicates that balloon inflation for 15 minutes duration in the distal part of the urethra of dogs and cats results in a mild reversible inflammatory reaction.

Adverse effects caused by polypropylene and polyvinyl feline urinary catheters.

Effects of 3 days of open dwelling urethral catheterization were evaluated in normal male cats. Commercially manufactured polypropylene and polyvinyl feline urinary catheters of sufficient length to permit constant urine drainage were compared. Catheters were similar in length, diameter, and design. Hematuria occurred in 6 of 6 cats with polypropylene catheters and in 4 of 6 cats with polyvinyl catheters. For cats with polypropylene catheters, hematuria began within 24 hours of catheter insertion. Hematuria induced by polypropylene catheters was usually more severe in final urinalyses than that induced by polyvinyl catheters. Catheter-induced bacteriuria was found in 5 of 6 cats with polypropylene catheters and in 3 of 6 cats with polyvinyl catheters. Staphylococci and streptococci were the most common bacterial isolates. Microscopic lesions in urethras and bladders were significantly less severe in cats with polyvinyl catheters than cats with polypropylene catheters. With few exceptions, urethras of cats with polyvinyl catheters were microscopically indistinguishable from urethras of noncatheterized cats. Polypropylene catheters consistently induced urethritis which was most severe in some bacteriuric cats. Severe lesions were found in the bladders of all cats with polypropylene catheters. Bladder lesions were common in cats with polyvinyl catheters, but were usually less severe in cats with polypropylene catheters. There was no apparent relation between bacteriuria and bladder lesions.

Feline urological syndrome.

A case of feline urolithiasis is described. It was demonstrated that serial determinations of renal function were mandatory in order to provide a favorable prognosis. Because hyperkalemia was present, the fluid of choice for the initial treatment was saline. The various considerations in the prevention, treatment and monitoring of cats with feline urolithiasis syndrome are discussed.