• 1. McLoughlin MA. Surgical emergencies of the urinary tract. Vet Clin North Am Small Anim Pract 2000; 30: 581601.

  • 2. McLoughlin MA, Bjorling DE. Ureters. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: WB Saunders, 2003; 161928.

    • Search Google Scholar
    • Export Citation
  • 3. Franti CE, Ling GV, Ruby AL, et al. Urolithiasis in dogs. V: regional comparisons by breed, age, sex, anatomic location, and mineral type of calculus. Am J Vet Res 1999; 60: 2942.

    • Search Google Scholar
    • Export Citation
  • 4. Martin GS, Mannino DM, Eaton S, et al. The epidemiology of sepsis in the United States from 1979 to 2000. N Engl J Med 2003; 348: 15461554.

    • Search Google Scholar
    • Export Citation
  • 5. Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign Guidelines 2012. International Guidelines for management of severe sepsis and systemic shock. Crit Care Med 2013; 41: 580637.

    • Search Google Scholar
    • Export Citation
  • 6. Bentley AM, Otto MC, Shofer FS. Comparison of dogs with septic peritonitis: 1988–1993 versus 1999–2003. J Vet Emerg Crit Care (San Antonio) 2007; 17: 391398.

    • Search Google Scholar
    • Export Citation
  • 7. Yoshimura K, Utsunomiya N, Ichioka K, et al. Emergency drainage for urosepsis associated with upper urinary tract calculi. J Urol 2005; 173: 458462.

    • Search Google Scholar
    • Export Citation
  • 8. Ramsey S, Robertson A, Ablett M, et al. Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi. J Endourol 2010; 24: 185189.

    • Search Google Scholar
    • Export Citation
  • 9. Pearle MS, Pierce HL, Miller GL, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160: 12601264.

    • Search Google Scholar
    • Export Citation
  • 10. Mokhmalji H, Braun PM, Martinez Portillo JF, et al. Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomized clinical trial. J Urol 2001; 165: 10881092.

    • Search Google Scholar
    • Export Citation
  • 11. Rao PN, Dube D, Weightman N, et al. Prediction of septicemia following endourological manipulation for stones in the upper urinary tract. J Urol 1991; 146: 955960.

    • Search Google Scholar
    • Export Citation
  • 12. Berent AC, Weisse C, Todd K, et al. Use of locking-loop pigtail nephrostomy catheters in dogs and cats: 20 cases (2004–2009). J Am Vet Med Assoc 2012; 241: 348357.

    • Search Google Scholar
    • Export Citation
  • 13. Berent AC. Treatment for ureteral obstructions in dogs and cats: review of traditional and new interventional diagnostic and therapeutic options. J Vet Emerg Crit Care (San Antonio) 2011; 21: 86103.

    • Search Google Scholar
    • Export Citation
  • 14. Berent AC, Weisse C, Beal M, et al. Use of indwelling, double-pigtail stents for treatment of malignant ureteral obstruction in dogs: 12 cases (2006–2009). J Am Vet Med Assoc 2011; 238: 10171025.

    • Search Google Scholar
    • Export Citation
  • 15. Lam NK, Berent A, Weisse C, et al. Endoscopic placement of ureteral stents for the treatment of bilateral ureteral stenosis in a dog. J Am Vet Med Assoc 2012; 240: 983990.

    • Search Google Scholar
    • Export Citation
  • 16. Snyder DM, Steffey MA, Mehler SJ, et al. Diagnosis and surgical management of ureteral calculi in dogs: 16 cases (1990–2003). N Z Vet J 2005; 53: 1925.

    • Search Google Scholar
    • Export Citation
  • 17. Gookin JL, Stone E, Spaulding K, et al. Unilateral nephrectomy in dogs with renal disease: 30 cases (1985–1994). J Am Vet Med Assoc 1996; 208: 20202026.

    • Search Google Scholar
    • Export Citation
  • 18. Urie BK, Tillson D, Smith C, et al. Evaluation of clinical status, renal function, and hematopoietic variables after unilateral nephrectomy in canine kidney donors. J Am Vet Med Assoc 2007; 230: 16531656.

    • Search Google Scholar
    • Export Citation
  • 19. Runge JJ, Berent AC, Mayhew PD, et al. Transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi in dogs and cats: 27 cases (2005–2008). J Am Vet Med Assoc 2011; 239: 344349.

    • Search Google Scholar
    • Export Citation
  • 20. Houston DM, Moore AE. Canine and feline urolithiasis: examination of over 50,000 urolith submissions to the Canadian veterinary urolith centre from 1998 to 2008. Can Vet J 2009; 50: 12631268.

    • Search Google Scholar
    • Export Citation
  • 21. Lekcharoensuk C, Lulich JP, Osborne CA, et al. Patient and environmental factors associated with calcium oxalate urolithasis in dogs. J Am Vet Med Assoc 2000; 217: 515519.

    • Search Google Scholar
    • Export Citation
  • 22. Adams LG, Syme SM. Renal disease: canine lower urinary tract disease. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 6th ed. Philadelphia: Elsevier Saunders, 2005; 18501879.

    • Search Google Scholar
    • Export Citation
  • 23. Slichter SJ. Evidence-based platelet transfusion guidelines. Hematology Am Soc Hematol Educ Program 2007:1721788.

  • 24. Ferkau A, Gillmann HJ, Mischke R, et al. Infection-associated platelet dysfunction of canine platelets detected in a flow chamber model. BMC Vet Res 2013; 9: 112.

    • Search Google Scholar
    • Export Citation
  • 25. Zeck J, Schallheim J, Lew SQ, et al. Whole blood platelet aggregation and release reaction testing in uremic patients [published online ahead of print Jun 26, 2013]. Biomed Res Int doi:10.1155;2013;486290.

    • Search Google Scholar
    • Export Citation
  • 26. DiBartola SP. Renal disease: clinical approach and laboratory evaluation. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 6th ed. Philadelphia: Elsevier Saunders, 2005; 1716.

    • Search Google Scholar
    • Export Citation
  • 27. Kawahara T, Ito H, Terao H, et al. Ureteral stent encrustation, incrustation, and coloring: morbidity related to indwelling times. J Endourol 2012; 26: 178182.

    • Search Google Scholar
    • Export Citation
  • 28. Berent AC, Weisse CW, Todd K, et al. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006–2010). J Am Vet Med Assoc 2014; 244: 559576.

    • Search Google Scholar
    • Export Citation
  • 29. Bariol S, Farebrother T, Ruthven S, et al. Comparison of urinary stone and stent encrustation: biochemical analysis. J Endourol 2003; 17: 741743.

    • Search Google Scholar
    • Export Citation
  • 30. Finkle AL, Smith DR. Parameters of functional renal capacity in reversible hydroureteronephrosis in dogs. Invest Urol 1970; 8: 299310.

    • Search Google Scholar
    • Export Citation
  • 31. Klahr S, Morrison A, Buerkert J. Effects of urinary tract obstruction on renal function. Contrib Nephrol 1980; 23: 3446.

Advertisement

Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008–2012)

View More View Less
  • 1 Department of Internal Medicine, Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 2 Interventional Radiology and Endoscopy, Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 3 Interventional Radiology and Endoscopy, Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 4 Thomas Jefferson University Hospital, 111 S 11th St, Philadelphia, PA 19107.

Abstract

Objective—To describe the technical aspects and clinical outcome of endoscopic- and fluoroscopic-guided ureteropelvic lavage and ureteral stent placement for treatment of obstructive pyonephrosis in dogs.

Design—Retrospective case series.

Animals—13 client-owned dogs (14 obstructed ureters).

Procedures—All patients with obstructive pyonephrosis were treated with a ureteral stent. Medical records were reviewed for history, clinical signs, pre- and postprocedural clinical and imaging data, and short- and long-term outcomes.

Results—13 dogs (14 ureters) had unilateral or bilateral ureteral obstructions and pyonephrosis due to ureterolithiasis (n = 13) or a suspected ureteral stricture (1). Eleven dogs had positive results of bacteriologic culture of urine obtained from the bladder, renal pelvis, or both. Ten were thrombocytopenic, and 8 were azotemic. Stents were placed fluoroscopically with endoscopic (n = 11) or surgical (3) assistance. Median hospitalization time was 48 hours (range, 6 to 260 hours). Median follow-up time was 480 days (range, 2 to 1,460 days). Intraoperative complications occurred in 2 patients (stent occlusion from shearing of a guide wire, and wire penetration of the ureter at the location of a stone). Short-term complications included a bladder hematoma (n = 1) and transient dysuria (1). Long-term complications included stent encrustation (n = 1), stent migration (1), and tissue proliferation at the ureterovesicular junction (5), which had no clinical implications. Recurrent urinary tract infections were documented in 7 dogs.

Conclusions and Clinical Relevance—Ureteral stenting was a successful renal-sparing treatment for obstructive pyonephrosis in dogs and could often be performed in a minimally invasive manner. There were few major complications. This technique may be considered as an effective treatment option for this condition in dogs.

Abstract

Objective—To describe the technical aspects and clinical outcome of endoscopic- and fluoroscopic-guided ureteropelvic lavage and ureteral stent placement for treatment of obstructive pyonephrosis in dogs.

Design—Retrospective case series.

Animals—13 client-owned dogs (14 obstructed ureters).

Procedures—All patients with obstructive pyonephrosis were treated with a ureteral stent. Medical records were reviewed for history, clinical signs, pre- and postprocedural clinical and imaging data, and short- and long-term outcomes.

Results—13 dogs (14 ureters) had unilateral or bilateral ureteral obstructions and pyonephrosis due to ureterolithiasis (n = 13) or a suspected ureteral stricture (1). Eleven dogs had positive results of bacteriologic culture of urine obtained from the bladder, renal pelvis, or both. Ten were thrombocytopenic, and 8 were azotemic. Stents were placed fluoroscopically with endoscopic (n = 11) or surgical (3) assistance. Median hospitalization time was 48 hours (range, 6 to 260 hours). Median follow-up time was 480 days (range, 2 to 1,460 days). Intraoperative complications occurred in 2 patients (stent occlusion from shearing of a guide wire, and wire penetration of the ureter at the location of a stone). Short-term complications included a bladder hematoma (n = 1) and transient dysuria (1). Long-term complications included stent encrustation (n = 1), stent migration (1), and tissue proliferation at the ureterovesicular junction (5), which had no clinical implications. Recurrent urinary tract infections were documented in 7 dogs.

Conclusions and Clinical Relevance—Ureteral stenting was a successful renal-sparing treatment for obstructive pyonephrosis in dogs and could often be performed in a minimally invasive manner. There were few major complications. This technique may be considered as an effective treatment option for this condition in dogs.

Contributor Notes

One patient in this series was treated at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania.

Presented in abstract form at the American College of Veterinary Internal Medicine Forum, Seattle, June 2013.

Address correspondence to Dr. Berent (allyson.berent@amcny.org).