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Abstract

Objective—To evaluate the effectiveness of episioplasty for the treatment of perivulvar dermatitis or chronic or recurrent urinary tract infections (UTI) believed to be secondary to excessive perivulvar skin folds in dogs and to document whether a causal relationship exists between the presence of chronic or recurrent UTI and excessive perivulvar skin folds in female dogs.

Design—Retrospective study.

Animals—31 female dogs.

Procedure—Medical records of dogs with vulvar dermatitis (group 1; n = 15) or UTI (group 2; 16) were reviewed for history, signalment, physical examination findings, hematologic findings, results of urine or vaginal bacteriologic culture, and results of additional diagnostic procedures.

Results—14 of 15 dogs in group 1 had complete resolution of perivulvar dermatitis and associated clinical signs following episioplasty. One dog had a relapse of clinical signs and vulvar dermatitis 2 years after surgery in association with a 9-kg (19.8-lb) weight gain. Sixteen of 16 dogs in group 2 had complete resolution of clinical signs of UTI following episioplasty. Urine samples were obtained via cystocentesis no earlier than 1 month after surgery to confirm resolution of UTI in 13 of 16 of dogs in group 2. Mild-to-moderate incisional swelling was the only surgical complication reported for either group, with the exception of 1 dog in group 2 that had wound dehiscence. All owners were satisfied with surgical outcomes.

Conclusions and Clinical Relevance—All owners reported complete resolution of clinical signs for both groups of dogs. Episioplasty is an effective low morbidity treatment for perivulvar dermatitis and chronic UTI associated with excessive perivulvar skin folds. (J Am Vet Med Assoc 2001;219:1577–1581)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate transurethral cystoscopy and excretory urography for diagnosis of ectopic ureter in female dogs and identify concurrent urogenital abnormalities.

Design—Retrospective study.

Animals—25 female dogs.

Procedure—Medical records of female dogs that underwent transurethral cystoscopy, excretory urography, and ventral cystotomy were reviewed for signalment, history, physical examination findings, results of bacteriologic culture of urine, and surgical findings. Videotapes of transurethral cystoscopy and radiographic studies were reviewed systematically without knowledge of surgical findings.

Results—Ectopic ureters were diagnosed in 24 of 25 (96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs. Cystoscopic evaluation yielded a correct diagnosis in all dogs when results of ventral cystotomy were used as the diagnostic standard. Cystoscopic evaluation identified a terminal ureteral opening for all ureters. Urethral fenestrations, troughs, striping, and tenting were identified. Abnormalities of the vestibule were identified in all examinations available for review (24/25). The paramesonephric septal remnant and its association with ectopic ureters were identified and characterized by cystoscopy. Radiographic findings were discordant with surgical findings and correctly identified 36 of 46 (78.2%) ectopic ureters and 2 of 4 normal ureters. Hydroureter and renal abnormalities were associated with distal urethral ectopic ureters on radiographic evaluations.

Conclusions and Clinical Relevance—Transurethral cystoscopy was accurate and minimally invasive for identification and classification of ectopic ureters in dogs. Contrast radiography had limitations in diagnosis of ectopic ureters. Cystoscopic findings and associated vaginal and vestibular abnormalities support abnormal embryologic development in the pathogenesis of ectopic ureters. (J Am Vet Med Assoc 2003;223:475–481)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 6-month-old female domestic shorthair cat was admitted for evaluation of intermittent clinical signs of hematuria and inappropriate urination for the past 2 months.

Clinical Findings—Transabdominal ultrasonography revealed a multilayered mass in the urinary bladder apex consistent with full-thickness invagination of the bladder wall.

Treatment and Outcome—Exploratory surgery was performed, and partial inversion of the urinary bladder was confirmed. The invaginated bladder apex was manually reduced, and partial cystectomy was performed to remove the invaginated section of bladder wall. Histologic findings were consistent with vascular congestion and edema secondary to partial invagination. Bacterial culture of a section of the bladder mucosa demonstrated concurrent bacterial urinary tract infection. Clinical signs resolved following surgical resection of the bladder apex and antimicrobial treatment for the concurrent urinary tract infection.

Clinical Relevance—Partial invagination of the urinary bladder should be considered in the differential diagnosis for cats with clinical signs of hematuria, stranguria, and inappropriate urination. A diagnosis may be made on the basis of detection of invaginated tissue in the bladder apex during abdominal ultrasonography.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective

To use scintigraphy to determine the effects of partial ureteral obstruction on renal transit time and induction of diuresis in dogs.

Animals

8 adult dogs.

Procedure

Scintigraphy was performed, using technetium Tc 99m diethylenetriaminepentacetic acid (Tc 99m-DTPA), before and within 2 weeks after surgical induction of unilateral partial ureteral obstruction. Time of peak (TOP) for the parenchyma (pTOP) and whole kidney (wTOP) and mean-transit time (MTT) for the parenchyma (pMTT) and whole kidney (wMTT) were determined by evaluation of renal time-activity curves before and after deconvolution analysis. Percentage uptake for each kidney between 1 and 3 minutes after injection of Tc 99m-DTPA was determined and used to indicate glomerular filtration rate. The effect of diuresis was determined by measuring the slope of decrease in activity after IV administration of furosemide. Obstruction was documented by direct inspection of the ureter.

Results

There was a concomitant increase in pTOP, wTOP, pMTT, and wMTT of the kidney with the partially obstructed ureter in all dogs at various times between 2 and 9 days after surgery. Concurrently, renal time-activity curves changed shape. Percentage renal uptake of the affected kidney was decreased in 2 dogs. Response to furosemide injection was inconsistent for kidneys before surgery and for kidneys with obstructed and nonobstructed ureters after surgery.

Conclusions and Clinical Relevance

Scintigraphy may be a useful procedure for the evaluation of renal function in dogs with ureteral obstruction. Induction of diuresis appears to be of little value for differentiating renal function in dogs with obstructed and nonobstructed ureters. (Am J Vet Res 1999;60:1383–1389)

Free access
in American Journal of Veterinary Research

Objective

To evaluate the safety and efficacy of amitriptyline hydrochloride in the treatment of severe recurrent idiopathic cystitis (IC) in cats.

Design

Prospective study.

Animals

15 cats with IC that failed to respond to other treatments.

Procedure

Each cat received 10 mg of amitriptyline, PO, every 24 hours in the evening for 12 months or until signs recurred. Urinalysis, CBC, serum biochemical analysis, urine bacteriologic culture, and cystoscopy were performed initially, and after 6 and 12 months in responders. Severity scores of owner-observed signs of lower urinary tract (bladder and urethra) disease were recorded.

Results

During the first 6 months of treatment, 11 of the 15 cats had no owner-observed signs of lower urinary tract disease. During the next 6 months, 9 of 15 cats remained free of signs of cystitis. Despite clinical improvement, cystoscopic abnormalities persisted in all cats at the 6- and 12-month evaluations. Hematuria and proteinuria were decreased at the 12-month evaluation compared with the initial evaluation. Two of 15 cats initially appeared somnolent after amitriptyline treatment. Of 9 cats completing the study, 7 had increased body weight and 8 had decreased coat quality compared with the initial evaluations. Four cats developed small cystic calculi during the first 6 months of the study. Serum biochemical or hematologic abnormalities were not detected during the study.

Clinical Implications

Amitriptyline treatment successfully decreased clinical signs of severe recurrent IC in 9 of 15 cats treated. Somnolence, weight gain, decreased grooming, and transient cystic calculi were observed during treatment in some cats. (J Am Vet Med Assoc 1998;213:1282-1286)

Free access
in Journal of the American Veterinary Medical Association

Objective

To describe results of retrograde urethrography in cats with idiopathic, nonobstructive lower urinary tract disease (LUTD), to review the normal anatomy of the feline urethra, and to relate anatomy observed radiographically to the pathogenesis and diagnosis of LUTD in cats.

Design

Retrospective case series and anatomic study.

Animals

53 cats with signs of nonobstructive LUTD for which an underlying cause could not be determined. Results for these cats were compared with those for 6 healthy female cats undergoing urethrocystoscopy for another study and 6 male cats without a history of LUTD undergoing necropsy examination.

Procedure

Medical records, results of positive-contrast retrograde urethrography (cats with idiopathic, nonobstructive LUTD) and urethrocystoscopy (healthy female cats), and necropsy findings (healthy male cats) were reviewed.

Results

Abnormalities were not detected during urethrocystoscopy, dissection, or urethrography. Previously, the urethra in male cats has been described simply as a long tube that tapers caudally, and the only structures consistently differentiated by radiography have been pelvic and penile parts. In this study, the seminal colliculus, isthmus of the urethra, preprostatic part of the urethra, and urethral crest were consistently observed in male cats in addition to pelvic and penile parts. The urethral crest also was observed in the comparatively simple female urethra.

Clinical Implications

During retrograde urethrography in cats, prior distention of the bladder with positive-contrast medium may obscure radiographic signs associated with normal anatomic structures. Knowledge of urethral anatomy and radiographic signs associated with idiopathic, nonobstructive LUTD in cats should improve understanding of the pathogenesis and diagnosis of this disease. (J Am Vet Med Assoc 1997;211:741–748)

Free access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To evaluate effects of blood contamination on dipstick results, specific gravity (SG), and urine protein-to-urine creatinine ratio (UPCR) for urine samples from dogs and cats.

SAMPLE Urine samples collected from 279 dogs and 120 cats.

PROCEDURES Urine pools were made for each species (dogs [n = 60] and cats [30]). Blood was added to an aliquot of a pool, and serial dilutions were prepared with the remaining urine. Color and dipstick variables were recorded, and SG and UPCR were measured. For cats, 1 set of pools was used; for dogs, 2 sets were used. Comparisons were made between undiluted urine and spiked urine samples for individual colors. Repeated-measures ANOVA on ranks was used to compare dipstick scores and UPCR results; χ2 tests were used to compare proteinuria categorizations (nonproteinuric, borderline, or proteinuric).

RESULTS Any blood in the urine resulted in significantly increased dipstick scores for blood. In both species, scores for bilirubin and ketones, pH, and SG were affected by visible blood contamination. No significant difference for the dipstick protein reagent results was evident until a sample was visibly hematuric. The UPCR was significantly increased in dark yellow samples of both species. Proteinuria categorizations differed significantly between undiluted urine and urine of all colors, except light yellow.

CONCLUSIONS AND CLINICAL RELEVANCE Any degree of blood contamination affected results of dipstick analysis. Effects depended on urine color and the variable measured. Microscopic blood contamination may affect the UPCR; thus, blood contamination may be a differential diagnosis for proteinuria in yellow urine samples.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine maximum extrarenal plasma clearance of technetium-99m-mercaptoacetyltriglycine (99mTc–MAG3) and maximum extrarenal hepatic uptake of 99mTc–MAG3 in cats.

Animals—6 clinically normal adult cats.

Procedure—Simultaneously, baseline plasma clearance and camera-based uptake of 99mTc–MAG3 were determined in anesthetized cats. Double exponential curves were fitted to plasma clearance data. Injected dose was divided by area under the curve and body weight to determine 99mTc–MAG3 clearance. Regions of interest were drawn around kidneys and liver, and percentage dose uptake was determined 1 to 3 minutes after injection. After bilateral nephrectomy, simultaneous extrarenal plasma clearance and camera- based hepatic uptake of 99mTc–MAG3 were evaluated in each cat.

Results—Mean ± SD baseline plasma clearance and extrarenal clearance were 5.29 ± 0.77 and 0.84 ± 0.47 mL/min/kg, respectively. Mean extrarenal clearance (as a percentage of baseline plasma clearance) was 16.06 ± 7.64%. For right, left, and both kidneys, mean percentage dose uptake was 9.42 ± 2.58, 9.37 ± 0.86, and 18.79 ± 2.47%, respectively. Mean hepatic percentage dose uptake before and after nephrectomy was 12.95 ± 0.93 and 21.47 ± 2.00%, respectively. Mean percentage change of hepatic uptake after nephrectomy was 166.89 ± 23.19%.

Conclusions and Clinical Relevance—In cats, extrarenal clearance of 99mTc–MAG3 is higher than that of other species; therefore, 99mTc–MAG3 is not useful for estimation of renal function in felids. Evaluation of renal function in cats may be more accurate via camera- based versus plasma clearance-based methods because camera-based studies can discriminate specific organs. (Am J Vet Res 2003;64:1076–1080)

Full access
in American Journal of Veterinary Research

Abstract

Case Description—An 11-year-old 72-kg (158-lb) sexually intact female alpaca was examined for diagnosis and treatment of hematuria of 4 months' duration.

Clinical Findings—Pigmenturia was detected by the owner when the alpaca was 8 months pregnant. Radiographic, ultrasonographic, vaginal speculum, and cystoscopic evaluation of the urinary tract revealed normal vaginal and urethral epithelia and increased bladder vessel tortuosity, with pulses of hemorrhage from the left ureter. Regenerative anemia and mild leukopenia were detected and serum urea nitrogen and creatinine concentrations were within reference ranges.

Treatment and Outcome—Chronic hematuria resolved after unilateral nephrectomy of the left kidney, and no dysfunction was detected in the remaining kidney. Histologic evaluation of the kidney revealed a transitional cell tumor in the renal pelvis.

Clinical Relevance—Although anemia is common in South American camelids, hematuria is an uncommon sign of this condition. Chronic urinary tract infection, toxin ingestion, and neoplasia causing hematuria or hemoglobinuria should be considered in South American camelids with pigmenturia. Thorough and systematic evaluation of the urinary tract should be performed to locate the site of hemorrhage to treat hematuria appropriately.

Full access
in Journal of the American Veterinary Medical Association

Objective

To identify the underlying cause of clinical signs in cats with non obstructive diseases of the bladder and urethra.

Design

Prospective case series.

Sample Population

109 cats examined by the urology service of The Ohio State University's veterinary teaching hospital because of stranguria, hematuria, pollakiuria, or urination in inappropriate locations.

Procedure

History was obtained and a CBC, serum biochemical analyses, serologic tests for FeLV and feline immunodeficiency virus, urinalysis, bacterial culture of urine, and contrast radiography or urethrocystoscopy (females only) were performed.

Results

16 cats had cystic calculi: 8 had struvite uroliths, 7 had calcium oxalate uroliths, and 1 had a urolith of unknown composition in conjunction with an anatomic defect. Anatomic defects, including diverticulae, urethral strictures, and a malpositioned urethra, were identified in 12 cats. A urinary tract infection was identified in 1 cat, and neoplasia was diagnosed in 2. One of the cats with neoplasia also had a struvite urolith. The remaining 80 cats did not have an anatomic defect, urolith, or tumor. Ten of these cats also did not have radiographic or cystoscopic abnormalities and were presumed to have a behavioral disorder. The remaining 70 cats had radiographic or cystoscopic abnormalities, and idiopathic cystitis was diagnosed. In 14 of the cats with idiopathic cystitis, results of a urinalysis were normal. Cats with idiopathic cystitis were significantly more likely to eat dry food exclusively (59%) than were cats in the general population (19%).

Clinical Implications

Results suggest that idiopathic cystitis occurs commonly in cats with stranguria, hematuria, pollakiurfa, or inappropriate elimination and is associated with consumption of dry foods. Contrast radiography or cystoscopy is necessary for differentiating idiopathic cystitis from behavioral disorders in some cats. (J Am Vet Med Assoc 1997;210:46–50)

Free access
in Journal of the American Veterinary Medical Association