Case Description—A 5-year-old female spayed mixed-breed dog was examined because of signs of persistent stranguria following treatment for urethral obstruction.
Clinical Findings—Radiographic, ultrasonographic, cystoscopic, and histologic findings were consistent with encrusted cystitis. Results of bacteriologic culture of urine and bladder wall biopsy samples indicated growth of Staphylococcus pseudintermedius.
Treatment and Outcome—The dog was initially treated via IV administration of fluids, placement of an indwelling urinary catheter, lavage of the bladder with sterile saline (0.9% NaCl) solution, and administration of antimicrobial drugs and bethanechol (to improve voiding of urine from the bladder). Antimicrobial drugs were administered for 3 months, and a commercially available diet for dissolution of urinary calculi was fed. Clinical signs of encrusted cystitis gradually resolved during the 3 months after the initial examination. Results of urinalysis and abdominal ultrasonographic examination performed 4 months after the initial examination indicated resolution of the disease.
Clinical Relevance—Encrusted cystitis is extremely rare in small animals and has previously only been associated with Corynebacterium spp infection of the urinary bladder. Resolution of encrusted cystitis has previously been achieved via surgical debridement of the bladder and treatment with antimicrobial drugs. The clinical findings and successful resolution of clinical signs in the dog of the present report suggested that urease-positive bacteria other than Corynebacterium spp can cause encrusted cystitis and that feeding of a diet for dissolution of urinary calculi in conjunction with antimicrobial treatment may result in resolution of urinary bladder lesions and clinical signs attributable to the disease without the need for surgical debridement of encrusted plaques.
Objective—To evaluate complications and outcomes associated with surgical placement of gastrojejunostomy feeding tubes in dogs with naturally occurring disease.
Procedures—Multiple preoperative, intraoperative, and postoperative variables were evaluated. Daily postoperative abdominal radiographic examinations were performed to determine the presence of the following mechanical tube complications: kinking, coiling, knotting, and migration. Tube stoma abnormalities (erythema, cellulitis, and discharge) were observed daily and recorded by use of a standardized visual analog grading scale. Additionally, presence of complications was compared with median survival times.
Results—The most common indication for gastrojejunostomy tube placement was gastrointestinal disease (n = 11), with confirmed septic peritonitis in 8 of 11 dogs. Other indications for gastrojejunostomy tube placement included extrahepatic biliary surgery (n = 6) and pancreatic disease (9). Mean ± SD surgical time required for tube placement was 26 ± 14 minutes. Overall, mechanical tube complication rate was 46% (12/26), including coiling (7), migration (4), and kinking (2). Overall minor tube stoma complication rate was 77% (20/26) and included erythema (16), cellulitis (13), and discharge (17). Dislodgement or self-induced tube trauma resulted in accidental tube removal in 2 of 26 dogs, and inadvertent tube damage necessitated premature removal by the clinician in 1 of 26 dogs. Kaplan-Meier median survival time was 39 days with 13 of 26 dogs still alive.
Conclusions and Clinical Relevance—Gastrojejunostomy tube placement affords flexibility in the postoperative nutritional regimen by allowing for postgastric feeding with simultaneous access to the stomach.