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- Author or Editor: Diego Rossetti x
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OBJECTIVE To compare the complication rates and outcomes in cats with ureteral obstruction treated by placement of double-pigtail ureteral stents or ureteral bypass (UB) devices.
DESIGN Retrospective cohort study.
ANIMALS Cats with unilateral or bilateral ureterolithiasis that received double-pigtail ureteral stents (30 stents in 27 cats; stent group) or UB devices (30 devices in 23 cats; UB group).
PROCEDURES Medical records were reviewed to collect data on signalment, clinical signs, serum biochemical data, surgical procedure, duration of hospitalization, complications, and follow-up (≥ 6 months after placement) information. Outcomes were compared between device types.
RESULTS Median durations of surgery and hospitalization were significantly longer in the stent versus UB group. Perioperative mortality rate was 18% (5/27) in the stent group and 13% (3/23) in the UB group. Median survival time was shorter in the stent versus UB group. Stent placement was associated with a greater risk of lower urinary tract–related signs, such as hematuria (52% [14/27]) and pollakiuria or stranguria (48% [13/27]). The risk of device occlusion was also greater in the stent (26% [7/27]) versus UB (4% [1/23]) group. The percentage of cats requiring additional procedures to treat complications was greater in the stent (44%; complications included uroabdomen, stent occlusion, and refractory cystitis) versus UB (9%; complications included UB occlusion and urethral obstruction) group.
CONCLUSIONS AND CLINICAL RELEVANCE Although the benefits of stent placement in the treatment of ureteral obstruction in cats have been established, results suggested that cats treated with UB devices had a lower risk of complications and a longer survival time than those treated with double-pigtail ureteral stents.
A 2-year-old intact male Mini Lop rabbit (Oryctolagus cuniculus) exhibited acute paraplegia and was suspected of having a traumatic spinal injury after leaping from the owner’s arms.
In the physical examination, the patient was conscious and responsive and presented a loss of hind-limb motor function. The results of the neurologic examination indicated a T3-L3 spinal cord lesion. Vertebral column radiography and CT showed a fracture of the dorsal arch in the right caudal part of vertebra L1 and a fracture of the caudal end plate of vertebra L1 without displacement.
TREATMENT AND OUTCOME
The vertebral fracture was stabilized by a monolateral external fixator placed percutaneously with fluoroscopy guidance. The rabbit was discharged 48 hours after surgery. Three days later, the rabbit was able to walk with mild paraparesis, and 2 weeks after surgery, the rabbit showed full recovery of neurologic function. The follow-up performed 6 weeks after surgery showed normal gait, good alignment and complete consolidation of the fracture. The external fixator was then removed. The follow-up examination and radiographic findings showed complete recovery at 2 and 6 months after surgery.
The most common cause of traumatic posterior paralysis in rabbits is vertebral fracture. This article describes the possibility and successful outcome of stabilizing a vertebral fracture in a rabbit with an external fixator using a minimally invasive fluoroscopic technique. This technique, described to the authors’ knowledge for the first time in a rabbit, allows a fracture to be stabilized accurately without any incisions while minimizing complications and postoperative pain.