CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively.
CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs.
TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2.
CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.
Objective—To determine diagnostic accuracy of a compartmented bacteriologic culture and antimicrobial susceptibility testing plate (CCSP) for detection of bacterial urinary tract infection (UTI) in dogs and antimicrobial susceptibility testing of bacterial isolates.
Sample—62 frozen, previously characterized bacterial isolates from canine urine cultures and 147 canine urine samples.
Procedures—The study was conducted in 2 phases: preliminary assay validation (phase 1) and diagnostic validation (phase 2). For phase 1, the frozen bacterial isolates were revitalized and tested with the CCSP and with standard aerobic microbiological culture (SAMC). For phase 2, the urine samples were tested with the CCSP and SAMC in parallel.
Results—For phase 1, after 24 hours of culture, 46 of 62 (74%) bacterial isolates had growth on the CCSP and all (100%) had growth in SAMC. For bacterial isolates with growth, the CCSP allowed correct identification of 45 of 46 (98%) isolates. Isolates yielding no growth on the CCSP were gram-positive cocci (Staphylococcus spp [n = 7] and Enterococcus spp ). In phase 2, the overall diagnostic accuracy of the CCSP, compared with SAMC, was 94% (sensitivity, 81%; specificity, 99%). The positive predictive value was 98% and negative predictive value was 92%. Susceptibility results for enrofloxacin and trimethoprim-sulfamethoxazole as determined with the CCSP had greatest concordance with those determined by SAMC (71% and 96%, respectively), compared with other antimicrobial susceptibilities.
Conclusions and Clinical Relevance—Use of the CCSP led to accurate exclusion of UTI in dogs without a UTI but was less reliable for diagnosis of UTI, particularly infections caused by gram-positive cocci. Standard aerobic microbiological culture remains the gold standard for detection of UTI in dogs.
Objective—To evaluate the influence of acidifying or alkalinizing diets on bone mineral density and urine relative supersaturation (URSS) with calcium oxalate and struvite in healthy cats.
Animals—6 castrated male and 6 spayed female cats.
Procedures—3 groups of 4 cats each were fed diets for 12 months that differed only in acidifying or alkalinizing properties (alkalinizing, neutral, and acidifying). Body composition was estimated by use of dual energy x-ray absorptiometry, and 48-hour urine samples were collected for URSS determination.
Results—Urine pH differed significantly among diet groups, with the lowest urine pH values in the acidifying diet group and the highest values in the alkalinizing diet group. Differences were not observed in other variables except urinary ammonia excretion, which was significantly higher in the neutral diet group. Calcium oxalate URSS was highest in the acidifying diet group and lowest in the alkalinizing diet group; struvite URSS was not different among groups. Diet was not significantly associated with bone mineral content or density.
Conclusions and Clinical Relevance—Urinary undersaturation with calcium oxalate was achieved by inducing alkaluria. Feeding an alkalinizing diet was not associated with URSS with struvite. Bone mineral density and calcium content were not adversely affected by diet; therefore, release of calcium from bone caused by feeding an acidifying diet may not occur in healthy cats.
As a result of vehicular trauma, a 3-year-old neutered male domestic shorthair cat sustained luxation of the sacrocaudal joint and a urethral tear.
Retrograde contrast urethrocystography revealed a urethral tear at the level of the ischiatic tuberosity. Conservative treatment for 7 days with a urethral catheter was unsuccessful.
TREATMENT AND OUTCOME
An approach for a perineal urethrostomy was performed and revealed a large urethral tear (4 mm in length in a craniocaudal orientation and encompassing approx 50% of the urethral circumference) proximal to the bulbourethral glands. Urethroplasty was performed with a graft of a rectangular section of single-layer porcine small intestinal submucosa. Perineal urethrostomy was then completed routinely, and a urethral catheter was left in place for 5 days. Two days after removal of the urethral catheter, stranguria was noted. Retrograde contrast urethrocystography revealed a urethral stricture. Balloon dilation of the urethral stricture was performed, and the cat's stranguria improved. Ten weeks following balloon dilation, the cat developed hematuria, and a urinary tract infection and urethral stricture were diagnosed. Balloon dilation was repeated with instillation of triamcinolone solution at the stricture site. Eighteen months later (approx 21 months after the initial surgery), the cat was urinating normally.
The outcome for the cat of this report indicated that porcine small intestinal submucosa may be used to successfully augment urethroplasty for treatment of traumatic urethral tears in cats. Urethral balloon dilation with triamcinolone instillation may be used to treat postoperative urethral strictures.
A 4-year-old spayed female French Bulldog was referred for treatment of a suspected right-sided nasal angiofibroma associated with a 4-month history of unilateral nasal discharge and stertor.
The dog appeared healthy other than right-sided mucoid debris and decreased airflow through the right naris. The dog was anesthetized, and a large intranasal mass was observed obstructing the right nasal passage and abutting the nasal septum.
TREATMENT AND OUTCOME
A lateral rhinotomy was performed, and rigid endoscopes (0° and 30°) were used to examine the right nasal cavity. The mass filled the anterior aspect of the nasal cavity and involved a portion of the nasal turbinates with some erosion. A coblation unit was used to ablate tumor tissue laterally to remove the tumor in piecemeal fashion. Recovery was routine with only minor epistaxis after surgery, and the dog was discharged the next day. Eight months after surgery, follow-up CT revealed right-sided nasal turbinate and conchal atrophy consistent with prior mass ablation. No macroscopic recurrence was detected, and the owners reported only rare, clear rhinorrhea.
Findings suggested that coblation may be an alternative to radiation therapy for vascular tumors with minimal invasion and low metastatic potential.
Objective—To determine prevalence of within-household sharing of fecal Escherichia coli between dogs and their owners on the basis of pulsed-field gel electrophoresis (PFGE), compare antimicrobial susceptibility between isolates from dogs and their owners, and evaluate epidemiologic features of cross-species sharing by use of a questionnaire.
Sample Population—61 healthy dog-owner pairs and 30 healthy control humans.
Procedures—3 fecal E coli colonies were isolated from each participant; PFGE profiles were used to establish relatedness among bacterial isolates. Susceptibility to 17 antimicrobials was determined via disk diffusion. A questionnaire was used to evaluate signalment, previous antimicrobial therapy, hygiene, and relationship with dog.
Results—A wide array of PFGE profiles was observed in E coli isolates from all participants. Within-household sharing occurred with 9.8% prevalence, and across-household sharing occurred with 0.3% prevalence. No behaviors were associated with increased clonal sharing between dog and owner. No differences were found in susceptibility results between dog-owner pairs. Control isolates were more likely than canine isolates to be resistant to ampicillin and trimethoprim-sulfamethoxazole. Owners and control humans carried more multdrug-resistant E coli than did dogs.
Conclusions and Clinical Relevance—Within-household sharing of E coli was detected more commonly than across-household sharing, but both direct contact and environmental reservoirs may be routes of cross-species sharing of bacteria and genes for resistance. Cross-species bacterial sharing is a potential public health concern, and good hygiene is recommended.
Objective—To determine the prevalence of 4 urovirulence genes in fecal Escherichia coli isolates from healthy dogs and their owners and to determine whether detection of E coli strains with these genes was associated with a history of urinary tract infection (UTI).
Sample Population—61 healthy dog-owner pairs and 30 healthy non–dog owners.
Procedures—A fecal specimen was obtained from each participant, and 3 colonies of E coli were isolated from each specimen. A multiplex PCR assay was used to detect 4 genes encoding virulence factors: cytotoxic necrotizing factor (cnf), hemolysin (hlyD), s-fimbrial and F1C fimbriae adhesin (sfa/foc), and pilus associated with pyelonephritis G allele III (papGIII). Human participants completed a questionnaire to provide general information and any history of UTI for themselves and, when applicable, their dog.
Results—26% (16/61) of dogs, 18% (11/61) of owners, and 20% (6/30) of non–dog owners had positive test results for ≥ 1 E coli virulence gene. One or more genes were identified in fecal E coli isolates of both dog and owner in 2% (1/61) of households. There was no difference in the detection of any virulence factor between dog-owner pairs. Female owner history of UTI was associated with detection of each virulence factor in E coli strains isolated from their dogs' feces.
Conclusions and Clinical Relevance—Dogs and humans harbored fecal E coli strains possessing the genes cnf, hlyD, sfa/foc, and papGIII that encode urovirulence factors. It was rare for both dog and owner to have fecal E coli strains with these virulence genes.