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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe use of transurethral cystoscope–guided laser lithotripsy for fragmentation of cystic and urethral uroliths and determine procedure duration and short-term and long-term outcome in dogs.

Design—Retrospective case series.

Animals—73 dogs with naturally occurring uroliths in the urinary bladder, urethra, or both.

Procedures—Transurethral cystoscope–guided laser lithotripsy was performed in all dogs, and medical records were reviewed for short-term and long-term outcome and complications.

Results—Laser lithotripsy resulted in complete fragmentation of all uroliths in all 28 female dogs and a majority of male dogs (39/45 [86.7%]). Dogs with urethroliths had shorter median laser time than dogs with cystic uroliths. Basket extraction and voiding urohydro-propulsion were successful for removal of the urolith fragments following laser lithotripsy. Complications related to cystoscope-guided laser lithotripsy occurred in 5 of 28 (17.9%) female dogs and 6 of 45 (13.3%) male dogs.

Conclusions and Clinical Relevance—Transurethral cystoscope–guided laser lithotripsy was successful in female dogs and most male dogs for fragmentation of cystic and urethral uroliths. Short-term complications were most commonly related to urethral swelling and resolved with placement of an indwelling urinary catheter. There were no long-term complications.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the outcome in dogs undergoing urethral stent placement for management of urethral obstruction secondary to transitional cell carcinoma (TCC).

Design—Retrospective case series.

Animals—19 dogs with histopathologically confirmed TCC.

Procedures—Information regarding urethral stent placement and follow-up treatment was obtained from review of medical records. Quality of life assessment was performed with an owner questionnaire.

Results—Self-expanding nitinol stents were successfully placed in 17 of 19 dogs; stent placement was not possible in one dog, and another dog was euthanatized 2 days after stent placement, but before discharge from the hospital. Median survival time in 17 dogs following successful long-term stent placement was 78 days (range, 2 to 366 days). Complications following stent placement in 18 dogs included incontinence (n = 7), reobstruction from continued growth of urethral TCC (3), acute reobstruction shortly after the procedure (1), and stent migration (2). Of the 17 owners surveyed, 16 were satisfied with the outcome and would recommend urethral stent placement.

Conclusions and Clinical Relevance—The placement of self-expanding nitinol urethral stents was successful in alleviating TCC-induced urethral obstruction and providing good quality of life for most dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To test the hypothesis that feline calcium oxalate uroliths are intrinsically more resistant to comminution via shock wave lithotripsy (SWL) than canine calcium oxalate uroliths through comparison of the fragility of canine and feline uroliths in a quantitative in vitro test system.

Sample Population—Calcium oxalate uroliths (previously obtained from dogs and cats) were matched by size and mineral composition to create 7 pairs of uroliths (1 canine and 1 feline urolith/pair).

Procedure—Uroliths were treated in vitro with 100 shock waves (20 kV; 1 Hz) by use of an electrohydraulic lithotripter. Urolith fragmentation was quantitatively assessed via determination of the percentage increase in projected area (calculated from the digital image area of each urolith before and after SWL).

Results—After SWL, canine uroliths (n = 7) fragmented to produce a mean ± SD increase in image area of 238 ± 104%, whereas feline uroliths (7) underwent significantly less fragmentation (mean image area increase of 78 ± 97%). The post-SWL increase in fragment image area in 4 of 7 feline uroliths was < 50%, whereas it was > 150% in 6 of 7 canine uroliths.

Conclusions and Clinical Relevance—Results indicate that feline calcium oxalate uroliths are less susceptible to fragmentation via SWL than canine calcium oxalate uroliths. In some cats, SWL may not be efficacious for fragmentation of calcium oxalate nephroliths or ureteroliths because the high numbers of shock waves required to adequately fragment the uroliths may cause renal injury. (Am J Vet Res 2005;66:1651–1654)

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in American Journal of Veterinary Research

Abstract

Case Description—2 dogs and 5 cats were evaluated for treatment of ureteroliths.

Clinical Findings—Spontaneous retrograde movement of 1 or more ureteroliths was detected by radiography, ultrasonography, fluoroscopy, and a combination of fluoroscopy and ultrasonography. The ureteroliths moved retrograde up to 4 centimeters. Retrograde movement of ureteroliths into the renal pelvis resulted in improved renal function in some patients but made complete surgical removal of all uroliths more difficult.

Treatment and Outcome—Medical management was not successful, and ureteroliths were surgically removed. Surgical management of ureteroliths was complicated by retrograde movement of ureteroliths in the perioperative period.

Clinical Relevance—Ureteroliths can move retrograde within the ureter and even back into the renal pelvis. Retrograde movement of ureteroliths may make surgical planning more difficult.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe the use of sclerotherapy for the renal-sparing treatment of idiopathic renal hematuria (IRH) in dogs and report clinical outcomes.

Design—Retrospective case series.

Animals—6 dogs (8 renal pelvises) with IRH.

Procedures—Medical records of dogs that underwent sclerotherapy were reviewed. Each ureterovesicular junction was identified cystoscopically to determine the side of bleeding, and a retrograde ureteropyelogram was performed with endoscopic and fluoroscopic guidance. A ureteropelvic junction balloon was used for ureteral occlusion, and pelvis filling volumes were recorded. A povidone iodine mixture, followed by a sterile silver nitrate solution, was infused into the renal pelvis. A double-pigtail ureteral stent was placed after the procedure. Information on preprocedure and postprocedure biochemical changes, imaging parameters, and clinical outcomes was obtained.

Results—6 dogs (5 males and 1 female) had sclerotherapy for unilateral (4) or bilateral (2) bleeding. Five were right-sided and 3 were left-sided. The median age and weight of dogs were 3 years and 42.4 kg (93.28 lb), respectively. Median procedure time was 150 minutes. One dog that did not have a ureteral stent placed following the procedure developed short-term signs of renal pain and pyelectasis. Cessation of macroscopic hematuria occurred in 4 of 6 dogs (median, 6 hours). Two additional dogs improved moderately. Median follow-up time was 8 months (range, 3.5 to 20.5 months).

Conclusions and Clinical Relevance—Topical sclerotherapy for IRH was safe and effective. Local sclerotherapy for IRH in dogs could be considered a valuable and minimally invasive renal-sparing treatment over ureteronephrectomy.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To assess the diagnostic utility of transurethral cystoscopic biopsy in dogs with histologically confirmed transitional cell carcinoma (TCC) of the urinary bladder and urethra.

Design—Retrospective case series.

Animals—92 dogs with histologically confirmed TCC.

Procedures—Information on sex, breed, neuter status, body weight, tumor location, biopsy method, number of biopsy procedures, experience level of clinician performing biopsy, and quality of biopsy sample was obtained from medical records. The association of variables with likelihood of achieving a diagnostic-quality biopsy sample was evaluated by use of logistic regression.

Results—If used as the initial biopsy method, cystoscopic biopsy samples were of diagnostic quality in 65% of male dogs and 96% of female dogs with histologically confirmed TCC. Cystoscopic biopsy samples were significantly more likely to be of diagnostic quality in female dogs than in male dogs.

Conclusions and Clinical Relevance—Cystoscopic biopsy is an effective method to obtain biopsy samples in dogs with TCC of the bladder and urethra. Cystoscopy is more likely to produce a diagnostic-quality biopsy sample in female dogs with TCC than in male dogs with TCC. Cystoscopy should be considered as a primary means of biopsy in male and female dogs with masses of the urinary bladder or urethra.

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in Journal of the American Veterinary Medical Association