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  • Author or Editor: Maureen A. Griffin x
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Abstract

CASE DESCRIPTION

During the same week, 3 sequential patients (a 10-year-old 8.7-kg spayed female poodle cross [dog 1], 13-year-old 2.6-kg spayed female domestic longhair cat, and 13-year-old 9.0-kg castrated male mixed-breed dog [dog 2]) underwent CT-angiography (day 0) and transarterial embolization (day 1) for nonresectable hepatocellular carcinoma (n = 2) or prostatic carcinoma (1).

CLINICAL FINDINGS

Contrast-induced nephropathy (CIN) was suspected in all animals on the basis of higher serum creatinine concentrations after contrast medium administration (exposure), compared with baseline concentrations before exposure, consistent with CIN definitions. The total dose of contrast medium was < 3 mL/kg for each exposure. For all 3 patients, creatinine concentration peaked at a median of 3 days (range, 2 to 3 days) after the first exposure (day 0), and the median absolute and relative increases in creatinine concentration after exposure (vs baseline concentrations before exposure) were 2.9 mg/dL (range, 2.2 to 3.7 mg/dL) and 410% (range, 260 to 720%), respectively.

TREATMENT AND OUTCOME

The patients received individually tailored supportive care for acute kidney injury. Serum creatinine concentrations began to improve at a median of 4 days (range, 3 to 4 days) and returned to within reference limits at a median of 7 days (range, 3 to 13 days) following initial exposure.

CLINICAL RELEVANCE

CIN should be considered as a potential complication following IV administration of contrast medium. Short-term outcome following CIN can be excellent with supportive care.

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in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION

An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters.

CLINICAL FINDINGS

Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction.

TREATMENT AND OUTCOME

The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence.

CLINICAL RELEVANCE

To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.

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in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION

4 cats (6 to 9 months old) were evaluated because of clinical signs consistent with a portosystemic shunt (PSS).

CLINICAL FINDINGS

Among the 4 cats, 3 had neurologic abnormalities including ataxia, head pressing, disorientation, and obtundation. One cat was evaluated because of urethral obstruction; a retrieved urethral stone was determined to have urate composition. Clinicopathologic findings (hypoproteinemia, low BUN concentration, and high serum bile acids concentration) were consistent with a PSS in all cats. A diagnosis of intrahepatic PSS (IHPSS) was made for all cats on the basis of ultrasonographic and CT findings.

TREATMENT AND OUTCOME

All cats underwent percutaneous transvenous coil embolization (PTCE). No major intraprocedural complications were encountered, and all cats were discharged from the hospital. For the 3 cats that were presented with neurologic signs, an evaluation performed at 12, 14, or 48 months after the procedure revealed resolution of the neurologic signs, and owners reported that the behavior of each cat appeared normal. One cat that initially had neurologic and gastrointestinal signs had lower urinary tract signs after PTCE and developed an acquired extrahepatic PSS.

CLINICAL RELEVANCE

Although IHPSSs in cats are uncommon, the outcomes of PTCE for the 4 cats of the present report suggested that this treatment may benefit cats with an IHPSS. No short-term complications were encountered, and all cats had improvement in clinical signs following PTCE, although an acquired extrahepatic PSS was later identified in 1 cat. Further investigation of the use of endovascular techniques for the treatment of IHPSSs in cats and other species is warranted.

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in Journal of the American Veterinary Medical Association