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1.
T.L. Hill A.C. Berent C.W. Weisse 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2014,28(5):1384-1390
Background
Benign urethral obstructions (BUO) in dogs result in substantial morbidity because of challenges with conventional therapies. Treatment of malignant urethral obstructions with intraluminal urethral stents is reported to successfully relieve obstructions.Hypothesis/Objectives
To evaluate the efficacy and outcome of urethral stent placement for treatment of BUO in dogs.Animals
Eleven client‐owned animals with urethral stents placed for treatment of BUO.Methods
Retrospective study in which medical records were reviewed in dogs diagnosed with BUO and treated with a metallic urethral stent. Data collected included signalment, cause of benign obstruction, procedure time, size and type of stent, complications, and short‐ and long‐term outcome.Results
Eleven dogs with 15 urethral stents were included. Intraluminal urethral stent(s) relieved the obstructions in all dogs. Four dogs had 2 stents placed in separate procedures because of incomplete patency after treatment (n = 1), inadvertent compression of the stent (n = 1), or tissue ingrowth through the stent (n = 2). The median continence score after stent placement was 10 of 10 (range 3–10) with 6 dogs being continent, 3 mildly incontinent, and 1 each moderately and severely incontinent. All owners considered their dog to have an excellent long‐term clinical outcome with long‐term urethral patency. The median follow‐up time was 24 months (range 4–48).Conclusions and Clinical Importance
Urethral stents appear to be an effective treatment for benign urinary obstructions. Moderate to severe incontinence developed in a minority (12.5%) of dogs. Stents relieved obstructions in all dogs with an excellent long‐term outcome. 相似文献2.
A 4-month-old intact male domestic shorthair cat was evaluated for urinary outflow obstruction after several weeks of medical management for traumatic urethral rupture. Positive-contrast retrograde urethrography and anterograde cystoscopy performed 4 weeks after the initial urethral injury confirmed a stricture approximately 1cm distal to the bladder trigone at the site of the initial urethral tear. A self-expanding metallic urethral stent (SEMS) was placed under fluoroscopic guidance to relieve the urethral stricture and re-establish luminal patency. After stent placement, the cat was able to void urine normally with minimal urinary incontinence noted. This resolved several months post-stent placement. No known clinical complications persisted other than mild intermittent hematuria. 相似文献
3.
Libermann SV Doran IC Bille CR Bomassi EG Rattez EP 《The Journal of small animal practice》2011,52(4):190-194
Objectives : To describe a minimally invasive technique for treating urethral obstructions in male dogs and to review the postoperative results. Methods : All dogs (n=9) had urethral obstruction due to calculi. Obstructions were verified by radiographic and ultrasonographic examinations. Dogs with impaired kidney function were not included in the study. A 5‐mm diameter trocar and cannula were placed in the ventral midline, 2 cm cranial to the umbilicus, allowing placement of a 10‐mm diameter cannula under visual guidance, adjacent to the apex of the bladder. The bladder was then partially exteriorised and sutured to the skin. A 5‐mm diameter cystoscopy sheath was introduced into the bladder lumen and advanced into the urethra. Continuous retrograde flushing was used to dislodge the calculi from the site of obstruction and collect them upstream. Results : The nine dogs were followed up for a minimum of 6 months. No major postoperative complications were identified. One dog exhibited transient macroscopic haematuria (for 3 weeks postoperatively). All urethral calculi were removed in the nine dogs. No recurrence was found during the follow‐up period. Clinical Significance : A minimally invasive approach is used to treat urethral obstructions resulting from calculi in the male dogs. 相似文献
4.
Audrey K Cook Kelley Thieman Mankin Ashley B Saunders Carly E Waugh Laura C Cuddy Gary W Ellison 《Irish veterinary journal》2013,66(1):8
Treatment options for dogs with nasopharyngeal stenosis include fluoroscopic placement of metallic stents. Reported complications include entrapment of hair and food, obstruction and persistent nasal discharge. Two toy breed dogs were examined for persistent nasal discharge and halitosis at 4 and 20 months after placement of permanent metallic stents for acquired nasopharyngeal stenosis. Full thickness defects were found in the palate of both dogs, with extensive communication between the mouth and the nasal passages. Portions of the metal stent were observed within the lesion in both patients. Additional treatment was declined by the owner of one dog; the stent was removed through the fistula in the other dog. Palatal erosion with secondary oronasal fistulation is a potential complication of nasopharyngeal stent placement in dogs. 相似文献
5.
Four dogs presented for evaluation and treatment of severe pulmonic valve stenosis and underwent stenting of the pulmonic valve annulus using bare-metal balloon-expandable stents. All dogs survived the procedure with immediate reduction of the transpulmonary valve pressure gradient and increase in activity levels. One dog had a stent fracture and migration 1 month after the intervention. This dog underwent a second procedure, in which multiple stents were used to alleviate the obstruction. The stents that were placed at the level of the right ventricular outflow tract fractured within 1 month of the procedure, and the patient died when a third (surgical) approach was attempted. The other three dogs remain alive 54, 42, and 29 months after the procedure. Stent angioplasty may be a viable option for dogs with valvular pulmonic stenosis in which routine balloon valvuloplasty does not provide a successful outcome. Aggressive attempts to diminish RVOT dynamic obstruction with high-dose beta blockade and avoiding deployment of the stent within the RVOT are recommended to prevent stent fracture and migration. 相似文献
6.
The mucosal margin of the urethra is best assessed by positive contrast urethrography, but ultrasonography offers complementary information such as urethral wall thickness and size of medial iliac lymph nodes. Ultrasonography of the urethra is quick, noninvasive and does not require sedation or general anesthesia. In patients with complete urethral obstruction, ultrasonography may be the only way to image the urethra. Twelve dogs which were presented to Tufts University School of Veterinary Medicine with clinical signs referable to the urinary bladder, urethra or vagina were examined ultrasonographically. Seven were neutered females and five were neutered males. Each dog had a hyperechoic, nonshadowing line at the epithelial surface of the proximal urethra. In the seven female patients and one of the males, the urethral wall was also thick and hypoechoic to surrounding tissue. In the other males, the urethral epithelial changes were at the level of the prostate, and the limits of the urethra were not visible. In six dogs, the urethral change was the only abnormality seen, while in six, bladder wall, bladder luminal and/or prostatic parenchymal changes were also detected. Three patients had hydronephrosis, and one had enlarged medial iliac lyumph nodes. Biopsies were obtained via suction with urinary catheterization (n = 6), exploratory celiotomy (n = 3), urethroscopy (n = 2), or at post-mortem (n = 1). A histopathologic diagnosis of urethral transitional cell carcinoma was obtained in ten dogs. The ultrasonographic appearance was not pathognomonic for transitional cell carcinoma, as one dog with transitional cell dysplasia and one dog with severe ulcerative and necrosupperative cystitis and urethral stricture had similar findings. 相似文献
7.
OBJECTIVE: To evaluate long-term outcome following nitinol stent placement in dogs with tracheal collapse. DESIGN: Retrospective case series. ANIMALS: 12 client-owned dogs with endoscopically diagnosed tracheal collapse refractory to medical management. PROCEDURES: Medical records were reviewed for 12 dogs in which 1 or more self-expanding nitinol stents were placed for the treatment of endoscopically diagnosed tracheal collapse. A total of 17 stents were placed. RESULTS: Survival times after stent placement ranged from 1 to 48 months. Three of 12 dogs died within 6 months after stent placement. Nine dogs survived > 1 year after stent placement, and 7 dogs survived > 2 years. Of the deceased dogs, 5 of 9 succumbed to tracheal disease. Other causes of death included congestive heart failure, cerebral neoplasia, cerebrovascular accident, and renal failure. Material failure (stent fracture) was a common complication (5/12 dogs). Other complications reported included excessive granulation tissue within the stent lumen, tracheitis, and pneumonia. CONCLUSIONS AND CLINICAL RELEVANCE: Placement of an intraluminal stent with self-expanding nitinol stents was a successful palliative treatment for tracheal collapse in dogs that did not respond to medical management. Disease progression is inevitable, but substantial improvement in respiratory function may be achieved for a period of months to years. 相似文献
8.
Hume DZ Solomon JA Weisse CW 《Journal of the American Veterinary Medical Association》2006,228(3):392-396
CASE DESCRIPTION-Two adult male castrated cats were evaluated because of a history of constipation, tenesmus, or intermittent vomiting. CLINICAL FINDINGS-Radiography and ultrasonography revealed luminal narrowing in the colon of 1 cat and a colonic mass in the other. A histopathologic diagnosis of colonic adenocarcinoma was made in both cats. TREATMENT AND OUTCOME-Under fluoroscopic guidance, a self-expanding metallic stent was advanced over a wire and across the area of colonic stenosis and deployed. One cat had progressive weight loss but maintained a normal appetite, energy, and a high quality of life. Fecal continence was maintained, and tenesmus was rarely observed. The cat was euthanized because of tumor metastasis 274 days after the colonic stent was placed. The other cat retained fecal continence, and the owners reported subjective improvement in the severity of tenesmus, compared with that prior to stent placement. The cat was euthanized 19 days after stent placement because of perceived decreased quality of life. CLINICAL RELEVANCE-The use of self-expanding metallic stents for alleviation of colonic obstruction secondary to adenocarcinoma in cats appears to be effective. This technique provides a simple, quick, nonsurgical option for palliation in cats with advanced metastatic or systemic disease in which surgical resection may not be possible or warranted. 相似文献
9.
Mayhew PD Richardson RW Mehler SJ Holt DE Weisse CW 《Journal of the American Veterinary Medical Association》2006,228(8):1209-1214
OBJECTIVE: To determine clinicopathologic features, surgical management, complications, and long-term outcome associated with diseases of the extrahepatic portion of the biliary tract treated via choledochal stent placement in dogs. DESIGN: Retrospective case series. ANIMALS: 13 dogs. PROCEDURE: Data were obtained from medical records, and follow-up information was obtained via reexamination or telephone interview with owners or referring veterinarians. RESULTS: 10 dogs had extrahepatic biliary obstruction (EHBO), 6 as a result of pancreatitis. Two dogs had rupture of the common bile duct associated with cholelithiasis. In 1 dog, a stent was placed prophylactically after gastroduodenostomy was performed for a perforated duodenal ulcer. Nine of 13 dogs survived the perioperative period and were discharged. No recurrence of EHBO or other complications developed in the discharged dogs while the stents were in place. Median follow-up period from surgery to last owner contact was 13.3 months. In 1 dog, the stent was removed endoscopically 10 months after surgery and EHBO recurred 9 months after stent removal because of cholangitis. In 4 of 5 dogs that were discharged from the hospital, in which the fate of the stent could be confirmed and the stent was secured to the duodenal wall with absorbable suture materials, the stents were passed in the feces 1 to 11 months after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Choledochal tube stenting is an effective method of decompression of the extrahepatic portion of the biliary tract in dogs and provides a less complex alternative to traditional cholecystoenterostomy techniques in select cases. 相似文献
10.
Lane IF Fischer JR Miller E Grauer GF Lappin MR 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2000,14(1):43-49
Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed. 相似文献
11.
J. D. FOWLER DVM MVSC D. L. HOLMBERG DVM MVSC DipiomateACVS 《Veterinary surgery : VS》1987,16(2):139-145
Reconstruction of the proximal urethra using a distally based tube flap mobilized from the ventral bladder wall was performed on 12 clinically normal dogs after total prostatectomy and resection of 2 cm of membranous urethra. One dog was euthanized at 6 hours and one at 36 hours after surgery because of surgical complications. Five dogs were euthanized at 10 days, two dogs at 6 weeks and three dogs at 12 weeks. Advancement of the tube flap allowed for tension-free anastomosis to the membranous urethra. Vascular integrity was maintained in all flaps. Intermittent to continuous postoperative urinary incontinence occurred in 7 of 10 dogs. The incontinence was transient in all 6 and 12 week dogs except one in which a persistent stress incontinence developed. Mild to severe dysuria was noted in 8 of 10 dogs, but was also transient in all of the 6 and 12 week dogs, with the exception of one dog. Postoperative urethral closure pressure profilometry revealed decreased tone in the membranous urethra in all 6 and 12 week dogs. It was concluded that proximal urethral reconstruction, using a ventral bladder tube flap, is a viable technique that may permit functional urodynamic recovery in dogs with significant proximal urethral loss. 相似文献
12.
Repair of urethral defects using fascia lata autografts in dogs 总被引：10，自引：0，他引：10
OBJECTIVE: To evaluate the feasibility of urethroplasty using a free fascia lata (FL) graft in the dog. STUDY DESIGN: In vivo experimental study. ANIMALS: Mixed-breed dogs (n=14). METHODS: Half of the circumference of the urethra, approximately 1.5 cm long, was excised in 14 male dogs to induce a urethral defect. FL (approximately 2 cm x 2 cm) harvested from the lateral thigh was sutured to the urethra using a 3-0 polyglactin 910 continuous pattern. Dogs were monitored daily for bladder distention and had urethral catheters until normal voiding was observed. On day 60, each dog had a positive contrast urethrogram, and then 8 dogs were euthanatized for gross and histologic examination. Six dogs were monitored for urologic problems for 6 months, and a positive contrast urethrogram was repeated. RESULTS: All dogs recovered successfully; 4 dogs had difficulty voiding for 2-3 days and urine was aspirated from these dogs every 3 hours until signs of painful urination disappeared. On positive contrast urethrograms, urethral anatomy was considered normal except in 4 dogs that had an irregular contour. Gross urethral examination confirmed an absence of ulceration, stricture, diverticula, or fistula formation, and the FL-lined graft survived in all dogs. No degenerative and reparative responses were observed. On histologic examination of the penile urethra, the lumen was intact, covered with transitional epithelium, and surrounded by corpus spongiosum with cavernous spaces and blood-filled vessels. CONCLUSIONS: Free FL grafts are incorporated satisfactorily and would appear to be useful for repairing urethral defects. CLINICAL RELEVANCE: FL grafts should be considered for repair of urethral defects in dogs. 相似文献
13.
Objective— To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life-threatening urinary tract obstruction.
Study Design— Clinical case reports.
Animals— Dogs (n=2) with bladder tumors.
Methods— Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.
Results— Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.
Conclusion— En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.
Clinical Relevance— In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion. 相似文献
Study Design— Clinical case reports.
Animals— Dogs (n=2) with bladder tumors.
Methods— Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.
Results— Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.
Conclusion— En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.
Clinical Relevance— In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion. 相似文献
14.
15.
Adams LG Berent AC Moore GE Bagley DH 《Journal of the American Veterinary Medical Association》2008,232(11):1680-1687
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. 相似文献
16.
Akiko Uemura Yusuke Ozai Lina Hamabe Tomohiko Yoshida Ryou Tanaka 《Journal of veterinary science (Suw?n-si, Korea)》2022,23(3)
BackgroundStenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs.ObjectivesTo evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs.MethodsThe medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically.ResultsTwenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs.ConclusionsCompared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse. 相似文献
17.
Iatrogenic proximal urethral obstruction after inadvertent prostatectomy during bilateral perineal herniorrhaphy in a dog 
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下载免费PDF全文 Sereda C Fowler D Shmon C 《The Canadian veterinary journal. La revue veterinaire canadienne》2002,43(4):288-290
Proximal urethral obstruction was diagnosed 2 days after bilateral perineal herniorrhaphy in a 12-year-old male Pomeranian-cross dog. The obstruction was caused by ligation of the proximal urethra during resection of a presumed paraprostatic cyst. Surgical repair involved reconstruction of the urethra and bladder wall, but urinary incontinence persisted. 相似文献
18.
OBJECTIVE: To describe the use of intraluminal tracheal stenting in 3 cats with either benign or malignant tracheal obstruction. STUDY DESIGN: Retrospective clinical study. ANIMALS: Three client-owned cats. METHODS: Medical records were reviewed and information regarding signalment, clinical signs, physical examination findings, diagnostic tests performed, treatment, outcome and follow-up were retrieved. Intraluminal tracheal stent placement was performed as previously described in the literature. RESULTS: Three cats received intraluminal tracheal stents for the treatment of tracheal obstruction due to 3 different underlying causes: stricture secondary to traumatic endotracheal intubation, stricture secondary to a previous tracheotomy, and neoplasia. Self-expanding metallic stents of varying sizes were placed, and all cats recovered uneventfully from the procedures. The cat with tracheal neoplasia was euthanized because of pulmonary metastatic disease 6 weeks post-stent placement. The two cats with tracheal obstructions secondary to benign strictures are currently 39 months and 32 weeks post-stent placement, respectively. No complications were noted during the post-stent period in any of the 3 cats. CONCLUSIONS: Intraluminal tracheal stenting was easily, safely, and rapidly performed without complications and resulted in immediate improvement in clinical signs in all three cases. None of the cats in this study developed significant stent-associated complications during the study period. CLINICAL RELEVANCE: Intraluminal tracheal stenting has the potential to be a viable option for the treatment of tracheal obstruction in cats and perhaps for similar disease processes in other veterinary patients. 相似文献
19.
Objective : To report clinical findings and outcome in dogs and cats undergoing choledochotomy or primary repair of extrahepatic biliary duct rupture. Methods : Retrospective study of dogs (n=7) and cats (n=2) that had choledochotomy or primary bile duct repair. Results : Extrahepatic biliary obstruction was confirmed at surgery in all cases. The underlying cause in four dogs and both cats was choledocholithiasis, two dogs had gall bladder mucocoeles with associated bile duct rupture, and one dog had inspissated bile obstructing the bile duct secondary to gall bladder carcinoid tumour. Three dogs and both cats had choledochotomies performed to relieve extrahepatic biliary obstruction, and four dogs with bile duct rupture underwent primary repair of the defect. One dog with a bile duct rupture was re‐explored four days postoperatively and had suffered dehiscence of the repair; this rupture was re‐repaired. All animals were discharged from the hospital, and did not have clinical recurrence of extrahepatic biliary obstruction. Clinical Significance : Choledochotomy and primary repair of extrahepatic biliary duct rupture were associated with low perioperative morbidity and no mortality in this small cohort of cases. These techniques are reasonable options either alone or in conjunction with other procedures when bile duct patency cannot be re‐established by catheterisation or bile duct discontinuity exists. 相似文献
20.
Congenital urethral sphincter mechanism incompetence is a cause of urinary incontinence in female dogs and cats. In some of these animals, urethra hypoplasia is the primary diagnosis, with the urethra being almost absent in some patients. Treatment of this problem can be difficult. This paper describes two techniques for the surgical treatment of eight cats and one dog with severe urethral hypoplasia. In five animals, partial excision of the bladder neck was performed to create a longer "urethra." In the other four, an attempt was made to conserve bladder volume while simultaneously creating a urethra with a bladder neck flap reconstruction technique. One cat was lost to follow-up, but the clinical signs resolved in three cats and the remaining animals improved. Two cats had recurring cystitis, possibly associated with bladder neck diverticula because of uterine horn remnants terminating abnormally in the bladder. The results in this limited series suggest that reconstructive surgery in cases of severe urethral hypoplasia improves continence control. 相似文献