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1.
Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse A 4-year-old Quarter Horse mare was evaluated because of recurrent esophageal obstruction. Endoscopic examination revealed a proliferative mass in the esophagus approximately 55 cm aborad to the nares. Histologic examination of biopsy specimens revealed diffuse suppurative esophagitis and granulation tissue with no evidence of neoplasia. The mass was excisedand ablated transendoscopically with a neodymium:yttrium-aluminum-garnet laser. During a follow-up examination 2 weeks after the final laser procedure, the mass was no longer apparent, and the esophagus appeared healed. Six months after the final examination, there had been no recurrence of the mass. In this horse, transendoscopic laser excision was efficacious and avoided problems associated with an esophagotomy.  相似文献   

2.
The bladder of a 750-kg Clydesdale mare had everted through the urethra into the vagina immediately after parturition. The bladder was reinverted into the peritoneal cavity by an attending veterinarian, but 4 days later, the bladder was everted again in the vagina. The mare was able to void urine through both ureters, which could be seen in the mucosal surface of the bladder. The everted bladder had become edematous and could not be reinverted through the urethra. A considerable portion of the fundus was necrotic. The mare was administered xylazine epidurally to induce perineal analgesia, and the necrotic portion of the bladder was resected and healthy bladder tissue was opposed with a double layer of simple continuous sutures. The urethral sphincter was longitudinally incised through the vaginal mucosa to allow reinversion of the bladder through the urethra. A purse-string suture inserted in the urethral opening decreased the urethral diameter and prevented recurrence of the condition. An inflated Foley catheter was maintained in the bladder for 5 days. The mare recovered normal urination after the catheter was removed.  相似文献   

3.
A 9-year-old intact male cat was presented for vomiting and straining to defecate. A large abdominal mass was palpated. The urinary bladder was full and non-expressible. Exploratory laparotomy revealed that the mass was compressing the colon and encircling the urethra caudal to the bladder. The mass was removed, the urethra transected, and the urinary bladder marsupialized to the ventral abdominal wall to allow urine drainage. Histopathologic examination of the mass revealed a prostatic carcinoma. The cat died approximately 6 weeks after removal of the mass. This is the first reported case of a prostatic carcinoma causing urethral obstruction and obstipation in a cat.  相似文献   

4.
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   

5.
A 6 year old Haflinger gelding was presented to the reporting clinics with a history of chronic dysuria. A large cystic calculus (12 x 9 x 9 cm) was diagnosed cystoscopically. Lithotripsy was carried out endoscopically in the standing, sedated patient with a Holmium:YAG surgical laser (2100 nm, 0.5-3.5 J/pulse, 3-60 pulses/sec.). The endoscope was inserted into the bladder via perineal urethrostomy. Fragmentation of the urolith was carried out with a laser fiber (core diameter 600 microns) in contact mode. Healing proceeded uneventfully. On follow up examination 8 weeks post surgery, no signs of recurrence, cystitis or strictures of the urethra were present.  相似文献   

6.
OBJECTIVE: To explore the use of urethral endoscopy and laser lithotripsy in the diagnosis and management of urolithiasis in goats and pot-bellied pigs. DESIGN: Prospective clinical study. ANIMALS: 16 male goats and 6 male pot-bellied pigs with dysuria. PROCEDURE: Abdominal ultrasonography and urethral endoscopy were performed on all 22 animals. Endoscopic-guided holmium:yttrium-aluminum-garnet laser lithotripsy was performed in 3 goats and 2 pot-bellied pigs. RESULTS: Urolithiasis was identified in 15 goats and 5 pot-bellied pigs. Primary urinary bladder paralysis and cystitis were identified in the remaining pot-bellied pig and goat. Mean bladder diameters of obstructed small- and large-breed goats were 7 and 9.5 cm, respectively. The mean bladder diameter of obstructed pot-bellied pigs was 9.5 cm. Five of 20 animals with obstructive urolithiasis had severe urethral necrosis or stricture formation at the time of urethroscopy. All of these animals were euthanatized within 6 months because of persistent dysuria. When used, laser lithotripsy successfully fractured the distally located obstructing stones in the 3 goats and 2 pot-bellied pigs. CONCLUSIONS AND CLINICAL RELEVANCE: Urethral endoscopy is useful for evaluating urethral patency in goats and pot-bellied pigs. Examination of the urethral mucosa following relief of urethral obstructions aids in the assessment of the long-term prognosis for urethral stricture. Urethral endoscopy also expands the therapeutic options for management of urolithiasis by providing a route for conducting laser lithotripsy. Laser lithotripsy proved to be safe and effective for clearing distally located calculi refractory to removal by traditional urethral flushing. Lithotripsy application is restricted to calculi lodged in the urethra.  相似文献   

7.
The incidence of hypospadias is increasing in man, but the condition is rarely reported in horses. There are few available data regarding the surgical management of this disorder in horses, with no previous published report of urethral reconstructive surgery and only two reports documenting phallectomy procedures. This case report documents hypospadias repair, not previously reported in the horse, in a Thoroughbred foal with proximal hypospadias. The indication for surgery was contact dermatitis of the hind leg, which was impairing the foal's ambulation and had the potential to impair the foal's racing ability. Preoperative examination revealed a proximal hypospadias with a wide urethral plate. The anus was normal. The foal was otherwise thriving. A single stage urethroplasty was performed, during which the urethral plate was tubularised in two layers and the urethral meatus was successfully relocated distally to open upon the glans. The urethroplasty was covered with dartos fascia and the penile shaft skin and prepuce were reconstructed. Minor superficial dehiscence of the wound was successfully managed conservatively. Post‐operatively, urine was voided through the opening created on the glans penis, resolving the contact dermatitis. Follow‐up after 3 years confirmed that the horse continues to void through the re‐sited meatus without complication and had gone on to race successfully. In conclusion, we present the first report of reconstructive urethroplasty for the treatment of a horse for proximal hypospadias with good functionality and long‐term outcome.  相似文献   

8.
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   

9.
CASE DESCRIPTION: A 1-day-old Standardbred foal with a history of extreme respiratory distress after birth consistent with upper airway obstruction was evaluated. A temporary tracheostomy tube was placed by the referring veterinarian. CLINICAL FINDINGS: On initial examination, there was evidence of hypoxic-ischemic syndrome, secondary to perinatal asphyxia. Endoscopy revealed obstruction of both nares at the level of the choanae; a diagnosis of bilateral choanal atresia was made. TREATMENT AND OUTCOME: The foal was anesthetized and underwent transendoscopic laser fenestration of the buccopharyngeal membranes. Three weeks after surgery, cicatricial narrowing of the choanae was apparent and further transendoscopic ablation was performed. Recurrent stenosis necessitated revision surgeries involving a combination of laser ablation with topical administration of mitomycin and, subsequently, a combination of radial incisions into the stenotic tissue and repeated bougienage with a cuffed endotracheal tube. The degree of stenosis decreased, and at 1 year of age, the horse was an appropriate size for its age, had choanae that were almost maximally open (> 85%), and had entered training. Mild stenosis was still evident when the horse was reexamined the following year, although there was no evidence of exercise intolerance or respiratory compromise. CLINICAL RELEVANCE: Bilateral choanal atresia in a foal can be successfully treated via transendoscopic fenestration of the buccopharyngeal membranes, enabling the horse to subsequently participate in athletic activities. Secondary problems resulting from initial asphyxia and recurrent stenosis at the surgical site can be overcome but may require prolonged and extensive treatment.  相似文献   

10.
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11.
A 4-year-old Paint mare was examined because of respiratory tract infection, dermatitis, and weight loss of 2 months' duration. Initial examination revealed generalized pruritic dermatitis, ocular and nasal discharges, and stranguria. Laboratory abnormalities included leukopenia and hypoalbuminemia. Further examination of the respiratory tract revealed grade III of IV pharyngitis and pyogranulomatous pneumonia. Endoscopic examination of the bladder revealed a prolific mass at the junction of the bladder and urethra. Hypoproteinemia was suspected to be caused by protein-losing enteropathy. On histologic examination, skin, rectal, pharyngeal, and urethral biopsy specimens were characterized by infiltration of eosinophils and lymphocytes, and a diagnosis of multisystemic eosinophilic epitheliotropic disease was made. The horse improved following treatment with dexamethasone, trimethoprim-sulfamethoxazole, and an antihistamine and was discharged after 19 days of hospitalization. Treatment with dexamethasone was continued for 4 weeks after hospitalization but was then discontinued. Eight months after discharge, the horse was performing as a pleasure horse and did not require any medical treatment. Multisystemic eosinophilic epitheliotropic disease is typically associated with a poor prognosis in horses. The dermatitis, protein-losing enteropathy, and lower respiratory tract disease in this horse were consistent with previous reports; however, pharyngitis and urethritis have not, to our knowledge, been previously reported in horses with this disease.  相似文献   

12.
This case report records an obstructive urolithiasis due to a large calcium carbonate urethral stone in an 11-year-old Arabian stallion. The stallion had colicky pain, anuria, and reduction in food and water intakes. Palpation of the penis revealed rhythmic contractions of the urethra, a hard mass in the penile urethra at the level of the ischial arch, and a dilated urethra proximal to the mass. Rectal examination revealed a distended and turgid urinary bladder. Passing a urethral catheter revealed a complete urethral obstruction at the level of the ischial arch. Ultrasonography revealed a calculus that appeared as an irregular, hyperechoic arch-like thick line with acoustic shadowing. Subischial urethrotomy was conducted under epidural anesthesia. Uneventful recovery was seen with no recurrence or complications for 12 months of available follow-up. In conclusion, clinical, rectal, and ultrasound examinations are valuable for definite diagnosis of urethral calculi in horses and the subischial urethrotomy appears to be successful in correcting this condition in horses.  相似文献   

13.
OBJECTIVE: To characterize urodynamic function and anatomy before and after colposuspension in anesthetized female Beagles. ANIMALS: 12 adult female Beagles. PROCEDURE; During general anesthesia (thiopental sodium induction and halothane maintenance), urethral pressure profiles, leak point pressure measurements with a 50-ml bladder volume, positive contrast cystograms, and retrograde vaginourethrocystograms were performed. A caudal midline laparotomy was used to perform colposuspension. Urodynamic and radiographic studies were repeated after surgery. RESULTS: Leak point pressures were increased (120 to 168.9 cm H2O), and maximum urethral closure pressures decreased (43.7 to 19.3 cm H2O ) after colposuspension. The urethra and bladder were moved cranially; the external urethral orifice was positioned closer to the pelvic cavity, and the neck of the bladder was positioned more cranially into the abdomen. Length of the urethra, as measured by use of vaginourethrocystograms, was increased by 3%. As measured by use of urethral pressure profiles, total profile length was increased by 19.9%, and functional profile length was increased by 19.2%. CONCLUSIONS AND CLINICAL RELEVANCE: Increased leak-point pressure correlated with the expected clinical improvement attributable to colposuspension. Increased exposure of the urethra to abdominal and pelvic cavity pressures may be the mechanism by which incontinent dogs become continent after colposuspension. Results of the leak-point pressure test may correlate with clinical behavior before and after colposuspension for treatment of incontinence.  相似文献   

14.
The cause of haematuria often can be surmised based on a horse's signalment, recent history, and clinical signs that may accompany haematuria. The site, if not the cause, of haemorrhage can sometimes be revealed by examining that portion of the urinary tract palpable per rectum, by endoscopically examining the urethra and bladder, or by ultrasonographically examining the kidneys. When cystolithiasis or urethrolithiasis is determined to be the cause of haematuria, further examination is indicated to identify disease of one or both kidneys that might have precipitated formation of the urolith. Contrast-enhanced, cross-sectional imaging of the abdomen of small equids might be of value when a vascular anomaly of a kidney is suspected. Neoplastic cells can sometimes be found in the urine of horses suffering from neoplasia of the bladder or in peritoneal fluid of horses suffering from renal neoplasia. When a kidney is determined to be the source of haemorrhage, urine can be obtained for bacterial culture and cytological examination by passing tubing through the biopsy port of an endoscope into the ureter draining the kidney in question. Histological examination of tissue obtained by biopsy of the kidney or the mucosa of the bladder may be indicated when neoplasia of one of these organs is suspected. Immunohistochemical examination of endoscopically obtained tissue from a cystic carcinoma can identify whether the neoplastic cells express COX-2 receptors, thereby determining if treating the horse with a COX-2 selective NSAID might be effective.  相似文献   

15.

Background

In male cattle, rupture of the urinary bladder is usually associated with urethral obstruction by uroliths. Less common causes include urethral compression or stricture. This case report describes the findings in a young Limousion breeding bull with rupture of the urinary bladder because of urethral compression by a haematoma after coccygeal fracture.

Case presentation

The bull had been introduced into a 40-head Red-Holstein herd one week before being injured. One week after introduction to the herd, the bull had an acute onset of anorexia and he was referred to the clinic. There was marked abdominal distension, reduced skin turgor and enophthalmus. The serum concentration of urea and creatinine was increased. Ultrasonographic examination revealed severe ascites and abdominocentesis yielded clear yellow fluid with high urea and creatinine concentrations, which supported a diagnosis of uroperitoneum. The bull was euthanatized because of a poor prognosis. Postmortem examination revealed a comminuted fracture of the first two coccygeal vertebrae associated with a massive haematoma that obstructed entire pelvic cavity. The haematoma compressed the urethra thereby preventing outflow of urine, which resulted in a 5-cm tear ventrally at the neck of the bladder. It was assumed that the newly-introduced bull had sustained the vertebral fractures when he was mounted by a cow.

Conclusions

The present case study serves to expand the differential diagnosis of urinary bladder rupture. Therefore, in addition to obstructive urolithiasis, compression and stricture of the urethra might be considered in male cattle with uroperitoneum.  相似文献   

16.
As it was urinating, a six-month-old Swiss braunvieh heifer produced a second stream of urine from a fistula that opened on the ventrolateral margin of the left vulval lip. A catheter was introduced into this opening and passed easily into the bladder. Urethrography showed that the fistula joined the urethra in the mid-pelvic region and that a single canal originated from the bladder. Endoscopy confirmed this finding and also revealed a duplication of the vaginal portion of the cervix, a division of the cranial vagina by a septum and a fibrous band in the region of the hymenal ring. Cytogenetic examination revealed reciprocal translocation between chromosomes 20q23 and 22q23. A diagnosis of urethra duplex, duplication of the vaginal portion of the cervix and reciprocal autosomal translocation between chromosomes 20 and 22 was made on the basis of these findings.  相似文献   

17.
A cystic calculus approximately 6 cm in diameter was diagnosed by ultrasonography and endoscopy in a 12‐year‐old Trakehner gelding with a history of haematuria and dysuria. Transurethral endoscopic lithotripsy with electrohydraulic shock waves was performed as a minimally invasive treatment option. Fragmentation of the calculus was achieved, the fragments of the calculus left in the bladder and excretion assisted by infusion of Ringer's solution. Twenty‐four hours after the third lithotripsy, the horse suffered a recurrence of dysuria and pollakiuria due to partial obstruction of the urethra by the calculus fragments. The treatment was repeated within the urethra until clearance of the fragments was achieved. The sharp fragments had produced a zone of urethral mucosal trauma, approximately 10 cm in length. At the follow‐up visit 4 weeks later, the patient had developed inflammation and swelling of the urethral mucosa, which was successfully treated with a 14 day course of anti‐inflammatory drugs. This resulted in normal urination. At the last follow‐up, the horse had been recurrence‐free for 12 months.  相似文献   

18.
为了探索犬前列腺摘除术的不同通路及其关键技术,选择3～5月龄、3～5 kg体重的4只杂交犬,分成1、2组,分别采用翻开耻骨片和经腹底部正中切口牵拉膀胱以暴露前列腺的手术通路,对前列腺进行完整摘除后作尿道断端吻合,术后观察犬的精神、食欲、饮欲、排便、排尿等情况,并于术后第3周进行剖检,观察膀胱及尿道断端的愈合情况。结果显示,采用上述2种手术通路进行前列腺摘除后,试验犬的精神、食欲、饮欲、排便、排尿等一切正常,膀胱有少量出血点,尿道吻合处愈合良好。试验结果表明,采用6-0单丝尼龙线和结节缝合法是吻合尿道断端的可靠方法,而使用盆腔脂肪组织覆盖尿道吻合处能够有效地预防吻合处漏尿且与周围组织黏连,是保证吻合处良好愈合的有利因素。  相似文献   

19.
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   

20.
A 7-week-old Appaloosa filly was admitted for persistent urinary incontinence since birth. Vaginal speculum examination revealed urine flowing from an opening in the right vaginal wall. Cystoscopy demonstrated that the ureters did not terminate at the bladder. The endoscope passed easily from the vagina directly into a dilated right ureter. An excretory urogram confirmed the vaginal termination of at least one ureter, based upon extensive filling of the vagina with contrast media in the absence of bladder filling. Bilateral hydroureter and dilated renal pelves were demonstrated both by excretory urography and by ultrasonography. Euthanasia was requested by the owner in lieu of attempted surgical correction. At necropsy, it was confirmed that the right ureter entered the vagina and the left ureter terminated at the urethra. The diagnosis of bilateral ectopic ureter in this foal was suggested by the history and clinical signs, supported by endoscopy and ultrasonography, and confirmed by excretory urography and necropsy. This case establishes the value of diagnostic imaging techniques in the antemortem diagnosis of ectopic ureter.  相似文献   

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