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1.
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   

2.
CASE DESCRIPTION-4 dogs were evaluated because of recurrent urinary tract infections. CLINICAL FINDINGS-All dogs had recurrent urinary tract infections and similar clinical signs; 3 dogs had urinary incontinence. Digital vaginal examination revealed vestibulovaginal stenosis in all dogs, which was confirmed by results of contrast vaginourethrography. From image measurements, the vestibulovaginal ratio (ratio of the height of the vestibulovaginal junction to the maximum height of the vagina on a lateral vaginourethrogram) was calculated for each dog. Three dogs had severe stenosis (vestibulovaginal ratio, < 0.20; severe stenosis is defined as a vestibulovaginal ratio < 0.20), whereas the fourth dog had moderate stenosis (vestibulovaginal ratio, 0.24; ratio range for moderate stenosis is 0.20 to 0.25). TREATMENT AND OUTCOME-All dogs were anesthetized for surgical correction of the vestibulovaginal stenosis. Vaginal resection and anastomosis of the stenosis was performed in all 4 dogs, with 1 dog also undergoing episioplasty. Complete resolution of clinical signs was apparent in 3 dogs; 1 dog had postoperative complications including pollakiuria and stranguria, which resulted in rectal and vaginal prolapse. This dog underwent ovariohysterectomy, after which clinical signs resolved. All dogs had resolution of urinary tract infections at the time of follow-up (6 to 8 months after surgery). CLINICAL RELEVANCE-Resection and anastomosis may resolve recurrent urinary tract infections in dogs with severe or moderate vestibulovaginal stenosis. Episiotomy was not necessary for success of surgical treatment, and overall, that procedure increased morbidity, the severity of intraoperative hemorrhage, and duration of surgery.  相似文献   

3.
Objectives: To evaluate the clinical efficacy of the transobturator vaginal tape inside‐out (TVT‐O) in incontinent female dogs affected with urethral sphincter mechanism incompetence (USMI) and to determine its urodynamic and morphologic effects. Study Design: Case series. Animals: Incontinent spayed female dogs (n=7). Methods: TVT‐O tape was inserted in 7 incontinent female dogs diagnosed with USMI. Urethral pressure profilometry (UPP) and vaginourethrograms were performed preoperatively, and 1 and 3 months postoperatively. Clinical efficacy of the technique was evaluated and complications reported. Follow‐up information was evaluated by a telephone questionnaire. Results: All dogs were continent immediately after the procedure. Incontinence recurred 2 months after surgery in 1 dog and was treated by phenylpropanolamine administration. At mean follow‐up time of 11.3 months, 6 of 7 dogs were continent. An iatrogenic urethral tear occurred intraoperatively in 1 dog. No postoperative complications were encountered. The postoperative UPPs showed significantly increased maximal urethral closure pressure and integrated pressure. Postoperative vaginourethrograms were unremarkable. The surgical procedure did not modify the location of the urinary bladder neck in dogs with a “pelvic urinary bladder” preoperatively. Conclusions: TVT‐O was efficient in maintaining short term continence in 6 of 7 dogs affected with USMI.  相似文献   

4.
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   

5.
An eight-year-old, male castrated German shepherd dog was presented with signs consistent with urinary obstruction. Cystoscopy and contrast radiography showed two distinct urethral masses. Penile amputation and perineal urethrostomy were performed to alleviate the clinical signs. Histopathology of the masses revealed two low-grade chondrosarcomas. At the time of writing, 18 months after surgery, the dog remained disease free.  相似文献   

6.
Four adult dogs weighing <10 kg presented for the evaluation of severe mitral valve stenosis with clinical signs. Owing to the size of the dogs, a hybrid surgical and interventional approach was utilized for balloon valvuloplasty. A left lateral thoracotomy was performed to allow direct entry through the left atrial wall. Transesophageal echocardiography was utilized for the entirety of the procedure in all dogs, and fluoroscopy was additionally used in two dogs. One dog had mild to moderate intra-operative bleeding from the left atrial wall during the procedure, but no other intra-operative complications were observed. No dogs developed a clinically relevant amount of worsened mitral regurgitation. Based on mitral leaflet mobility and transmitral flow profiles, there was perceived improvement in all four dogs. One dog died 6 h after extubation due to respiratory arrest. The remaining dogs survived to discharge and had resolution of clinical signs at home and discontinuation of heart failure medications. One dog died of an unknown cause at five months and another developed atrial fibrillation, and the owners elected to euthanize at ten months after the procedure. One dog continues to do well six months after the procedure as of the time of this writing. Hybrid balloon valvuloplasty can be a viable management option for small breed dogs with severe mitral stenosis exhibiting clinical signs, and both transesophageal echocardiography and fluoroscopy can be used intra-operatively to assist in successful procedural outcomes.  相似文献   

7.
Three intrapelvic urethral anastomosis techniques were performed on 12 mature male dogs to compare the degree of stricture. The intrapelvic urethra was transected 1 cm caudal to the prostate, and anastomosis was performed using either suturing of the urethra over an indwelling catheter, suturing of the urethra without an indwelling catheter, or apposition of the urethra without sutures over an indwelling catheter. Postoperatively, the dogs were evaluated using clinical urination patterns, biochemical tests, radiography, and pathology. Three of four suture-catheter dogs and one of four catheter-only dogs had normal urinary patterns. Stricture (25-84%) with urethral dilation or fistulas tracts was visible on retrograde, positive contrast urethrograms of 3 of 12 intact dogs 20 weeks after surgery, and on all 12 excised lower urinary tracts. Suture-catheter dogs subjectively had the least amount of stricture. All eight dogs (1 suture-catheter dog, 4 suture-only dogs, and 3 catheter-only dogs) with severe stricture (greater than 60% lumen diameter reduction) had histopathologic signs of chronic, inflammatory urinary tract disease, including four with chronic, ascending lymphocytic pyelonephritis. Hydroureter and hydronephrosis developed in two catheter-only dogs. Complete urethral transection resulted in some degree of stricture, regardless of technique used for anastomosis. Urethral anastomosis over an indwelling catheter appeared to result in a lesser degree of stricture and clinical and histopathologic derangement.  相似文献   

8.
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   

9.
An 11-year-old spayed female Labrador Retriever and a 9-year-old castrated male miniature Poodle were evaluated because of clinical signs of hyperadrenocorticism. Cortisol testing did not support a diagnosis of hypercortisolemia in either dog; however, imaging studies revealed unilateral adrenal tumors in both dogs. Serum concentrations of 17-hydroxyprogesterone, progesterone, and estradiol were high in both dogs, and androstenedione concentrations were also high in 1 dog. It is suspected that sex hormone secretion by the adrenal tumors in these dogs resulted in clinical signs of hyperadrenocorticism. Clinical signs and hormonal abnormalities resolved in the male dog after surgical resection of the tumor. There was no improvement in clinical signs after treatment with mitotane in the female dog, which died 2 months after diagnosis. Histologic evaluation confirmed the presence of adrenocortical carcinoma in both dogs.  相似文献   

10.
INTRAOPERATIVE RADIOTHERAPY OF CANINE BLADDER CANCER   总被引：2，自引：0，他引：2  
Thirteen dogs had partial surgical extirpation followed by whole bladder intraoperative radiotherapy for urinary bladder cancer. Eleven of the neoplasms were transitional cell carcinomas (five Stage T1, six stage T2); one was rhabdomyosarcoma (Stage T2), and one was leiomyosarcoma (Stage T2). Histopathologic evaluation showed that neoplasia extended to the margins of the excised tissue in at least 11 of the 13 dogs. Radiotherapy from a 137Cs teletherapy machine was applied to the surgically exteriorized bladder, with doses at the 90% isodose level varying from 2188 to 2888 cGy (10 of 13 dogs receiving 2670–2700 cGy). Sixty-one percent of the dogs were alive at 1 year, 30% at 18 months, and 15% at 2 years. From the time of initial clinical signs of bladder neoplasia, 69% of the irradiated dogs were alive at 1 year, 46% at 18 months, and 23% at 2 years (one dog is still living, at 70 months). Of the owner-reported or clinically determined posttherapy complications, there was increased frequency of urination in 46% of the dogs, urinary incontinence in 46%, cystitis in 38%, and stranguria in 15%. Either persistence or recurrence of neoplasia was found in six (46%) of the dogs and metastasis in four (30%), with two of these having both recurrence and metastasis. Qualitative assessment of the complications was not done, but owner-perceived severity of the complications, metastasis, or diagnosed persistence or recurrence of the neoplasm were the major reasons for ultimately killing most of the dogs.  相似文献   

11.
The clinical presentation and advanced size of the two calculi described in this report are both atypical and noteworthy. Both dogs were presented initially with signs of hematuria, stranguria, and perineal discomfort. Each calculus was visible on survey abdominal radiographs and was present in the region of the ischial arch. Both dogs underwent a perineal urethrotomy to retrieve the calculus. Resolution of clinical signs was obtained in one case, which was referred within 2 months of the onset of clinical signs. The second dog was medically managed for approximately 2.5 years before referral. Surgical intervention failed to restore urinary continence in this second dog. Early detection of similar cases may be important in optimizing clinical outcome following appropriate treatment.  相似文献   

12.
Syringobulbia is a pathologic condition characterized by one or more fluid‐filled cavities within the brainstem. This retrospective case series describes observations in eight dogs with syringobulbia diagnosed during MRI. All dogs were adult, small‐breed dogs with concurrent syringomyelia and neurologic deficits localized to sites rostral to the spinal cord, which cannot be explained by syringomyelia (eg, six dogs had vestibular signs). On MRI, the fluid‐filled cavities had signal intensity characteristics like cerebrospinal fluid, were in the medulla oblongata, and were solitary in each dog. Initially, the shape of the cavity was a slit in five dogs and bulbous in two dogs. Magnetic resonance imaging was repeated in five dogs (6‐55 months of age). One dog had progression of syringobulbia from slit‐like to bulbous, and four dogs had unchanged slit‐like syringobulbia. One dog developed slit‐like syringobulbia after cranioplasty. A variety of medical and surgical treatments were performed with improvement of some but not all clinical signs. One dog died following surgery due to cardiopulmonary failure and the other seven dogs were alive at least 1 year after the initial diagnosis, which was the least time of follow‐up. One surviving dog developed a unilateral hypoglossal nerve deficit 2 months after the initial diagnosis and megaesophagus 14 months later. In conclusion, detecting a fluid‐filled cavity in the medulla oblongata consistent with syringobulbia is possible in dogs undergoing MRI. The cavity is likely acquired, slit‐like or bulbous, progressive, or static, and might be associated with breed size and neurologic signs localized to the medulla oblongata.  相似文献   

13.
OBJECTIVE: To determine prevalence and radiologic and histologic appearance of vesicourachal diverticula in dogs without clinical signs of urinary tract disease. DESIGN: Original study. ANIMALS: 50 dogs between 4 months and 17 years old representing 22 breeds that had been euthanatized for unrelated reasons; none of the dogs had a history or clinical signs of urinary tract disease. PROCEDURE: Retrograde positive-contrast radiography was performed, and radiographs were examined for macroscopic diverticula. Necropsy specimens from the urinary bladder vertex were examined by means of light microscopy for diverticula and signs of inflammation. RESULTS: 17 of the 50 (34%) dogs had vesicourachal diverticula, and 1 additional dog had a urachal cyst. Fifteen of the 17 diverticula were macroscopic; surface area of the diverticulum could be measured radiographically in 13 of these dogs and ranged from 1 to 90 mm2. The remaining 2 diverticula were microscopic. Sixteen diverticula were intramural and 1 was extramural. Light microscopic signs of bladder wall inflammation could be detected in 5 dogs, 4 of which had macroscopic diverticula. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a high percentage of dogs without clinical signs of urinary tract disease may have vesicourachal [corrected] diverticula. Further studies are needed to determine the clinical relevance of vesicourethral diverticula in dogs.  相似文献   

14.
OBJECTIVE: To assess the outcome of extrahepatic portosystemic shunt (EHPSS) treatment in dogs aged 5 years and older. DESIGN: Retrospective case series. ANIMALS: 17 client-owned dogs. PROCEDURES: Medical records for dogs (> or = 5 years old) that underwent surgical attenuation of an EHPSS (1992 through 2005) were evaluated; data, including clinical signs, clinicopathologic findings, surgical procedure, and outcome, were recorded. Follow-up information was obtained via patient examination or telephone interview with veterinarians and owners. RESULTS: Dogs (5 to 9 years old [median age, 6.6 years]) had neurologic (n = 12), urinary tract (8), and gastrointestinal tract (6) EHPSS-associated clinical signs. Serum bile acids and ammonia concentrations were abnormal in all evaluated dogs. Treatment of EHPSSs included complete (n = 6 dogs) or partial (2) suture attenuation or ameroid constrictor placement (9). Two dogs died following surgery. Follow-up information (6 to 120 months) was available for 13 dogs. Deaths were attributable to heart failure (n = 1), bacterial hepatitis (2; with pyelonephritis in 1 dog), and unknown causes (3). At a median of 23 and 25 months, serum bile acids concentrations had almost normalized in 5 of 8 dogs and ammonia concentrations were within reference limits in 3 of 5 dogs, respectively; dogs with abnormal liver function test results had no associated clinical signs. Median long-term survival time was 72 months. CONCLUSIONS AND CLINICAL RELEVANCE: Attenuation of EHPSS in > or = 5-year-old dogs ameliorated signs of liver dysfunction in surviving dogs, although return of normal liver function occurred less frequently than expected.  相似文献   

15.
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   

16.
Between Jan 1, 1981, and June 30, 1985, fibromas were diagnosed in tissues removed from the urinary bladders of 51 dogs. Hematuria, the most common clinical sign, was associated with the fibromas in 47 of 50 cases. Most dogs responded well to surgical excision of the neoplasms, with rapid resolution of the hematuria followed by long periods without abnormal clinical signs. Three dogs were euthanatized because of continuing or recurrent clinical problems, which included bladder dysfunction. One dog required continuing medication with antibiotics and corticosteroids to control hematuria.  相似文献   

17.
OBJECTIVES: To document the histories, clinical findings, and management of seven puppies with laryngeal collapse occurring secondarily to brachycephalic airway syndrome. METHODS: Seven brachycephalic puppies aged between 4.5 and six months underwent surgery for management of brachycephalic airway syndrome following presentation for exercise intolerance and increased respiratory noise and effort. RESULTS: Stenotic nares of varying severity and an elongated soft palate were common to all dogs. All dogs had tracheal hypoplasia and this was severe in four dogs. Laryngeal collapse was present in all dogs. Two dogs had stage I, four dogs stage II, and one dog stage III laryngeal collapse. The dog with stage III laryngeal collapse and one dog with stage II laryngeal collapse died. There was no apparent association between the changes evident on thoracic radiographs or the degree of tracheal hypoplasia and postoperative outcome. CLINICAL SIGNIFICANCE: The development of severe secondary laryngeal changes in dogs aged six months or less supports the suggestion that immature brachycephalic dogs should undergo assessment and, if indicated, surgery as soon as any clinical signs of BAS are apparent.  相似文献   

18.
Gross and light microscopic features of transitional cell carcinomas (TCC) of the urinary tract were examined in Beagle dogs used for the study of the long-term effects of low-dose, whole-body, 60Co gamma radiation. Thirty-eight cases of TCC occurred among 990 dogs that were from 0 to 14 years of age. There was no conclusive evidence of a radiation effect. The 38 TCC were equally divided between male and female dogs, but there was a significant difference in the sex distribution of urethra-origin TCC. Eleven males had a primary urethral TCC compared to only two females. There was no significant difference between the urethra-origin and bladder-origin TCCs in the number of tumors that caused clinical signs, metastasized, or that contributed to the death of the dog. All cases of urethral TCC in male dogs occurred in the prostatic urethra. The majority of these cases were not recognized to be neoplasms at gross necropsy, but microscopic examination revealed the TCC. Our findings differ from previous reports stating that TCC occurs more frequently in female than male dogs, and they especially differ from reports claiming that urethra-origin TCC is predominantly a disease of female dogs.  相似文献   

19.
Objectives— To describe clinical signs, magnetic resonance imaging (MRI) and surgical findings using a lateral approach to the lumbosacral intervertebral foramen and to evaluate clinical outcomes in dogs with or without concurrent dorsal decompression and annulectomy.
Study Design— Retrospective study.
Animals— Dogs (n=20) with degenerative lumbosacral stenosis (DLSS).
Methods— Medical records (2002–2006) of dogs that had lumbosacral lateral foraminotomy alone or in combination with dorsal decompression were reviewed. Degree of dysfunction was assessed separately for each pelvic limb; dogs with unilateral signs were included in group A, those with bilateral signs in group B. Retrieved data were: signalment, history, neurologic status on admission, 3 days, 6 weeks, and 6 months postoperatively, duration of clinical signs, results of MRI, surgical site(s), intraoperative findings, and outcome.
Results— Based on the clinical and MRI findings unilateral foraminotomy was performed in 8 dogs, bilateral foraminotomy in 1 dog, unilateral foraminotomy with concurrent dorsal decompression in 7 dogs, and bilateral foraminotomy with concomitant dorsal decompression in 4 dogs. Surgery confirmed the presence of foraminal stenosis in all dogs, with osteophyte formation and soft tissue proliferations being the most common lesions. Outcome was good to excellent in 19 dogs and poor in 1 dog. Mean follow-up was 15.2 months (range, 6–42 months).
Conclusion— Lateral foraminotomy addresses compressive lesions within exit and middle zones of the lumbosacral foramen.
Clinical Relevance— Successful surgical management of DLSS is dependent on recognition and correction of each of the compressive lesions within the lumbosacral junction.  相似文献   

20.
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   

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