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1.
Objective – To describe a case of presumptive secondary pseudohypoaldosteronism (PHA) in a cat with urinary tract infection and chronic urethral obstruction. The obstruction was believed to have resulted from sloughed urinary bladder mucosa secondary to pressure necrosis. Case Summary – A 5‐year‐old, 4 kg, castrated male Siamese cat presented for vomiting and stranguria. Medical history included a perineal urethrostomy for urethral obstruction. Physical examination revealed a large, painful, nonexpressible urinary bladder. Point‐of‐care testing demonstrated electrolyte derangements consistent with a postrenal azotemia and metabolic acidosis. Results of urine culture was positive for bacterial growth. Diagnostic imaging revealed presence of retroperitoneal fluid, marked urinary bladder wall thickening, bilateral hydroureter, mild bilateral pyelectasia, and small nephroliths. The patient was treated for a urinary tract obstruction and infection. In the 3 weeks following initial discharge, the patient was evaluated on multiple occasions for lethargy, intermittent vomiting, inappropriate urination, and progressive polyuria and polydipsia. Although the urinary bladder was easily expressed during repeat examinations, it was persistently distended and subjectively thickened upon palpation. Repeat ultrasound of the urinary tract showed evidence of sloughed tissue in the bladder lumen, likely secondary to chronic urethral obstruction and pressure necrosis. A cystotomy was performed to remove the necrotic tissue, and a revised perineal urethrostomy was done due to a partial urethral stricture. Bladder biopsies were obtained at this time. Postoperatively, the cat was reported by the owners to be urinating normally but continued to be polyuric and polydipsic in the week following discharge. One week after surgery, the cat presented in hypovolemic shock with laboratory findings consistent with a presumptive diagnosis of secondary PHA. New or Unique Information Provided – PHA has not been reported previously in a cat. This case report suggests that aldosterone resistance should be considered in cats with consistent laboratory findings and a history of documented obstructive uropathy and urinary tract infection.  相似文献   

2.
A three-and-a-half-year-old male neutered Siamese cat presented with idiopathic feline lower urinary tract inflammation and dysuria, which appeared to be caused by stricture of the urethral meatus. Wedge meatoplasty was performed, which relieved the cat's dysuria and restored a normal urine stream. To my knowledge, this is the first report of meatoplasty as a treatment for stricture of the urethral meatus in a cat.  相似文献   

3.
OBJECTIVE: To assess the management of traumatic urethral ruptures using a systematic attempt at urethral catheterisation. METHODS: Eleven cats that had been diagnosed with a traumatic urethral rupture over a five-year period were included in this study. Rupture was assessed by positive-contrast retrograde urethrography. An attempt was made to manage these ruptures by placing an indwelling urethral catheter. RESULTS: The placement of an indwelling urethral catheter, could be performed in 10 out of 11 cats, which indicated a partial rupture. In one cat, catheterisation was not possible because of complete urethral rupture. A urethral catheter was placed into the urinary bladder via the urethra in five animals. In the other five animals, urethral catheterization required cystotomy using a modified 'inside to outside' technique. Urethral catheter removal occurred between five and 14 days after placement. Urethral healing was accomplished in all cases of catheterisation with a good outcome in eight of the 10 cats. Two cats showed clinical signs related to stricture formation during the follow-up period (seven to 72 months). Retrograde urethrography provided a definitive diagnosis of partial rupture in only six of the 10 cases of partial rupture. CLINICAL SIGNIFICANCE: Results suggested that primary alignment with the placement of a urethral catheter should be attempted for the management of traumatic urethral ruptures in cats. Gentle urethral catheterisation seems to be an effective procedure for diagnosing and dealing with partial urethral rupture in cats. Clinical stricture formation can occur, but the risk does not seem to be high. Further studies are warranted in order to define the ideal duration for maintenance of an indwelling urethral catheter in cases of traumatic partial urethral rupture.  相似文献   

4.
An 11-year-old domestic shorthair cat presented with a six-week history of regurgitation following a dental procedure. Endoscopy identified a single oesophageal stricture in the cervical oesophagus. Stricture reformation occurred following endoscopic balloon catheter dilation on two occasions. Following a third balloon dilation a biodegradable polydioxanone self-expanding stent was placed across the stricture site. Following the implantation the cat was able to eat soft canned food orally without regurgitation. Fluoroscopic examination performed four months after placement indicated that the stent was no longer present and the cervical oesophagus was able to pass boluses of canned food with no signs of obstruction.  相似文献   

5.
A 1-year-old, female spayed domestic shorthair cat was presented with a 4-week history of dysphagia and regurgitation soon after oral treatment with clindamycin. Fluoroscopic and endoscopic examinations confirmed the presence of a single cervical oesophageal stricture 4 cm caudal to the pharynx. A fluoroscopically and endoscopically guided balloon dilation was performed six times consecutively over a period of 3 weeks as reformation of the stricture appeared within 3-7 days. Feeding via percutaneous endoscopic gastrostomy-tube as long-term management of the condition was declined by the owner. A self-expanding metal oesophageal stent with the following dimension was subsequently implanted: fully open diameter 16 mm, length 30 mm. After stent implantation, the cat was fed on mashed canned food and did not show any clinical signs for 12 months. Twelve months post-implantation the cat was no longer able to eat even liquid food, became lethargic and the owner opted for euthanasia. On post-mortem examination the stent surfaces were overgrown by oesophageal mucosa by approximately 50%. Stent obstruction was detected and caused by swallowed hair which also seemed to have hampered mucosal integration in the distal part of the stent.  相似文献   

6.
The objective of this study is to evaluate the dilation of the ureter using endoureterotomy and an expanding-sheath double pigtail ureteral stent in the treatment of experimentally induced ureteral strictures in the porcine animal model. This is a new treatment in the ureteral strictures resolution in Veterinary Urology, although it is not a common affection, it usually appears as a consequence of ureteritis and in the iatrogenic female genital surgery. The experimental study is design in three phases: induction of experimental stricture, diagnosis and treatment of the stricture and follow-up. We have used 10 healthy Large White female pigs. The internal ureteral diameter was measured prior to laparoscopic ligature stricture induction using retrograde ureteropyelography (RUPG). Experimental stricture was diagnosed 4 weeks after intervention, using RUPG and ultrasound, and treated by endoureterotomy and subsequent placement of a double pigtail ureteral stent, which was removed 6 weeks later. The study finished 4 weeks later with measurement of ureteral diameters using RPUG and ultrasound evaluation. Except in one case, all ureters displayed permanent dilation of the strictured area for 10 weeks after treatment (6 weeks with ureteral stent and 4 more weeks without stent). Finally, this technique proved to be effective in cases of short-length and short-living ureteral strictures, and represents a viable alternative to conventional surgery in animals.  相似文献   

7.
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   

8.
A 14-year-old male neutered domestic shorthair cat presented with a 4-year history of urinary incontinence following prepubic urethrostomy. Physical examination confirmed peristomal dermatitis, urine scalding and constant urine leakage. Haematology, serum biochemistry and urinalysis were unremarkable. Ultrasonography revealed a non-distended urinary bladder. An artificial urethral sphincter mechanism, with subsequent incremental inflation of the cuff 6 weeks later, resulted in complete resolution of clinical signs, return to normal urinary function and excellent quality of life. The cat was still continent at 5-year follow-up. Further studies including additional cases are required to highlight effectiveness and harms of the procedure.  相似文献   

9.
A 15-year-old, male neutered cat was referred for investigation of dysuria. A retrograde urethrography was performed which showed two space-occupying masses within the lumen of the mid-to-proximal urethra. Exploratory coeliotomy revealed two urethral masses. Segmental urethrectomy was performed to resect the mass, and the lower urinary tract was reconstructed by vesico-urethral anastomosis. Histopathology showed the mass to be a transitional cell carcinoma with incomplete surgical margins. Tumour regrowth was suspected when dysuria was found approximately 318 days after surgery. Clinical signs were palliated by radiation using weekly fractions of 6 Gy for three weeks. The cat died of unknown causes 386 days postoperatively.  相似文献   

10.
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   

11.
OBJECTIVE: To evaluate use of balloon-expandable and self-expanding metallic stents in management of malignant urethral obstructions in dogs. DESIGN: Original study. ANIMALS: 12 dogs with malignant urethral obstructions. PROCEDURES: The extent and location of urethral obstructions and the diameter of adjacent unaffected luminal segments were determined by use of fluoroscopically guided wires and measuring catheters. Stents were chosen to extend approximately 1 cm proximal and distal to the obstruction. Stent diameters were chosen to be approximately 10% greater than the diameter of healthy portions of the urethra to prevent displacement. Stents were placed in the urethra under fluoroscopic guidance to restore luminal patency. RESULTS: 3 dogs received balloon-expandable metallic stents, and 9 dogs received self-expanding metallic stents. The placement procedures were rapid, safe, and effective at restoring luminal patency and were not associated with major complications. Complications included recurrent urethral obstruction secondary to blood clot formation and urethral edema in 1 dog and stent dislodgement into the urinary bladder in 1 dog. All dogs were able to urinate immediately after the procedure. Nine dogs (3/4 females and 6/8 males) were continent or mildly incontinent after stent placement. Of the remaining 3 dogs, 2 developed severe incontinence and 1 had an atonic bladder. Seven dogs were considered to have good to excellent outcome, 3 had fair outcome, and 2 had poor outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Transurethral placement of metallic stents was a safe and effective palliative treatment option for dogs with malignant urethral obstructions.  相似文献   

12.
This report describes a cat that suffered pelvic urethral rupture associated with multiple pelvic fractures. A vaginourethroplasty was performed as a salvage procedure, via intrapelvic anastomosis of the proximal urethra to the caudal vagina, following failure of a primary urethral anastomosis. Urinary diversion was achieved via tube cystostomy and a vagino-urethral catheter was maintained for 3 days postoperatively. Anterograde cystourethrography was performed at 7 days and 14 days postoperatively. Absence of contrast leakage from the vagino-urethral anastomosis was documented at 14 days postoperatively and the tube cystostomy was removed. An Escherichia coli urinary tract infection was treated following removal of the tube cystostomy and subsequent urine culture revealed no evidence of urinary tract infection. The cat retained normal urinary continence and elimination behaviour during the 7-month follow-up period. Vaginourethroplasty could be considered as a salvage option for management of traumatic pelvic urethral rupture in the neutered female cat.  相似文献   

13.
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   

14.
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15.
A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.  相似文献   

16.
Urethral leiomyoma in a cat   总被引：1，自引：0，他引：1  
A 13-year-old spayed cat was examined because of a suspected lower urinary tract obstruction. After 2 days, a urethral catheter could not be passed, and the cat was euthanatized. At necropsy, a 1.2-cm intramural mass was detected, obstructing the proximal portion of the urethra. Histologic examination of the well-circumscribed mass revealed a urethral leiomyoma.  相似文献   

17.
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   

18.
Objective— To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony.
Study Design— Case series.
Animals— Dogs (n=9) and cats (6).
Methods— Medical records (January 2004–January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred.
Results— Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration.
Conclusions— An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur.
Clinical Relevance— An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.  相似文献   

19.

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   

20.
OBJECTIVE: To investigate the feasibility and long-term outcome of a modified subpubic urethrostomy technique termed transpelvic urethrostomy (TPU) in cats. STUDY DESIGN: Prospective clinical study. ANIMALS: Eleven male cats with obstructive lower urinary tract disease that could not be relieved, and requiring a surgical urinary diversion, were selected for TPU. METHODS: With the cat in dorsal recumbency, the penis was exposed and the ventral pelvis was denuded by median adductor muscle elevation. An approximately 12 mm x 15 mm area of ischium was removed. The pelvic urethra, 8-20 mm cranial to the bulbourethral glands, was incised longitudinally and sutured to the skin to create a urethrostomy. RESULTS: All cats were neutered males (2-9 years); none were uremic or hyperkalemic at admission. Urine was cultured if there was leukocyturia, nitrituria, and/or bacteriua. Bacteria were isolated from 2 specimens. A patent urethrostomy was created in all cats without operative complications. Except for 1 cat without associated clinical signs, stricture was not evident between 9 and 42 months after urethrostomy. One cat had postoperative urinary incontinence (UI) that resolved within 4 weeks. Two cats each had 1 episode of idiopathic lower urinary tract disease after 6-month follow-up; both responded to medical therapy. CONCLUSIONS: TPU was used as a successful urinary diversion procedure relieving signs of urinary tract obstruction and preventing further obstruction, with few complications. The incidence of UI after TPU remains minimal. CLINICAL RELEVANCE: TPU should be considered as a salvage urinary diversion procedure in cats (as an alternative to prepubic and subpubic techniques). TPU may also be considered as a possible primary urinary diversion solution (an alternative to perineal urethrostomy) for obstructive lower urinary tract disease in cats.  相似文献   

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