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1.
A 13-month-old Angus steer was examined with a 6-week history of lethargy, malaise and dribbling urine. Laboratory exam revealed crystalluria and poor renal function. Ultrasound revealed hydronephrosis and hydroureter. Euthanasia was chosen because of a poor prognosis for economic recovery. Necropsy demonstrated numerous calculi causing partial urethral obstruction approximately 25 cm from the end of the penis. Secondary renal changes were confirmed. Urolithiasis occurs commonly in ruminants. Secondary obstruction is usually complete with severe consequences. This is the first report of chronic partial obstructive urolithiasis resulting in endstage renal disease.  相似文献   

2.
Naturally occurring xanthine urolithiasis in a domestic shorthair cat   总被引：1，自引：0，他引：1  
A five year-old neutered male domestic shorthair cat was presented after three episodes of urethral obstruction and anuria requiring relief urethral catheterisation. A double contrast cystogram revealed the presence of multiple small cystollths which were radlolucent on plain radiographs. A perlneal urethrostomy and a cystotomy were performed to relieve the urethral obstruction and to remove the cystoliths. Quantitative analysis revealed the cystoliths to be composed of 100 per cent xanthine. Clinical history suggested the xanthinuria to be naturally occurring. Unfortunately, the cat was killed in a road traffic accident two months after the surgical procedure, preventing further long-term assessment.  相似文献   

3.
Objective: To characterize the clinical characteristics, electrolyte changes, acid–base changes, and renal parameters in a consecutive population of cats with urethral obstruction. Design: Retrospective clinical study. Setting: University Veterinary Teaching Hospital. Animals: Two hundred and twenty‐three male cats that presented consecutively with urethral obstruction between 1997 and 1999. Interventions: None. Measurements and main results: The medical records of 223 cats with urethral obstruction were reviewed for signalment, previous medical history, indoor/outdoor status, body weight, clinical signs, physical examination findings, renal function tests (blood urea nitrogen and creatinine), and blood gas and electrolyte analysis. The majority of cats were relatively stable without serious metabolic derangements. Only 12% (24/199) of cats had severe hyperkalemia (>8.0 mmol/L). Hyperkalemia did not occur in isolation; the majority of these cats had concurrent acidemia and low ionized calcium concentrations. Potassium was significantly inversely correlated with pH, bicarbonate, pCO2, sodium, chloride, and ionized calcium, but positively correlated with blood urea nitrogen and creatinine. Ionized calcium was positively correlated with pH and bicarbonate. Of the animals with a potassium concentration greater than 8.0 mmol/L, 75% (18/24) had an ionized calcium concentration of less than 1.0 mmol/L. Seventy‐nine percent (19/24) of cats with a potassium concentration greater than 8.0 mmol/L had a blood pH<7.20. Similarly, 74% (23/31) of cats with a pH<7.20 had an ionized calcium concentration <1.00 mmol/L. Conclusions: The majority of cats with urethral obstruction presented with mild electrolyte and blood gas changes and were relatively stable, although 12% of cats had multiple, life‐threatening metabolic derangements. Of 219 cats in this study, 205 (93.6%), where it could be determined, survived to discharge from the hospital, supporting the fact that most cats with urethral obstruction survive the acute episode with emergency treatment.  相似文献   

4.
Indwelling urinary catheters with a closed urine collection system were maintained in 30 male cats for 3 days after induction of irritant cystitis. All cats received subcutaneous fluids during the 3 days the catheters were in place. The effects of four different treatment regimens on urinary tract infection rates, incidence of urethral obstruction, and development of urinary tract lesions over a 10-day period were compared with results in a nontreated group. Treatments were 1) amoxicillin for 5 days PO; 2) prednisolone for 5 days PO; 3) both amoxicillin and prednisolone for 5 days PO; and 4) dimethylsulfoxide (DMSO) for 3 days intravesicularly. Euthanasia was done before the end of the 10-day experimental period if the cats had two bouts of urethral obstruction or if the cats became uremic for causes unrelated to urethral obstruction. Seven cats were euthanatized before the conclusion of the experiment. These cats had been treated with prednisolone, prednisolone and amoxicillin, or DMSO. All cats that received amoxicillin alone or no therapy survived the 10-day period. Mortality was due to repeated urethral obstruction or to uremia associated with pyelonephritis or papillitis. Urinary tract infection rate was similar in all groups. The group treated with prednisolone alone had the highest incidence of renal infection. Inflammatory lesions in the lower urinary tract were similar in all groups. In conclusion, persistent urinary tract infection often develops in cats with cystitis after indwelling urethral catheterization even when closed systems of urine drainage are used.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

5.
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   

6.
The aim of this study was to evaluate the course of urethral obstruction in cats. Forty-five male cats with urethral obstruction or lower urinary tract signs referable to urethral obstruction were included in the study. Follow-up information was gained by telephone interview in most cases and was available in 39 cats. Of the 22 cats with idiopathic urethral obstruction, eight (36%) re-obstructed after 3-728 days (median 17 days). Of 10 cats with urolithiasis, three (30%) re-obstructed after 10, 13 and 472 days, respectively. Of the seven cats with urethral plugs, three (43%) re-obstructed after 4, 34 and 211 days, respectively. Recurrent signs of lower urinary tract disease including obstruction were common in cats with urethral obstruction (20/39; 51%) and occurred in the same frequency irrespective of the primary cause of the obstruction. Recurrent obstruction (14/39; 36%) was the most common reason for euthanasia and was performed in 8/39 (21%) cats.  相似文献   

7.
An 8-month-old owned European cat showing abdominal pain, fever, distended painful bladder and urinary blockage was presented. Intravenous fluids were immediately administered and, after sedation, a urinary catheter was applied. Blood and urine analysis revealed cystitis and a moderate-to-severe degree of renal failure. About 20 thread-like nematodes, identified as Capillaria plica larvae and fragments of adult stages, were found in the urine sediment. After treatment with an oral formulation of fenbendazole at 25 mg/kg q 12 h for 10 days, urinary signs and bladder worms disappeared. Cases of Capillaria species bladder worms in cats are rarely reported and most infected cats show no clinical signs, presumably because of a low parasite burden. In the present study, feline capillariosis was associated to urethral obstruction, severe difficulties in urination, cystitis and renal failures.  相似文献   

8.
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   

9.
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   

10.
A 6‐year‐old, male castrated domestic short hair cat presented for urethral obstruction. Despite passage of a urinary catheter, urine could not be drained through the catheter, but urine flow was noted around the catheter. Special imaging studies, including ultrasound and fluoroscopy, revealed that the catheter had been passed into an abnormal small bicornuate structure that entered the urethra from dorsally within the pelvic canal. This structure was believed to be a uterus masculinus or remnants of the Mullerian ducts. The anomalous structure was not felt to be related to the cause of the urethral obstruction, but was simply an incidental finding which resulted in difficult catheterization.  相似文献   

11.
Cats with mild urethral obstruction are anesthetized, the obstruction removed and the bladder lavaged. Moderately affected cats are sedated and given IV fluids, and usually return to normal soon after the obstruction is removed. Severely affected cats are given IV fluids, NaHCO3 and Ca gluconate, sedated or anesthetized and unblocked. Fluid administration is continued to avoid renal failure. The bladder can be expressed 3-4 times daily or bethanechol given to aid recovery of detrusor muscle function. Halothane, 1% thiopental or thiamylal, or ketamine-acepromazine can be used to anesthetize blocked cats. An 18- or 20-ga, 2 1/2-inch over-the-needle catheter or a lacrimal needle is used to relieve the obstruction, after which a 3 1/2-Fr Silastic or vinyl catheter is used for catheterization and bladder lavage with sterile saline. Cystotomy allows recuperation before definitive corrective surgery.  相似文献   

12.
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   

13.
An 8-year-old Hanoverian gelding was examined because of urine dribbling and urethral obstruction. Mild proprioceptive deficits of the left hind limb were evident during neurologic examination. Ultrasonography per rectum revealed dilatation of the pelvic portion of the urethra. Endoscopy of the urethra revealed 2 webs of tissue: 1 was located 10 cm proximal to the external urethral opening; the other was located 65 cm proximal to the external urethral opening and prevented passage of the endoscope into the urinary bladder. The mass was ablated with a neodymium:yttrium-aluminum-garnet laser, using a transendoscopic noncontact technique. On follow-up examination 6 months after laser surgery, an endoscope could easily be passed into the bladder, and no urethral web was seen. The horse was able to void a stream of urine but continued to dribble urine intermittently. The proximal location of the urethral lesion in this horse would have made use of traditional surgical methods problematic, whereas transendoscopic laser photoablation was easy and effective.  相似文献   

14.
A 2-year-old male neutered Scottish Terrier presented with dysuria caused by complete urethral obstruction due to a stricture secondary to catheter-induced trauma. The urethral obstruction was resolved by balloon dilation of the stricture under fluoroscopic guidance.  相似文献   

15.
Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.  相似文献   

16.
Objective: To measure serum parathyroid hormone (PTH) and 25‐hydroxyvitamin D3 concentrations in cats with urethral obstruction. Design: Prospective single cohort study. Setting: University affiliated veterinary teaching hospital. Animals: Male cats with urethral obstruction. Interventions: Routine blood samples drawn from male cats with urethral obstruction. Measurements and main results: Measured variables included blood gas parameters, plasma sodium, potassium, chloride, and ionized calcium concentrations, as well as serum blood urea nitrogen, creatinine, phosphorus, PTH, and 25‐hydroxyvitamin D3 concentrations. PTH was inversely correlated with ionized calcium and positively correlated with serum phosphorus. No discernable relationship could be found between 25‐hydroxyvitamin D3 and any of the measured parameters. Conclusions: Lack of parathyroid response does not appear to be the underlying mechanism for ionized hypocalcemia in cats with urethral obstruction.  相似文献   

17.
An incision, or urethrotomy, is made into the urethral lumen to remove or relieve an obstruction temporarily. When permanent diversion of urine flow proximal to an obstructed, severely damaged, or diseased urethra is required, a urethrostomy is performed. Urethrostomy is also performed to diminish the risk of urethral obstruction due to recurrent urinary calculi that are not likely to be resolved with medical therapy. Whenever possible, to reduce the risk of urethral stricture or recurrent urinary tract infection, urethral surgery is avoided when an obstruction can be relieved by retrohydropropulsion or catheterization. Urethrotomy can be performed in the prescrotal or perineal regions depending on the level of the urethral obstruction. Although urethrostomy can be made in the perineal and antepubic positions, scrotal urethrostomy is the procedure of choice provided the lesion is distal to this area. Specific urethrotomy and urethrostomy procedures are described, including discussion about selection of the appropriate procedure for the urethral problem, patient stabilization considerations, general postoperative management, and risk of complications.  相似文献   

18.
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   

19.
Objective-To describe the technique and determine outcome for male cats with urethral obstruction treated with fluoroscopically guided percutaneous antegrade urethral catheterization (PAUC). Design-Retrospective case series. Animals-9 client-owned neutered male cats with urethral obstruction and inability to pass a retrograde urinary catheter. Procedures-Information regarding the procedure and hospitalization was obtained from medical records. Long-term follow-up was obtained via medical record review or telephone interview. Results-Diagnoses included iatrogenic urethral tear (n = 6), obstructive urethral calculi (1), urethral ulceration (1), and urethral stricture (1). Seven of the 9 procedures were successful. The 2 patients in which PAUC failed had mechanical obstructions preventing guide wire access across the urethral obstruction. Procedure times ranged from 25 to 120 minutes. No complications were noted in any patients during the procedure. One patient was euthanized because of unrelated disease. Follow-up information was available for 6 of 8 surviving patients. No complications that could be directly attributed to the procedure were noted. All 6 patients had a perineal urethrostomy performed 0 days to 6 weeks following the procedure because of reobstruction of the lower urinary tract. None of these patients had documented urethral strictures and none had recurrence of clinical signs following perineal urethrostomy. Conclusions and Clinical Relevance-Results suggested that PAUC can be a simple, rapid, minimally invasive, and safe technique to facilitate transurethral catheterization in select cases. Patients with iatrogenic urethral tears may be good candidates. Patients with impacted urethral calculi, severe strictures or ulcerations, or a nondistended urinary bladder may be less amenable to PAUC.  相似文献   

20.
Summary

Xanthine calculi were found in a 7‐month‐old male Cavalier King Charles spaniel with urethral obstruction and renal insufficiency. Because the only two other reported cases of naturally occurring xanthine urolithiasis concerned a Cavalier King Charles and a King Charles spaniel the urine of the littermates and parents of the patient were also examined for xanthinuria. Semi‐quantitative analysis revealed high urine concentrations of hypoxanthine and xanthine in the patient and his female littermate. Quantitative analysis by high‐pressure liquid chromatography (HPLC) of the urine samples from the family of this Cavalier King Charles spaniel and nine control dogs revealed that hypoxanthine and xanthine excretion was 30 and 60 times higher in the affected patient and the female littermate than in the others dogs. The pattern of xanthinuria, which is caused by a deficiency of the enzyme xanthine oxidase, in the relation diagram of this family of Cavalier King Charles Spaniels was consistent with an autosomal recessive mode of inheritance.  相似文献   

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