urethral obstruction
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2022 ◽  
Vol 58 (1) ◽  
pp. 17-27
Author(s):  
Kira L. Bourne ◽  
Kaitlan N. Hovis ◽  
Christopher R. Dolan ◽  
Brandan Wusterfeld-Janssens ◽  
Heather Wilson-Robles

ABSTRACT Intrapelvic hemangiosarcoma (IP HSA) is an uncommon primary location of canine HSA, and its presentation appears to be different than that of other intra-abdominal HSA locations. The objectives of this study were to report on the clinical presentation, diagnostic options, and clinical outcomes of dogs with IP HSA. Medical records from two veterinary teaching hospitals between 2000 and 2019 were reviewed for dogs diagnosed with IP HSA. Inclusion criteria consisted of a cytologic or histopathologic diagnosis of HSA from a mass arising from the muscles of the pelvic canal. Exclusion criteria included masses arising from organs within the pelvic canal, including the urethra, prostate, and urinary bladder. Twelve dogs were ultimately included in the study. Clinical presentation of IP HSA was varied, with clinical signs including hindlimb lameness, urethral obstruction, and evidence of hemoperitoneum. The median progression free survival was 92 days (range: 1–1057 days). The overall survival time was 165 days (range: 1–1170 days). IP HSA is an underreported location of canine HSA with similar biologic behavior and outcome compared with visceral HSA. It serves as an important differential in patients presenting with new-onset lameness and urethral obstruction.


2021 ◽  
pp. 1098612X2110606
Author(s):  
Kendall E Wilson ◽  
Allyson C Berent ◽  
Chick W Weisse ◽  
Donald Szlosek

Objectives The aims of this study were to evaluate serum symmetric dimethylarginine (SDMA) and creatinine concentrations in cats with urethral obstruction pre- and post-decompression of the obstruction, and to determine if pre-decompression values were predictive of post-decompression renal function, as measured by SDMA and creatinine. Methods This was a prospective observational study. Twenty-five client-owned cats with urethral obstruction were hospitalized for decompression of the obstruction. Serum SDMA and creatinine were prospectively assessed at presentation, 24 h post-decompression and 5–20 days post-decompression. Urinalysis and culture were assessed at presentation and at the final follow-up. Exclusion criteria included positive urine culture, reobstruction or failure to obtain required samples. Results Mean SDMA concentration dropped by 41.8% from an initial pre-decompression concentration of 17.6 µg/dl to 10.3 µg/dl 24 h post-decompression ( P <0.001). The mean creatinine value dropped by 38.4% from an initial pre-decompression concentration of 2.5 mg/dl to 1.5 mg/dl 24 h post-decompression ( P <0.001). There was no association between SDMA concentration at initial presentation and SDMA concentration 5–20 days after urethral catheterization (Spearman’s ρ = 0.205, P = 0.314). Creatinine concentration upon initial presentation was associated with the 5–20 day values after urethral catheterization (Spearman’s ρ = 0.583, P <0.002). Twenty percent of cases were excluded due to bacterial growth on initial urine culture. SDMA and creatinine concentrations were significantly higher in these cases (median 59 µg/dl and 10.9 mg/dl, respectively) compared with those with negative cultures (median 14 µg/dl and 1.6 mg/dl [ P <0.002 and P <0.001], respectively). Conclusions and relevance Both SDMA and creatinine decreased significantly after urethral catheterization, suggesting that renal function post-decompression cannot be predicted by the pre-decompression concentrations of these values.


2021 ◽  
Vol 8 (10) ◽  
pp. 225
Author(s):  
Yoon-Ho Roh ◽  
Jeong-Nam Kim ◽  
Pill-Moo Byun ◽  
Dae-Hyun Kim ◽  
Seong-Mok Jeong ◽  
...  

Symphyseal distraction osteotomy (SDO) with a polymethyl methacrylate (PMMA) spacer is an effective surgical treatment for cats with pelvic stenosis. This study reports the successful treatment of urethral obstruction due to ischiocavernosus muscle (IM) tension after SDO with a PMMA spacer. A 2-year-old castrated male Korean domestic shorthair feline had megacolon and pelvic canal stenosis. The ratio of the maximal diameter of the colon to the L5 length and the pelvic canal diameter ratio were 1.6 and 0.45, respectively. Pelvic SDO was performed with a PMMA spacer, leading to pelvic canal enlargement (pelvic canal diameter ratio: 0.73). Two days after surgery, dysuria was identified immediately after removing the preoperatively placed urinary catheter. Complete blood counts and serum biochemical profiles were within the reference intervals, and a positive contrast retrograde urethrogram confirmed urethral obstruction at the level of the membranous–pelvic urethra region. Increased tension of the IM leading to a narrowed urethra was suspected as the cause of urethral obstruction. After IM release at the level of origin on the ischium, the patient had an uneventful recovery with spontaneous urination. Muscle release resulted in excellent functional restoration, with no intraoperative or postoperative complications reported during the 12-month long-term follow-up. Therefore, SDO with IM release could be a feasible therapeutic option for severe pelvic stenosis without complications, such as urethral obstruction, in cats.


Conjecturas ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 45-55
Author(s):  
Francisco Antônio Félix Xavier Júnior ◽  
Glayciane Bezerra de Morais ◽  
Thyago Habner de Souza Pereira ◽  
Isadora Oliveira de Carvalho ◽  
Fernanda Menezes de Oliveira e Silva ◽  
...  

Acute Kidney Injury (AKI) can be defined as a spectrum of diseases associated with a sudden onset of a renal failure status, the feline patient has azotemia, the disorder in fractional electrolyte excretion (FE), and shedding of epithelial cells from renal tubular segments observed in the urinary sediment. Thus, the objective of the present study was to evaluate the FE, plasma and urinary osmolality, and urinary specific gravity (USG) in cats that spontaneously developed AKI due to urethral obstruction (UO) and healthy cats. Blood and urine samples were collected from a group of 20 cats diagnosed with AKI secondary to urethral obstruction (GAKI; n=20) and clinically healthy cats (GC; n=15). The serum creatinine (sCre) and urinary creatinine (uCre), were measured by spectrophotometry, serum and urinary analyzes of sodium, potassium and chloride by ion selective electrode device and serum and urinary osmolarity by osmometer. The GAKI results were statistically compared with those of the CG using Student's t tests to assess normal data, while the Maan-Whitney test was used for non-normal data. A significant increase in the sCr, sK, FENa, FECl and RFI parameters of the GAKI cats when compared to the GC (p < 0.05). The sCl, USG, uCr, uK and uOSM parameters decreased significantly when compared between the two groups. Thus, given the established methodology and the results found, it is possible to infer that an increase in EFNa, EFCl in addition to the RFI and a decrease in USG and uOSM were associated with cats with AKI and can serve as markers of kidney damage, as well as monitoring the prognosis.


Author(s):  
Kalogianni Lamprini ◽  
Pardali Dimitra ◽  
Garcia-Gonzalez Beatriz ◽  
Konstantinidis O. Alexandros ◽  
Psaralexi Evanthia ◽  
...  

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Elizabeth Bearrick ◽  
Kevin Hebert ◽  
Laura Maciejko ◽  
Bridget Findlay ◽  
Katherine Theisen ◽  
...  

Urology ◽  
2021 ◽  
Vol 25 (2) ◽  
Author(s):  
E.A. Kvyatkovsky ◽  
T.O. Kvyatkovska ◽  
E.V. Pilin

Uroflowmetry is an effective, non-invasive method for detecting lower urinary tract obstruction. However, by the nature of the uroflowgram, it is impossible to distinguish between the anatomical and functional obstruction of the urethra. The aim of the study was to develop a screening non-invasive method for the diagnosis of anatomical urethral obstruction using uroflowmetry with a pharmacourodynamic test with selective alpha-1-blocker silodosin. The study involved 235 patients aged 66.2±1.8 years (from 30 to 76 years) with symptoms of the lower urinary tract (LUTS). Uroflowmetry was performed using a “Flow-K” uroflowmeter. Ultrasound examinations of the kidneys, prostate and bladder with determination of residual urine were performed using a HONDA HS-2000 ultrasound machine. All patients underwent a pharmacourodynamic test: repeated uroflowmetry 2.5-3 hours after a single dose of 8 mg of silodosin, taking into account the pharmacodynamics of the drug. During the pharmacourodynamic test, 15 patients with obstructive or obstructive-interrupted uroflowgram had no reaction to silodosin, which was considered a positive test for anatomical (mechanical) urethral obstruction. Аn increase the maximum and average volumetric flow rate of urine during urination by 25-30%, respectively from 9.02±0.24 ml/s up to 11.69±0.32 ml/s and from 5.64±0.21 ml/s to 7.03±0.25 ml/s, were noted in 220 patients with obstructive, obstructive-interrupted obstructive-intermittent or intermittent type of uroflowgram when conducting a pharmacaurodynamic test. Such results were considered negative for anatomical (mechanical) urethral obstruction. They testified to functional obstruction of the urethra, which was subsequently successfully corrected with prescribing selective alpha-1-blockers. Patients with a positive pharmacourodynamic test were prescribed further examination using such methods as ureteroscopy, urethrocystoscopy, retrograde urethrography, to confirm the violation of the patency of the urethra or bladder neck. Urethral stricture was diagnosed in 10 patients, a calculus of the posterior urethra in 2 patients, a median lobe of the prostate gland in 3 patients with BPH. In the presence of obstructive or obstructive-interrupted uroflowgram in patients with LUTS, the pharmacourodynamic test with silodosin can be used as a screening non-invasive test to detect anatomical obstruction of the lower urinary tract.


2021 ◽  
pp. 2002-2008
Author(s):  
Darlan Henrique Canei ◽  
Mariana Elisa Pereira ◽  
Maria Natália de Freitas ◽  
Yolanda Paim Arruda Trevisan ◽  
Carolina Zorzo ◽  
...  

Background and Aim: Urethral obstruction (UO) is a common condition in feline medicine. Severe acid-base and electrolyte disorders promote relevant electrocardiographic changes in these animals. Cardiac biomarkers such as cardiac troponin I have been shown to be useful in identifying cats with myocardial disease, but it has not been investigated whether UO leads to myocardial damages. This study aimed to evaluate biochemical changes, electrocardiographic findings, troponin I measurements, and electrolyte disturbances for 7 days in cats with UO. Materials and Methods: This follow-up prospective study included 33 cats diagnosed with UO for 7 days. For all cats, clinical examination, serum biochemistry, electrolyte analyses, blood pressure, and electrocardiography were performed. Cardiac troponin I was measured in the serum in 16 cats at 3 different times. Results: The mean age of the feline population was 1.83±1.58 years (mean±standard deviation). Creatinine, urea, blood urea nitrogen, glucose, phosphorus, base excess, bicarbonate, and serum potassium decreased significantly (p≤0.05), while ionic calcium and blood pH increased significantly (p≤0.05) at different times. Electrocardiographic abnormalities were observed in 21/33 (63.63%) of the felines on admission day. The electrocardiographic abnormalities were no longer observed on the subsequent days. Only one feline showed changes in troponin I cardiac concentrations. Conclusion: This study suggests the sum and severity of electrolyte abnormalities aggravate the clinical and cardiovascular status of these patients. However, cTnI, blood pressure, and heart rate within the reference range do not exclude the presence of major cardiovascular and metabolic abnormalities. The hyperglycemia in felines with UO appears to be associated with decreased renal clearance, which may reflect the severity of hyperkalemia and azotemia. The metabolic and cardiovascular changes of these felines are minimized by the establishment of appropriate intensive care; however, cardiac and blood gas monitoring is essential to assess the severity of the disease.


2021 ◽  
pp. 1098612X2110331
Author(s):  
Isabelle Mérindol ◽  
Marilyn Dunn ◽  
Catherine Vachon

Objectives The objective of this retrospective study was to describe the feline population presented for urinary incontinence at a veterinary teaching hospital between 2009 and 2019, with a particular focus on cats with a non-neurologic underlying cause. Methods The medical records of cats diagnosed with urinary incontinence were retrospectively evaluated. Signalment, clinical presentation, results of diagnostic tests, diagnosis of the underlying cause and treatments were recorded. When information was available, outcome was recorded and follow-ups divided into three time frames (0–1 week, 1 week to 3 months and >3 months). Results Thirty-five cats were presented with urinary incontinence. Of these, 18 cats with complete medical records presented urinary incontinence of non-neurologic origin. The most common clinical signs at presentation were urine leakage while resting (12/18), urine-soiled perineum (8/18), urine dribbling (8/18) and no spontaneous micturition (5/18). The most common underlying cause was urethral obstruction (67%; 12/18), with a majority due to urethral strictures (58%; 7/12). Other causes were suspected inflammation (2/12), neoplasia (1/12), urolithiasis (1/12) and foreign body (1/12). In 8/10 cats in which it was performed, cystoscopy and contrast cystourethrography were the methods that led to the diagnosis. Twelve cats with urethral obstruction underwent interventional procedures, resulting in complete resolution of incontinence in 7/12 and improvement in 1/12. Urinary tract infection was a common complication after 3 months (4/18). Conclusions and relevance When incontinence of non-neurologic origin is suspected in a cat, urethral obstruction should be considered. Advanced imaging studies (cystoscopy and contrast studies) are useful for diagnosis. A good prognosis was reported in cats undergoing interventional procedures with no long-term treatment.


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