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Kendall A, Byron JK, Westropp JL, Coates JR, Vaden S, Adin C, Oetelaar G, Bartges JW, Foster JD, Adams LG, Olby N, Berent A. ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs. J Vet Intern Med 2024; 38:878-903. [PMID: 38217372 PMCID: PMC10937496 DOI: 10.1111/jvim.16975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024] Open
Abstract
Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.
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Affiliation(s)
- Allison Kendall
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Julie K. Byron
- Department of Veterinary Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
| | - Jodi L. Westropp
- Department of Veterinary Medicine and EpidemiologyUniversity of CADavisCaliforniaUSA
| | - Joan R. Coates
- Department of Veterinary Medicine and SurgeryUniversity of Missouri College of Veterinary MedicineColumbiaMissouriUSA
| | - Shelly Vaden
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Chris Adin
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, University of FloridaGainesvilleFloridaUSA
| | - Garrett Oetelaar
- VCA Canada Calgary Animal Referral and Emergency (CARE) CentreCalgaryAlbertaCanada
| | - Joe W. Bartges
- College of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Larry G. Adams
- Department of Veterinary Clinical SciencesPurdue University College of Veterinary MedicineWest LafayetteIndianaUSA
| | - Natasha Olby
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Allyson Berent
- Service of Interventional Radiology and Interventional EndoscopyAnimal Medical CenterNew York CityNew YorkUSA
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Hsieh ES, Palm C, Segev G, Johnson EG, Leung K, Westropp JL. Diagnostic yield of uroendoscopy compared to ultrasonography for evaluating lower urinary tract disorders in dogs. Vet Med (Auckl) 2022; 36:1700-1707. [PMID: 35986564 PMCID: PMC9511071 DOI: 10.1111/jvim.16501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/14/2022] [Indexed: 11/29/2022]
Abstract
Background Cystourethroscopy and vaginoscopy (uroendoscopy) is often used in the diagnostic evaluation of dogs with lower urinary tract disorders (LUTD). Objective/Hypothesis To evaluate if uroendoscopy is warranted in dogs with various LUTD, the agreement between uroendoscopic and ultrasonographic diagnoses were compared. Dogs with recurrent urinary tract infections (rUTI) will have the highest diagnostic agreement between uroendoscopy and ultrasonography (US) compared to dogs presenting for other LUTD. Animals Two hundred thirty‐seven dogs presenting between 2014 and 2019 with lower urinary tract signs (LUTS) that had US within 60 days preceding uroendoscopy. Methods Retrospective study. Dogs were categorized by primary indication for ultrasound. Pertinent uroendoscopic findings were recorded and agreements (κ analysis) between the final uroendoscopic diagnosis were compared with the final ultrasonographic diagnosis. Results Pertinent uroendoscopic findings were recorded for 69/237 (29%) cases. For dogs presenting primarily for urinary incontinence (UI), agreement between uroendoscopy and US was 71% (46/65; κ = 0.47, 95% CI 0.28‐0.66), for dogs with stranguria, 58% (29/50; κ = 0.47, 95% CI 0.31‐0.62) and for dogs with rUTI the agreement was substantial at 87% (26/30; κ = 0.70, 95% CI 0.43‐0.98). Urethral strictures were the majority (14/21; 67%) of pertinent uroendoscopic findings for dogs with stranguria, of which 12 were male dogs. Conclusions and Clinical Importance Agreement between uroendoscopy and US was moderate for all dogs. Based on these data, recommendation for uroendoscopy should be tailored to individual clinical presentation and signalment; transabdominal US is not the preferred modality for urethral lesions.
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Affiliation(s)
- Emmelyn S. Hsieh
- William R. Pritchard Veterinary Medical Teaching Hospital University of California Davis California USA
| | - Carrie Palm
- Department of Veterinary Medicine and Epidemiology University of California Davis California USA
| | - Gilad Segev
- Koret School of Veterinary Medicine The Hebrew University of Jerusalem Rehovot Israel
| | - Eric G. Johnson
- Department of Surgical & Radiological Sciences University of California Davis California USA
| | - Kaitlin Leung
- William R. Pritchard Veterinary Medical Teaching Hospital University of California Davis California USA
| | - Jodi L. Westropp
- Department of Veterinary Medicine and Epidemiology University of California Davis California USA
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Uva A, Gernone F, Cavalera MA, D'Ippolito P, Ricciardi M, Carelli G, Zatelli A. Acquired partial lower urinary tract obstruction caused by intravesical ureterocele in an adult dog. J Small Anim Pract 2022; 63:707-712. [PMID: 35211999 PMCID: PMC9543016 DOI: 10.1111/jsap.13489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
Ureterocele is an uncommon condition in dogs characterised by a cystic dilation of the submucosal portion of the distal ureter. A 4‐year‐old intact male Siberian husky with a 4‐month previous diagnosis of ureterocele was presented for pollakiuria. Abdominal ultrasound showed increased dimensions of the ureterocele, and a retrograde positive contrast urethrocystography detected a filling defect of the bladder neck lumen. The position of ureterocele was considered responsible for the partial urinary obstruction. This hypothesis is supported by the resolution of pollakiuria after surgical ureterocele resection. Based on a literature search, this is the first case of an intravesical ureterocele causing partial urinary obstruction in dogs. Ureterocele should be considered as a differential diagnosis in patients with pollakiuria.
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Affiliation(s)
- A Uva
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Strada Provinciale per Casamassima km. 3, 70010, Valenzano, Italy
| | - F Gernone
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Strada Provinciale per Casamassima km. 3, 70010, Valenzano, Italy
| | - M A Cavalera
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Strada Provinciale per Casamassima km. 3, 70010, Valenzano, Italy
| | - P D'Ippolito
- Laboratorio ACV Triggiano, Via C. Battisti 255/257, 70019, Triggiano, Italy
| | - M Ricciardi
- Private Practitioner CT-MRI Support Service, Via dei Glicini 11, 70016, Noicattaro, Italy.,Centro Veterinario Polidiagnostico, Via A. Stradella 49, 76123, Andria, Italy.,Ospedale Veterinario S. Fara, Via Generale Nicola Bellomo 91 bis, 70124, Bari, Italy
| | - G Carelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Strada Provinciale per Casamassima km. 3, 70010, Valenzano, Italy
| | - A Zatelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Strada Provinciale per Casamassima km. 3, 70010, Valenzano, Italy
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Taylor O, Knight R, Genain M, Owen L. Ultrasonography as a sensitive and specific diagnostic modality for the detection of ectopic ureters in urinary incontinent dogs. Vet Radiol Ultrasound 2022; 63:328-336. [PMID: 35064712 PMCID: PMC9306744 DOI: 10.1111/vru.13055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 10/19/2021] [Accepted: 10/30/2021] [Indexed: 11/30/2022] Open
Abstract
Ultrasonography is a widely available diagnostic modality for the identification of dogs with suspected ureteral ectopia; however published studies detailing its sensitivity and specificity are currently lacking. The aim of this retrospective, descriptive, diagnostic accuracy study was to evaluate the sensitivity and specificity of ultrasonography for the diagnosis of ureteral ectopia in incontinent dogs presenting to a referral institution, using cystoscopy as the gold standard. Medical records of urinary incontinent dogs presenting to a single institution (n = 38) were retrospectively reviewed for the presence of ureteric insertion abnormalities and concurrent urinary tract abnormalities. Ultrasonographic findings were compared with those from cystoscopic examination to determine diagnostic accuracy. The relationship between the presence of concurrent urinary tract abnormalities and ureteral ectopia was assessed using an independent samples t‐test and Mann–Whitney test. Statistical significance was set at P ≤ 0.05. Ultrasonography had a sensitivity of 93.5%, specificity of 100%, and diagnostic accuracy of 95% when identifying dogs with ureteral ectopia. When classifying individual ureters as ectopic or non‐ectopic, sensitivity was 87.8% and specificity was 86.7%. Dogs with ureteral ectopia had significantly more concurrent urinary tract abnormalities on ultrasound than unaffected dogs (P = 0.004). Ectopic ureters were associated with significantly more concurrent ipsilateral upper urinary tract ultrasonographic abnormalities than unaffected ureters (P < 0.001). Ultrasonography performed by an experienced ultrasonographer is a sensitive and specific screening tool for canine ureteral ectopia, which eliminates the need for heavy sedation, general anesthesia, and advanced imaging, although it should not be relied upon as the sole diagnostic modality for the assessment of individual ureters.
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Affiliation(s)
- Oliver Taylor
- Queen Mother Hospital for Animals Royal Veterinary College Hatfield UK
| | - Rebekah Knight
- Department of Veterinary Medicine Queen's Veterinary School Hospital Cambridge UK
| | - Marie‐Aude Genain
- Department of Veterinary Medicine Queen's Veterinary School Hospital Cambridge UK
| | - Laura Owen
- Department of Veterinary Medicine Queen's Veterinary School Hospital Cambridge UK
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Hooi KS, Vachon C, Martel DV, Dunn M. Retrospective evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs. J Vet Intern Med 2021; 36:156-163. [PMID: 34877712 PMCID: PMC8783319 DOI: 10.1111/jvim.16321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022] Open
Abstract
Background Cytoscopic‐guided laser ablation (CLA) is a technique that can be used to correct intramural ectopic ureters (EUs) in dogs. Hypothesis/Objectives To describe clinicopathologic, imaging, and cystoscopic findings in dogs undergoing CLA for intramural EU correction, and whether any of these findings are associated with continence outcomes. Animals Thirty‐one client‐owned dogs undergoing CLA between 2009 and 2019. Methods Retrospective cohort study. Data collected from medical records included signalment, clinical findings (including continence score at presentation), clinicopathologic findings (serum biochemistry profile, urinalysis, and urine culture results before CLA), ultrasonography, and cystoscopy findings. Follow‐up information was collected at 1 day to 1 week, 1 week to 1 month, and at >1 month time points after CLA. Final continence score was determined based on this follow‐up information. Multiple logistic regression was used to determine factors that were associated with final continence score. Results Median continence score of dogs at initial evaluation was 2 (range, 2‐4). Median continence score after CLA alone was 3 (range, 1‐5). Seventeen of 31 (54.8%) dogs received adjunctive medical management after CLA. Median continence score after CLA with or without adjunctive medical management was 5 (range, 1‐5). Overall, 67.7% of dogs were considered continent after CLA with or without adjunctive medical management. No preoperative or perioperative factors were found to be associated with final continence score. Conclusions Cystoscopic‐guided laser ablation for intramural EU in female dogs provides improvement in incontinence. Dogs remaining incontinent after CLA may improve with adjunctive medical management. Surgical management is required to manage incontinence in dogs with extramural EU.
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Affiliation(s)
- Kimberly S Hooi
- Faculty of Veterinary Medicine at the University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Catherine Vachon
- Faculty of Veterinary Medicine at the University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Dorothee V Martel
- Faculty of Veterinary Medicine at the University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Marilyn Dunn
- Faculty of Veterinary Medicine at the University of Montreal, Saint-Hyacinthe, Quebec, Canada
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Imaging techniques in Veterinary Medicine. Part I: Radiography and Ultrasonography. Eur J Radiol Open 2021; 8:100382. [PMID: 34712745 PMCID: PMC8529508 DOI: 10.1016/j.ejro.2021.100382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
In Veterinary Medicine all the Imaging techniques are used and described but, due to organizational, managerial and, mostly, economical reasons, Radiography and Ultrasonography are the most used. Veterinary Radiology teaching has a relatively small number of educational credits in the degree courses but, nowday, educational opportunities are remarkably increased thanks to a number of post-degree courses and masters, organized both by the universities and private veterinary associations. The relevance of Diagnostic Imaging is particularly true in Veterinary Medicine, in which Radiology could be considered “indispensable” for diagnosis, prognosis and follow up. Furthermore, it should not be forgotten that the diagnostic image represents a “document” and, has a relevant role in legal medical debats. In this first part, Radiography and Ultrasonography are described.
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Brzozowska M, Marzec M, Czerski A, Kiełbowicz Z, Lodzinska J. Unilateral extramural ureteral ectopia in a cat: Ultrasonographic and computed tomography findings. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Magdalena Brzozowska
- Department of Surgery Wrocław University of Environmental and Life Sciences Wrocław Poland
| | - Magdalena Marzec
- Department of Pathology Wrocław University of Environmental and Life Sciences Wrocław Poland
| | - Albert Czerski
- Department of Animal Physiology and Biostructure Division of Animal Physiology Wrocław University of Environmental and Life Sciences Wrocław Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery Wrocław University of Environmental and Life Sciences Wrocław Poland
| | - Joanna Lodzinska
- Hospital for Small Animals Royal (Dick) School of Veterinary Studies University of Edinburgh Roslin UK
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8
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Gremillion C, Cohen EB, Vaden S, Seiler G. Optimization of ultrasonographic ureteral jet detection and normal ureteral jet morphology in dogs. Vet Radiol Ultrasound 2021; 62:583-590. [PMID: 34131995 DOI: 10.1111/vru.13000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 12/01/2022] Open
Abstract
Ureteral jets are visualized with ultrasound as echogenic streams extending from the ureterovesicular junction into the urinary bladder. In clinical practice, diuretics are sometimes administered to increase visibility of ureteral jets, however this has not been well described in the veterinary literature. The purpose of this prospective, crossover study was to describe the normal morphology of canine ureteral jets, determine an optimal protocol for diuretic administration to increase visibility of ureteral jets, and confirm in vitro the effect that differences in specific gravity and velocity have on visibility. Ultrasound of 10 normal dogs was performed at baseline and following 1 mg/kg furosemide administered intravenously or subcutaneously. Increased numbers of ureteral jets were seen post-furosemide administration compared to baseline, with an overall increased number of ureteral jets identified following intravenous administration when compared to subcutaneous administration. Time to first ureteral jet was significantly shorter with intravenous compared to subcutaneous administration. Urine specific gravity significantly decreased following furosemide administration. For the in vitro study, saline solutions of varying specific gravities were infused into a bath of hypertonic saline with specific gravity of 1.037. There was good visibility in vitro with infusion of solutions of specific gravities of 1.010-1.025. Infusion of saline solution with a specific gravity of 1.030 had reduced visibility, while infusion of saline with equivalent specific gravity (1.037) was not visible with B-mode ultrasonography. Both intravenous and subcutaneous furosemide administration significantly increase ureteral jet detection with ultrasound secondary to differences in specific gravity, confirming results of prior studies.
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Affiliation(s)
- Christine Gremillion
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Eli B Cohen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Shelly Vaden
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Gabriela Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
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Werner M, Meyer-Lindenberg A, Felten S, Hartmann K, Dorsch R. [Cystoscopic-guided laser ablation for treatment of ectopic ureteroceles in 2 female dogs]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:310-316. [PMID: 33890272 DOI: 10.1055/a-1428-7266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Two female intact Labrador Retriever dogs (6 and 3 months of age, respectively) presented with a history of urinary incontinence. In both dogs, abdominal ultrasound revealed evidence of a unilateral ectopic ureterocele. Diagnosis of ureteral ectopia was established urethrocystoscopically by visualization of the ureteral orifice in the urethra, and an intramural course was confirmed via retrograde contrast fluoroscopy. Ectopic ureteral orifices were stenotic in both dogs. Cystoscopic- and fluoroscopic-guided laser ablation of the ectopic ureter were performed with a Hol:YAG laser. Following the procedure, both dogs were fully continent without any medical treatment. Cystoscopic- guided laser ablation of ureteroceles was effective and safe in these 2 dogs. Thus, this minimally invasive technique for the treatment of ectopic ureteroceles provides an alternative to surgical intervention.
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Affiliation(s)
- Melanie Werner
- Medizinische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München
| | - Andrea Meyer-Lindenberg
- Chirurgische und Gynäkologische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München
| | - Sandra Felten
- Medizinische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München
| | - Katrin Hartmann
- Medizinische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München
| | - Roswitha Dorsch
- Medizinische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München
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Griffin MA, Culp WTN, Munro MJL, Palm CA, Wanamaker MW. Surgical treatment of retroiliac ectopic ureters with secondary hydronephrosis and hydroureter in a dog. J Am Vet Med Assoc 2021; 258:740-747. [PMID: 33754813 DOI: 10.2460/javma.258.7.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters. CLINICAL FINDINGS Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction. TREATMENT AND OUTCOME The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence. CLINICAL RELEVANCE To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.
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11
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Unilateral Urogenital Disontogeny in a Dog. Case Rep Vet Med 2021; 2021:8831551. [PMID: 33936833 PMCID: PMC8060101 DOI: 10.1155/2021/8831551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of this report was to describe an uncommon congenital anomaly in a dog. An 8-year-old, mixed-breed, male dog, was referred because of progressive difficulties on defecation. A complete diagnostic work-up (hematological analysis, radiology, ultrasound, and computed tomography), followed by surgery and histopathology, allowed us to diagnose the condition as unilateral urogenital disontogeny. The disorder was characterized by unilateral anomalies of the urinary tract (ectopic and dilated hydroureter, hydronephrosis, and renal dysplasia) associated with ipsilateral anomalies of the genital system (partial permanence of the duct of Wolff evolved into an epididymal-like structure and testicular agenesis). En bloc surgical excision of the complex of urogenital anomalies was performed with no complications during or after surgery. Surgery was considered to be effective in this dog since he no longer showed clinical signs of illness.
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12
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Schwarz T, Bommer N, Parys M, Thierry F, Bouvard J, Pérez-Accino J, Saunders J, Longo M. Four-dimensional CT excretory urography is an accurate technique for diagnosis of canine ureteral ectopia. Vet Radiol Ultrasound 2020; 62:190-198. [PMID: 33350535 DOI: 10.1111/vru.12934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/24/2020] [Accepted: 10/01/2020] [Indexed: 01/12/2023] Open
Abstract
Computed tomographic (CT) excretory urography is commonly used to investigate canine ureteral ectopia (UE). Modern technology allows time-resolved CT imaging (four-dimensional CT excretory urography [4D-CTEU]) over a distance exceeding the detector collimation. Objectives of this prospective, observational, diagnostic accuracy study were to evaluate the diagnostic accuracy of CT excretory urography (CTEU) and 4D-CTEU for UE in dogs with lower urinary tract signs, assess the influence of pelvis positioning, and to determine the significance of the ureterovesical junction (UVJ) angle for UE diagnosis. Thirty-six dogs, with a total of 42 normotopic ureters, 27 intramural ectopic ureters, and three extramural ectopic ureters, underwent CTEU and 4D-CTEU with randomized pelvis positioning. Randomized CTEU and 4D-CTEU studies were scored by two observers for ureteral papilla location and murality on a grading scheme. Interobserver agreement, sensitivity, and specificity for ureter topia status and diagnosis were calculated. Computed tomographic excretory urography showed moderate interobserver agreement for the left ureter and perfect for the right ureter, whereas 4D-CTEU showed bilateral nearly perfect agreement between both observers. When comparing CTEU versus confirmed diagnosis, there was a sensitivity and specificity of 73% and 90.2%, respectively, whereas 4D-CTEU showed a sensitivity and specificity of 97% and 94.6%, respectively. An obtuse UVJ angle is significantly more commonly observed in ectopic intramural than normotopic ureters and is significantly associated with increased diagnostic confidence of UE. The use of a wedge to angle the pelvis did not increase the diagnostic confidence in determining ureteral opening position. Four-dimensional CT excretory urography is an accurate and reliable diagnostic technique to investigate UE as cause of urinary incontinence in dogs that is slightly superior to CTEU.
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Affiliation(s)
- Tobias Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Nick Bommer
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK.,Veterinary Specialists Scotland, Livingston, UK
| | - Maciej Parys
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Florence Thierry
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK.,Occitanie Veterinary Hospital, Toulouse, France
| | - Jonathan Bouvard
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Jorge Pérez-Accino
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Jimmy Saunders
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Maurizio Longo
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK.,Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Lodi, Italy
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13
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Coyne M, Szlosek D, Clements C, McCrann D, Olavessen L. Association between breed and renal biomarkers of glomerular filtration rate in dogs. Vet Rec 2020; 187:e82. [PMID: 32611706 PMCID: PMC7799420 DOI: 10.1136/vr.105733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 05/07/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
Background Kidney disease, especially chronic kidney disease (CKD), is common in older dogs. The biomarkers symmetric dimethylarginine (SDMA) and creatinine (Cr) are indicators of glomerular filtration rate (GFR). This retrospective study used these biomarkers to identify groups at risk of decreased GFR at the breed level. Methods Data from dogs with a single serum chemistry result that included Cr and SDMA submitted between July 2015 through December 2017 were included. Dogs were identified by breed and age group. Decreased GFR was defined as Cr above 1.9 mg/dl or SDMA above 18 µg/dl. Results Fourteen breeds had a significantly higher percentage of dogs with increased SDMA or Cr for one or more age groups. Geriatric and senior Shetland sheepdogs, Yorkshire terriers and Pomeranians were significantly more likely to have increased renal biomarkers. Boxers were identified with significantly increased renal biomarkers in the age groups spanning two months to 10 years of age. Conclusion Evidence of decreased GFR occurred commonly in older dogs of most breeds, especially geriatric dogs greater than 10 years of age, but there were some exceptions, with more significant changes affecting younger animals of several breeds. The combination of SDMA and Cr identified more cases of decreased GFR than either SDMA or Cr alone.
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Affiliation(s)
| | | | | | | | - Lauren Olavessen
- IDEXX Laboratories, Westbrook, Maine, USA.,PetIQ, Eagle, Idaho, United States
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Abstract
Incontinence is a frustrating condition for both pet owners and their veterinarians. Fortunately, most causes are easily diagnosed and most dogs respond to appropriate therapy. This article reviews normal urine storage and voiding, causes of incontinence, typical clinical presentation, diagnostics, and treatment.
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Affiliation(s)
- Mark J Acierno
- Department of Medicine, Midwestern University, 5715 West Utopia Road, Glendale, AZ 85308, USA
| | - Mary Anna Labato
- Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA.
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15
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Owen LJ. Ureteral ectopia and urethral sphincter mechanism incompetence: an update on diagnosis and management options. J Small Anim Pract 2018; 60:3-17. [DOI: 10.1111/jsap.12950] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 03/18/2018] [Accepted: 09/20/2018] [Indexed: 02/02/2023]
Affiliation(s)
- L. J. Owen
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES UK
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16
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Gallana M, Utsunomiya YT, Dolf G, Pintor Torrecilha RB, Falbo AK, Jagannathan V, Leeb T, Reichler I, Sölkner J, Schelling C. Genome-wide association study and heritability estimate for ectopic ureters in Entlebucher mountain dogs. Anim Genet 2018; 49:645-650. [PMID: 30276844 DOI: 10.1111/age.12728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 11/28/2022]
Abstract
An ectopic ureter is a congenital anomaly which may lead to urinary incontinence and without a surgical intervention even to end-stage kidney disease. A genetic component contributes to the development of this anomaly in Entlebucher mountain dogs (EMD); however, its nature remains unclear. Using the Illumina CanineHD bead chip, a case-control genome-wide association study was performed to identify SNPs associated with the trait. Six loci on canine chromosomes 3, 17, 27 and 30 were identified with 16 significantly associated SNPs. There was no single outstanding SNP associated with the phenotype, and the association signals were not close to known genes involved in human congenital anomalies of the kidney or lower urinary tract. Additional research will be necessary to elucidate the potential role of the associated genes in the development of ectopic ureters in the EMD breed.
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Affiliation(s)
- M Gallana
- Clinic for Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Y T Utsunomiya
- Department of Preventive Veterinary Medicine and Animal Reproduction, School of Agricultural and Veterinarian Sciences, São Paulo State University (Unesp), 14884-900, Jaboticabal, São Paulo, Brazil
| | - G Dolf
- Vetsuisse-Faculty, Institute of Genetics, University of Bern, Bremgartenstrasse 109a, 3012, Bern, Switzerland
| | - R B Pintor Torrecilha
- Department of Preventive Veterinary Medicine and Animal Reproduction, School of Agricultural and Veterinarian Sciences, São Paulo State University (Unesp), 14884-900, Jaboticabal, São Paulo, Brazil
| | - A-K Falbo
- Clinic for Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - V Jagannathan
- Vetsuisse-Faculty, Institute of Genetics, University of Bern, Bremgartenstrasse 109a, 3012, Bern, Switzerland
| | - T Leeb
- Vetsuisse-Faculty, Institute of Genetics, University of Bern, Bremgartenstrasse 109a, 3012, Bern, Switzerland
| | - I Reichler
- Clinic for Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - J Sölkner
- Division of Livestock Sciences, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Gregor Mendel Straße 33, 1180, Vienna, Austria
| | - C Schelling
- Vetsuisse-Faculty, Clinic for Reproductive Medicine and Center of Clinical Studies, University of Zurich, Eschikon 27, EHB F 22.1, 8315, Lindau, Switzerland
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17
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Meler E, Berent AC, Weisse C, Dunn M. Treatment of congenital distal ureteral orifice stenosis by endoscopic laser ablation in dogs: 16 cases (2010-2014). J Am Vet Med Assoc 2018; 253:452-462. [PMID: 30058968 DOI: 10.2460/javma.253.4.452] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine characteristics of and outcomes for dogs with congenital distal ureteral orifice stenosis (CDUOS) treated by cystoscopic-guided laser ablation (CLA). DESIGN Retrospective case series. ANIMALS 16 client-owned dogs with CDUOS treated by CLA at 2 veterinary hospitals between 2010 and 2014. PROCEDURES Medical records were reviewed and data collected regarding clinical findings, imaging results, surgery characteristics, treatment, and outcome. Follow-up information was collected from dog owners and referring veterinarians via standardized interview. RESULTS Dogs included 10 males and 6 females; median age was 11.5 months (range, 4 to 112 months). Labrador Retriever (n = 6; 3 males) was the most common breed. Intramural ectopic ureteral openings were identified at the site of stenosis in 15 dogs (18/20 stenotic ureteral openings). Treatment with CLA to enlarge and relocate the stenotic opening was successful in all dogs. Median duration of anesthesia and hospitalization was 105 minutes and 24 hours, respectively. No complications were noted. Fourteen dogs remained alive (2 lost to follow-up) during a median follow-up period of 14.5 months. Owners of 11 of 13 dogs reported improvement in their dog's quality of life after CLA. The treated ureteral orifice remained patent in the 2 dogs that were reimaged. CONCLUSIONS AND CLINICAL RELEVANCE CDUOS should be considered as a differential diagnosis for dogs with idiopathic distal ureteral obstruction, particularly young male Labrador Retrievers, and was most often associated with an intramural ectopic ureter in this study. Treatment with CLA was safe and effective for opening the ureteral orifice.
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18
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Interventional Radiology and Interventional Endoscopy in Treatment of Nephroureteral Disease in the Dog and Cat. Vet Clin North Am Small Anim Pract 2018; 48:843-862. [PMID: 29909932 DOI: 10.1016/j.cvsm.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Interventional endoscopy and interventional radiology have led to the development of minimally invasive techniques for management of kidney and ureteral diseases in the dog and cat including idiopathic renal hematuria, ureteral obstruction, and ectopic ureters. Sclerotherapy is a renal-sparing chemical cauterization technique used in cases of idiopathic renal hematuria. Diagnosis of ureteral obstruction is challenging in some cases based on ultrasound alone and antegrade pyelography should be considered. Treatment options for obstructions include nephrostomy tubes, ureteral stents, and subcutaneous ureteral bypass devices. Treatment with cystoscopic-guided laser ablation provides similar outcomes to surgery in dogs with intramural ectopic ureters.
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Secrest S, Bugbee A, Waller K, Jiménez DA. COMPARISON OF TRANSVERSE COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IMAGES AND MAXIMUM INTENSITY PROJECTION IMAGES FOR DIAGNOSING ECTOPIC URETERS IN DOGS. Vet Radiol Ultrasound 2016; 58:163-168. [DOI: 10.1111/vru.12461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/13/2016] [Accepted: 10/25/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia; Athens GA 30602
| | - Andrew Bugbee
- Department of Small Animal Medicine and Surgery; University of Georgia; Athens GA 30602
| | - Kenneth Waller
- Department of Surgical Sciences; University of Wisconsin; Madison WI 53706
| | - David A. Jiménez
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia; Athens GA 30602
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20
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Fox AJ, Sharma A, Secrest SA. Computed tomographic excretory urography features of intramural ectopic ureters in 10 dogs. J Small Anim Pract 2016; 57:210-3. [DOI: 10.1111/jsap.12460] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/21/2015] [Accepted: 01/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
- A. J. Fox
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia College of Veterinary Medicine; Athens GA 30602 USA
| | - A. Sharma
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia College of Veterinary Medicine; Athens GA 30602 USA
| | - S. A Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia College of Veterinary Medicine; Athens GA 30602 USA
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21
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Balogh O, Degrandi F, Hässig M, Reichler I. Validation of screening examinations of the ureteral orifices in dogs: Comparison of ultrasonography with dissection. Res Vet Sci 2015; 101:199-205. [DOI: 10.1016/j.rvsc.2015.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/17/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
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22
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Roundell CDG, Friend EJ. Resolution of incontinence using an artificial urethral sphincter in feline genitourinary dysplasia. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Queau Y, Larsen JA, Johnson EG, Westropp JL. Scintigraphy and exogenous creatinine clearance to assess renal function in a Newfoundland dog with ureteral ectopia. VETERINARY RECORD CASE REPORTS 2013. [DOI: 10.1136/vetreccr-2013-000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Yann Queau
- Veterinary Medical Teaching HospitalSchool of Veterinary MedicineUniversity of CaliforniaDavisCA95616USA
- Royal Canin SASAimarguesFrance
| | - Jennifer A. Larsen
- Department of Veterinary Molecular BiosciencesSchool of Veterinary MedicineUniversity of CaliforniaDavisCA95616USA
| | - Eric G. Johnson
- Department of Veterinary Surgery and RadiologySchool of Veterinary MedicineUniversity of CaliforniaDavisCA95616USA
| | - Jodi L. Westropp
- Department of Veterinary Medicine and EpidemiologySchool of Veterinary MedicineUniversity of CaliforniaDavisCA95616USA
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24
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Fritsche R, Dolf G, Schelling C, Hungerbuehler SO, Hagen R, Reichler IM. Inheritance of ectopic ureters in Entlebucher Mountain Dogs. J Anim Breed Genet 2013; 131:146-52. [DOI: 10.1111/jbg.12055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- R Fritsche
- Clinic for Animal Reproduction Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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25
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Novellas R, Stone J, Pratschke K, Hammond G. Duplicated ectopic ureter in a nine-year-old Labrador. J Small Anim Pract 2013; 54:386-9. [DOI: 10.1111/jsap.12056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R. Novellas
- Departament de Medicina i Cirurgia Animals, Edifici V; Campus Universitat Autònoma de Barcelona; 08193 Cerdanyola del Vallès Barcelona Spain
| | - J. Stone
- Pride Veterinary Centre; Riverside Road Derby Derbyshire DE24 8HX
| | - K. Pratschke
- School of Veterinary Medicine; University of Glasgow; Bearsden Road Glasgow G61 1QH
| | - G. Hammond
- School of Veterinary Medicine; University of Glasgow; Bearsden Road Glasgow G61 1QH
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26
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Silva M, Larangeira D, Penha E, Oriá A, Costa Neto J, Barrouin-Melo S. Ectopia ureteral unilateral congênita em uma cadela Teckel Dachshund com pelagem arlequim: relato de caso. ARQ BRAS MED VET ZOO 2012. [DOI: 10.1590/s0102-09352012000600015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O presente relato apresenta a primeira descrição de ectopia ureteral congênita na raça Teckel Dachshund, diagnosticada em uma cadela com pelagem arlequim. O animal, aos dois meses de idade, apresentava sinais de incontinência urinária e cistite bacteriana, sendo submetido a um plano diagnóstico para confirmação de ureter ectópico. A urografia excretora revelou hidroureter direito com desembocadura caudal ao trígono da bexiga. O exame físico do animal evidenciou ainda hérnia inguinal bilateral, o que reforçou a caracterização da origem congênita das alterações. Aspectos de bem-estar animal são também discutidos.
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Affiliation(s)
| | | | | | - A.P. Oriá
- Universidade Federal da Bahia, Brasil
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27
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Anders KJ, McLoughlin MA, Samii VF, Chew DJ, Cannizzo KL, Wood IC, Weisman DL. Ectopic ureters in male dogs: review of 16 clinical cases (1999-2007). J Am Anim Hosp Assoc 2012; 48:390-8. [PMID: 23033459 DOI: 10.5326/jaaha-ms-5302] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ureteral ectopia is a well-described cause of urinary incontinence in female dogs, but this condition has not been completely characterized in male dogs. Sixteen male dogs with ectopic ureters were evaluated between Jan 1999 and Mar 2007. Male dogs were similar to female dogs with ectopic ureters in terms of breed, presenting complaint, age of onset, and bilateral nature of the ectopia. Diagnosis was made by expert interpretation of imaging techniques such as excretory urography and contrast-enhanced computed tomography (CT). Overall, 11 of 13 dogs that had surgical correction of ectopic ureters were incontinent preoperatively. Urinary continence was restored in 82% of those dogs.
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Affiliation(s)
- Katherine J Anders
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, USA
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28
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Reichler IM, Eckrich Specker C, Hubler M, Alois B, Haessig M, Arnold S. Ectopic Ureters in Dogs: Clinical Features, Surgical Techniques and Outcome. Vet Surg 2012; 41:515-22. [DOI: 10.1111/j.1532-950x.2012.00952.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | - Michael Haessig
- Section for Herd Health; Vetsuisse-Faculty; University Zurich; Winterthurerstr. 260; Zurich; Switzerland
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29
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D'ANJOU MARCANDRÉ, BÉDARD AGATHE, DUNN MARILYNE. CLINICAL SIGNIFICANCE OF RENAL PELVIC DILATATION ON ULTRASOUND IN DOGS AND CATS. Vet Radiol Ultrasound 2010. [DOI: 10.1111/j.1740-8261.2010.01729.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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30
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North C, Kruger J, Venta P, Miller J, Rosenstein D, Randall E, White B, Fitzgerald S. Congenital Ureteral Ectopia in Continent and Incontinent-Related Entlebucher Mountain Dogs: 13 Cases (2006-2009). J Vet Intern Med 2010; 24:1055-62. [DOI: 10.1111/j.1939-1676.2010.0562.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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31
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Hoelzler MG, Lidbetter DA. Surgical management of urinary incontinence. Vet Clin North Am Small Anim Pract 2004; 34:1057-73, viii. [PMID: 15223216 DOI: 10.1016/j.cvsm.2004.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Urethral sphincter mechanism incompetence and ureteral ectopia are the two most common causes of urinary incontinence in dogs and cats. Surgical treatments for both disorders have been described. Once a diagnosis is made, surgical intervention may lead to improved outcomes with resolution of incontinence in many patients. Proper case selection and surgical technique are critical in achieving clinical success when managing these difficult cases.
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Affiliation(s)
- Michael G Hoelzler
- Department of Small Animal Clinical Sciences, C247 Veterinary Teaching Hospital, The University of Tennessee College of Veterinary Medicine Knoxville, TN 37996-4544, USA
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32
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Samii VF, McLoughlin MA, Mattoon JS, Drost WT, Chew DJ, DiBartola SP, Hoshaw-Woodard S. Digital Fluoroscopic Excretory Urography, Digital Fluoroscopic Urethrography, Helical Computed Tomography, and Cystoscopy in 24 Dogs with Suspected Ureteral Ectopia. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb02545.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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33
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Cannizzo KL, McLoughlin MA, Mattoon JS, Samii VF, Chew DJ, DiBartola SP. Evaluation of transurethral cystoscopy and excretory urography for diagnosis of ectopic ureters in female dogs: 25 cases (1992-2000). J Am Vet Med Assoc 2003; 223:475-81. [PMID: 12930085 DOI: 10.2460/javma.2003.223.475] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate transurethral cystoscopy and excretory urography for diagnosis of ectopic ureter in female dogs and identify concurrent urogenital abnormalities. DESIGN Retrospective study. ANIMALS 25 female dogs. PROCEDURE Medical records of female dogs that underwent transurethral cystoscopy, excretory urography, and ventral cystotomy were reviewed for signalment, history, physical examination findings, results of bacteriologic culture of urine, and surgical findings. Videotapes of transurethral cystoscopy and radiographic studies were reviewed systematically without knowledge of surgical findings. RESULTS Ectopic ureters were diagnosed in 24 of 25 (96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs. Cystoscopic evaluation yielded a correct diagnosis in all dogs when results of ventral cystotomy were used as the diagnostic standard. Cystoscopic evaluation identified a terminal ureteral opening for all ureters. Urethral fenestrations, troughs, striping, and tenting were identified. Abnormalities of the vestibule were identified in all examinations available for review (24/25). The paramesonephric septal remnant and its association with ectopic ureters were identified and characterized by cystoscopy. Radiographic findings were discordant with surgical findings and correctly identified 36 of 46 (78.2%) ectopic ureters and 2 of 4 normal ureters. Hydroureter and renal abnormalities were associated with distal urethral ectopic ureters on radiographic evaluations. CONCLUSIONS AND CLINICAL RELEVANCE Transurethral cystoscopy was accurate and minimally invasive for identification and classification of ectopic ureters in dogs. Contrast radiography had limitations in diagnosis of ectopic ureters. Cystoscopic findings and associated vaginal and vestibular abnormalities support abnormal embryologic development in the pathogenesis of ectopic ureters.
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Affiliation(s)
- Karin L Cannizzo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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34
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Rozear L, Tidwell AS. Evaluation of the ureter and ureterovesicular junction using helical computed tomographic excretory urography in healthy dogs. Vet Radiol Ultrasound 2003; 44:155-64. [PMID: 12718349 DOI: 10.1111/j.1740-8261.2003.tb01264.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Abdominal computed tomography (CT) using a protocol designed for evaluation of the ureters was performed on six normal purpose-bred research dogs. After noncontrast CT, a postcontrast scan was performed 3 min post midpoint of injection of 400 mgI/kg body weight of diatrizoate meglumine/sodium. Ureteral and ureterovesicular junction anatomy were readily assessed with minimal patient preparation. The ureters were similar in size to reported values and the renal pelvis, ureter, and ureterovesicular junction were easily identified on both noncontrast and contrast-enhanced scans. There was a significant relationship between bladder volume and interureterovesicular junction distance but not between bladder volume and ureterovesicular junction to internal urethral orifice distance. A reliable bony landmark for the identification of the internal urethral orifice could not be determined. The results of this preliminary study of normal anatomy should facilitate the clinical use of CT in the evaluation of ureteral disease (e.g., ureteral ectopia).
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Affiliation(s)
- Lance Rozear
- Department of Clinical Sciences, Section of Radiology, Tufts University School of Veterinary Medicine, North Grafton, MA 01536, USA
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