Circumcaval ureter associated with an intrahepatic portosystemic shunt in a dog

CASE DESCRIPTION

A 4-month-old Bernese Mountain Dog was examined because of shifting hind limb lameness and lethargy of 2 weeks' duration.

CLINICAL FINDINGS

The lameness was attributed to hypertrophic osteodystrophy. Portosystemic shunting was suspected on the basis of low serum albumin concentration and high serum bile acids concentration, and an intrahepatic shunt was identified ultrasono-graphically. Celiotomy was performed, and the shunt was partially closed with a cellophane band. During follow-up ultrasonography 7 months later, dilation of the left renal pelvis and proximal portion of the left ureter was identified. During exploratory celiotomy, the left ureter was found to pass dorsal to the caudal vena cava, and circumcaval ureter was diagnosed.

TREATMENT AND OUTCOME

The ureter was transected, repositioned ventral to the vena cava, and anastomosed. Follow-up ultrasonographic examinations revealed gradual resolution of the hydronephrosis and hydroureter.

CLINICAL RELEVANCE

Findings suggest that circumcaval ureter should be considered in the differential diagnosis for hydronephrosis and hydroureter in dogs. Partial obstruction of the middle segment of the ureter on ultrasonograms or contrast radiographs should increase the index of suspicion for this condition.

Cellophane banding of congenital intrahepatic portosystemic shunts in two Irish wolfhounds

Two three-month-old, male Irish wolfhound siblings were diagnosed with breed-typical left divisional congenital intrahepatic portosystemic shunts consistent with patent ductus venosus. The shunts were amenable to surgical dissection at a posthepatic location. Both dogs had cellophane banding for shunt attenuation. One dog was euthanased after developing post-ligation neurological dysfunction, which was refractory to treatment. The other dog survived and demonstrated shunt attenuation. Successful surgical management using cellophane banding of a patent ductus venosus has not been previously described in a large-breed dog.

An observational study of the management of traumatic tympanic membrane perforations

Controversies of how best to treat fresh tympanic membrane perforations have always existed. While some otolaryngologists prefer the paper patch method, others prefer modified myringoplasty. A prospective study is needed to investigate the most effective and least expensive management of this common ear trauma. This study examined prospectively, in three sections, a group of patients with a cellophane patch (n = 6), another group with a gentamicin ointment seal (n = 15) and a control group (n = 9) with a gentamicin plug placed at the distal end of the external auditory cavity. Successful healing of the traumatic tympanic membrane perforations was achieved in 50 per cent of the cellophane seal group, 86.7 per cent of the gentamicin ointment seal group and 77.8 per cent of the control group. This study shows that the management of a fresh tympanic membrane perforation should be limited to cleaning the traumatized ear and preventing infection.