Exploring the association between canine perineal hernia and neurological, orthopedic, and gastrointestinal diseases

Publisher Copyright: © 2022, The Author(s).Background: Perineal hernia (PH) is a relatively common condition in intact male dogs, but the etiology remains unclear. The objective of this study was to assess the contribution of gastrointestinal (GI), neurological, and orthopedic conditions to the development of PH in male dogs. Patient history with a focus on chronic GI disease was assessed using an owner questionnaire. Neurological conditions were explored, applying neurological, electromyographic (EMG), and motor nerve conduction velocity (MNCV) examinations and combining these with computed tomography (CT) imaging. To exclude possible orthopedic diseases, an orthopedic examination was conducted together with CT analysis. The chi-squared test was used to assess the associations between categorical variables. Results: Altogether, 66 male dogs with diagnosed PH were recruited for this study. The frequency of neurological, orthopedic, and GI diseases was low in dogs with PH. No signs of generalized neuro- or myopathies were detected. Still, perineal and bulbourethral reflexes were decreased or missing in 44.6% (29/65) and 40.0% (26/65) of dogs, respectively. Mild or moderate occlusion of the intervertebral foramen at the lumbosacral (LS) junction occurred in 18.5% (12/65) of dogs and was caused by spondylosis deformans in 83.3% (10/12). Moderate disc protrusion was evident in 9.2% (6/65) of dogs. Conclusion: No evidence was found that PH is caused by gastrointestinal, orthopedic, or neurological conditions. Abnormalities in perineal and bulbourethral reflexes are most likely secondary to PH.Peer reviewe

Perineaalityrä uroskoirilla: etiologiset tekijät sekä kirurginen hoito

Despite being a relatively common disease in male dogs, literature on canine perineal hernia (PH) contains several knowledge gaps. The etiology remains unclear, with considered factors including structural, neurological, gastrointestinal (GI), and even orthopedic conditions. The role of prostatic disease has also been debated, although prospective and systematic studies are lacking. Treatment is surgical and several techniques have been described, however, there are no prospective comparative studies. Recurrence is estimated between 0-36% and persistent postoperative GI signs may occur even without recurrence. Our study included 66 prospectively gathered male dogs with naturally occurring PH, that had not previously undergone PH surgery. We explored PH etiology with emphasis on prostatic, GI, neurological, and orthopedic conditions. For this purpose, we used owner questionnaires, neurological- and orthopedic examinations, electromyography, and motor nerve conduction velocity studies. In addition, we used computed tomography (CT) imaging to evaluate the lumbosacral (LS) area, hip joints, and the prostate of PH dogs. We compared the prostatic CT findings to those of age matched male dogs without PH. We found that prostates in the PH group were significantly larger (P < .001) and contained more cysts (P < .001) with a larger diameter than the control group. Additionally, paraprostatic cysts (17%) and mineralizations (32%) found in the PH group were missing in the control-group. Evidence of other etiological factors, such as generalized neurological disease or orthopedic conditions, was lacking. Although the perineal reflex was decreased or missing in 45%, and the bulbourethral reflex in 40% of dogs, we inferred that these findings were likely the result rather than the cause of PH. Similarly, we found that GI conditions were unlikely to be the cause of PH, as the frequency of chronic GI diseases was low. To assess the treatment of PH, we conducted a prospective randomized study comparing two techniques: the elevation of the internal obturator muscle (EIOM) (n = 36) and the fascia lata graft (FLG) (n = 30). Follow-up visits took place at 2- weeks and 3-, 6- and 12-months. We evaluated the non-inferiority of the FLG to the EIOM based on recurrence of the hernia on rectal examination. A defecation signs score (DSS) was calculated from the owner questionnaires, and complications and persistent clinical signs were reported. In dogs attending the 12-month follow-up (n = 63), the recurrence rate in the EIOM and FLG group were 8.8% and 10.3% respectively, with non-inferiority shown. The DSS decreased significantly after surgery and complications were uncommon; however, in some dogs, mild persistent defecation signs were evident. Based on the findings of the thesis, we found that the etiology of PH is likely linked to the enlarged and cystic prostate. Future studies should focus on how the prostate contributes to PH formation, with the aim to hinder the progression of or even prevent the disease. There was no evidence connecting GI, orthopedic, or neurological conditions to PH formation. Evaluating surgical treatment, we found FLG to be non-inferior to EIOM when considering recurrence. Interestingly, although all dogs improved postoperatively, mild persistent clinical signs remained in a portion of the dogs.Perineaalityrä (PT) on kastroimattomilla uroskoirilla esiintyvä ulostamisvaikeuksia aiheuttava sairaus, joka johtuu lantionpohjan lihasten surkastumisesta. PT:n seurauksena peräsuoli, eturauhanen tai virtsarakko voivat tyräytyä ihon alle peräaukon viereen. PT:n etiologia on edelleen huonosti tunnettu, mutta mahdollisiksi altistaviksi tekijöiksi on epäilty hormonaalisia, neurologisia ja rakenteellisia tekijöitä, sekä ruuansulatuskanavan sairauksia. Eturauhasen sairauksien on epäilty olevan yhteydessä tyrän syntymiseen, mutta niitä ei ole systemaattisesti arvioitu PT:ä sairastavilla koirilla. PT:n pääasiallinen hoito on kirurginen. Leikkaustekniikoita on useita ja vertailevia tutkimuksia niiden hoitotuloksista ei juurikaan ole. Leikkaushoitoon liittyy kuitenkin kohtalaisen korkea uusimisriski sekä ulostamisoireet, joita osalla koirista voi ilmetä myös leikkauksen jälkeen, vaikka tyräkorjaus olisikin onnistunut. Otimme tutkimukseen PT:ä sairastavia, perusterveitä uroskoiria. Omistajakyselyn, ortopedisen ja neurologisen tutkimuksen sekä lantion alueen tietokonetomografian (TT) ja elektrodiagnostiikan avulla tutkimme mahdollisia PT:n kehittymiseen vaikuttavia tekijöitä. TT-tutkimuksessa kiinnitimme huomiota erityisesti eturauhaseen, ja vertasimme PT:ä sairastavien sekä saman ikäisten terveiden kastroimattomien uroskoirien eturauhasia. Lisäksi vertasimme prospektiivisella, satunnaistetulla tutkimusasetelmalla kahta leikkausmenetelmää, perinteistä sisemmän peittäjälihaksen nostotekniikkaa (SPN) sekä faskia lata-siirteen käyttöä (FLS). Koirien oireita ja tyrän uusiutumista seurattiin oirekyselyillä, niiden perusteella lasketulla ulostamisoireindeksillä ja kontrollikäynneillä vuoden ajan leikkauksen jälkeen. Tutkimukseen osallistui 66 koiraa, joille tehtiin yhteensä 105 tyräleikkausta. Havaitsimme, että PT:ä sairastavilla koirilla oli verrokkiryhmään nähden tilastollisesti merkitsevästi suuremmat eturauhaset ja lisäksi kystien määrä eturauhasessa oli suurempi. Emme havainneet yhteyttä PT:n ja koiran neurologisten tai ortopedisten löydösten tai ruuansulatuskanavan ongelmien välillä. Leikkausmenetelmistä tyrä uusi 8,8 %:lla SPN-ja 10,3 %:lla FLS-tekniikalla leikatuista koirista. Molemmat menetelmät olivat yhtä tehokkaita estämään tyrän uusiutumista. Koirien ulostamisoireindeksi laski tilastollisesti merkitsevästi leikkauksen jälkeen ja komplikaatiot olivat epätavallisia. Kuitenkin pienellä osalla koirista oli edelleen lieviä ulostusongelmia leikkauksen jälkeen. Tutkimuksemme osoittivat, että suurentuneella ja kystisellä eturauhasella on todennäköisesti yhteys PT:n syntyyn. Jatkotutkimuksissa tulisi keskittyä eturauhasen ja PH:n tarkemman syy-yhteyden selvittämiseen. Näin voisimme hidastaa sairauden etenemistä sekä jopa ennaltaehkäistä PT:n kehittymistä

Prevalence of Taenia solium cysticercosis in Estonian pigs

Taenia solium on liigitatud World Health Organizationi poolt tähtsaks unarusse jäetud zonootiliseks haiguseks, ning globaalselt number üks parasitaarhaiguseks. Sellel on keeruline elutsükkel mis haarab kaasa peamiselt inimest ja siga, ning on endeemiline mitmetes madala ning keskmise sissetulekuga maades. Siiski kui tavaliselt tenioos ei põhjusta kliinilisi tunnuseid, inimeste neurotsüstitserkoos on tunnustatud üheks kõige harilikumaks neuroloogilise haiguse põhjustajaks endeemilistes maades. Töö eesmärgiks oli uurida sigade tsüstitserkoosi levimust Eesti sigadel kasutades post-mortem lihainspektsiooni. Leitud tsüstid uuritakse PCR’iga. Hüpoteesiks oli leida levimus mis oleks ≥0%. Kokku 1217 siga uuriti aastal 2014 Veebruarist Aprillini visuaalselt, palpeerides ning sisselõiked tehes parasiidi eeliskohtadesse. Üks tsüst leiti nuumsea südame vasakust vatsakesest, aga PCR analüüs ei saanud tõestada et tegu oleks Taenia perekonnaga, andes näilikuks levimuseks 0% (0.00-0.25 95% Cl). See et T.soliumi tsüstitsekide olemasolu ei saadud tõestatud selle uuringu jooksul ei tähenda et Eesti on tsüstitserkoosivaba. Tulemust tõenäoliselt mõjutab näiteks lihainspektsiooni madal sensitiivsus kui diagnoosimismeetod. See, et tsüste ikka leitakse vahepeal tapamajades ning et Eestis on diagnoositud inimestel taenioosit viimati aastal 2003, viitab sellele et lisauuringuid on vaja.Taenia solium is categorized by the World Health Organization as an important neglected zoonotic disease, as well as number one global parasitic disease. It has a complicated life cycle mainly involving pigs and humans, and is endemic in several low to middle income countries. Although human taeniosis rarely causes symptoms, human neurocysticercosis has been recognized as one of the greatest causes of neurological disease in endemic areas. The aim was to investigate the prevalence of cysticercosis in Estonian pigs through post-mortem meat inspection in Estonia’s three largest abattoirs. Found cysts would be analyzed with PCR. The hypothesis was that the prevalence of cysticercosis would be ≥0%. A total of 1217 pigs were examined from February to April 2014 through visual inspection, palpation as well as incisions of predilection sites to find cysts. One cyst was discovered in the left ventricle of the heart of a finishing pig. PCR analysis showed that the found cyst could not be identified as Taenia spp., confirming the hypothesis with an apparent prevalence of 0% (0.00-0.25 95% Cl). Although proof of the appearance of T. solium cysticerci in Estonian slaughterhouses was not obtained during this study, it doesn’t confirm that Estonia is free of the parasite. Low sensitivity of the applied inspection method is likely to have contributed to low amount of cysts. As cysts appear in slaughterhouses and taeniosis has been diagnosed in humans in Estonia in 2003, further studies are warranted