Diagnosis, management, and outcome of urethral obstruction secondary to the capsule associated with the artificial urethral sphincter device.

BackgroundUrethral obstruction secondary to artificial urethral sphincter (AUS) implantation is a recognized complication in dogs. However, urethral obstruction secondary to AUS-associated capsule formation has been described rarely.HypothesisDescribe clinical and diagnostic findings, management, and outcome in 6 dogs with urethral obstruction secondary to AUS-associated capsule formation.AnimalsSix client-owned dogs.MethodsRetrospective study. Medical records between January 1, 2010, and June 30, 2021, were reviewed to identify dogs with urethral obstruction associated with the AUS device.ResultsThe AUS device was implanted a median of 884 days (range, 20-2457 days) before presentation for urethral obstruction. Median age at time of urethral obstruction was 4.7 years (range, 3.1-8.7 years). Clinical signs at the time of urethral obstruction were stranguria (n = 4), pollakiuria (3), weak urine stream (2), and worsened urinary incontinence (1). In all dogs, the urethra was noted to be stenotic during urethroscopy and positive contrast cystourethrography. All dogs underwent surgery, and a fibrous capsule associated with the AUS was found to be causing urethral stenosis. Resolution of urethral obstruction occurred in all dogs after transection or removal of the capsule. Positive bacterial cultures were obtained from the capsule, AUS, or both in all dogs. Recurrence of urethral obstruction had not occurred in any dog at the time of follow-up.Conclusions and clinical importanceUrethral obstruction secondary to capsule formation is an uncommon but clinically important complication associated with use of the AUS. Continued investigation is needed to evaluate this complication more thoroughly, and its possible association with infection

Stenting of Malignant Urinary Tract Obstructions in Humans and Companion Animals.

Urine retention secondary to neoplastic obstructions of the upper and lower urinary tracts is a life-threatening condition in both humans and companion animals. Stents can be placed to temporarily or permanently open obstructed urinary tract lumens and are often able to be placed using minimally invasive techniques with guidance via ultrasonography or fluoroscopy. The literature for these techniques is vast for humans and growing for companion animals. The below review provides a discussion of the principles of stenting and types of ureteral and urethral stents, as well as the techniques for placing these stents in humans and companion animals

Urolithiasis in dogs: Evaluation of trends in urolith composition and risk factors (2006‐2018)

Abstract Background Urolithiasis is a common and often recurrent problem in dogs. Objective To evaluate trends in urolith composition in dogs and to assess risk factors for urolithiasis, including age, breed, sex, neuter status, urolith location, and bacterial urolith cultures. Sample Population A total of 10 444 uroliths and the dogs from which they were obtained. Methods The laboratory database at the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from dogs between January 2006 and December 2018. Mineral type, age, breed, sex, neuter status, urolith location, and urolith culture were recorded. Trends were evaluated and variables compared to evaluate risk factors. Results Calcium oxalate (CaOx) and struvite‐containing uroliths comprised the majority of all submissions from dogs, representing 47.0% and 43.6%, respectively. The proportion of CaOx‐containing uroliths significantly decreased from 49.5% in 2006 to 41.8% in 2018 (P = .006), with no change in the proportion of struvite‐containing urolith submissions. Cystine‐containing uroliths comprised 2.7% of all submissions between 2006 and 2018 and a significant nonlinear increase in this mineral type occurred over time (1.4% of all submissions in 2006 to 8.7% in 2018; P < .001). Of all cystine‐containing uroliths, 70.3% were from intact male dogs. Age, breed, and sex predispositions for uroliths were similar to those previously identified. Conclusions and Clinical Importance Although calcium oxalate‐ and struvite‐containing uroliths continue to be the most common uroliths submitted from dogs, a decrease in the proportion of CaOx‐containing uroliths and an increase in the proportion of cystine‐containing uroliths occurred during the time period evaluated

Urolithiasis in dogs: Evaluation of trends in urolith composition and risk factors (2006-2018).

BackgroundUrolithiasis is a common and often recurrent problem in dogs.ObjectiveTo evaluate trends in urolith composition in dogs and to assess risk factors for urolithiasis, including age, breed, sex, neuter status, urolith location, and bacterial urolith cultures.Sample populationA total of 10 444 uroliths and the dogs from which they were obtained.MethodsThe laboratory database at the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from dogs between January 2006 and December 2018. Mineral type, age, breed, sex, neuter status, urolith location, and urolith culture were recorded. Trends were evaluated and variables compared to evaluate risk factors.ResultsCalcium oxalate (CaOx) and struvite-containing uroliths comprised the majority of all submissions from dogs, representing 47.0% and 43.6%, respectively. The proportion of CaOx-containing uroliths significantly decreased from 49.5% in 2006 to 41.8% in 2018 (P = .006), with no change in the proportion of struvite-containing urolith submissions. Cystine-containing uroliths comprised 2.7% of all submissions between 2006 and 2018 and a significant nonlinear increase in this mineral type occurred over time (1.4% of all submissions in 2006 to 8.7% in 2018; P &lt; .001). Of all cystine-containing uroliths, 70.3% were from intact male dogs. Age, breed, and sex predispositions for uroliths were similar to those previously identified.Conclusions and clinical importanceAlthough calcium oxalate- and struvite-containing uroliths continue to be the most common uroliths submitted from dogs, a decrease in the proportion of CaOx-containing uroliths and an increase in the proportion of cystine-containing uroliths occurred during the time period evaluated

Ultrafiltration during intermittent hemodialysis in dogs with acute kidney injury

BackgroundUltrafiltration is performed to alleviate fluid overload in dogs with acute kidney injury (AKI) undergoing intermittent hemodialysis (IHD).ObjectivesTo describe prescription patterns for ultrafiltration in dogs receiving IHD for AKI and risk factors for ultrafiltration-related complications.AnimalsSeventy-seven dogs undergoing 144 IHD treatments between 2009 and 2019.MethodsMedical records of dogs receiving IHD for AKI were reviewed. The initial 3 IHD treatments in which ultrafiltration was prescribed were included. Ultrafiltration-related complications were defined as those requiring an intervention such as transient or permanent discontinuation of ultrafiltration.ResultsMean fluid removal rate per treatment was 8.1 ± 4.5&nbsp;mL/kg/h. Ultrafiltration-related complications occurred in 37/144 (25.7%) of treatments. Hypotension was rare (6/144, 4.2% of treatments). No ultrafiltration-related complications resulted in deaths. The mean prescribed fluid removal rate per treatment was higher in dogs with ultrafiltration-related complications than without (10.8 ± 4.9&nbsp;mL/kg/h vs 8.8 ± 5.1&nbsp;mL/kg/h, respectively; P&nbsp;=&nbsp;.03). The mean delivered fluid removal rate per treatment was significantly lower in dogs with UF-related complications compared to those without complications (6.8 ± 4.0&nbsp;mL/kg/h vs 8.6 ± 4.6&nbsp;mL/kg/h, respectively; P&nbsp;=&nbsp;.04). Variables associated with ultrafiltration-related complications (P &lt; .05) included central venous oxygen saturation, body temperature before IHD treatment, total extracorporeal circuit volume and BUN at the end of IHD treatment.Conclusions and clinical importanceUltrafiltration during IHD in dogs with AKI is overall safe. Higher prescribed ultrafiltration rates were associated with increased risk of complications. Decrease in central venous oxygen saturation is associated with ultrafiltration-related complications, emphasizing the utility of in-line blood monitoring

Bilateral external jugular vein anomalies preventing hemodialysis catheter placement in a cat with anuria secondary to species intoxication

Case series summary A 2-year-old female spayed Abyssinian cat was evaluated for lethargy and inappetence that first occurred approximately 4 days prior. In addition, urination had not been observed by the owner for 5 days. A Lilium species plant had been brought into the house approximately 5 days before initial evaluation, and intoxication was therefore suspected. Bloodwork revealed anemia, severe azotemia and hyperkalemia. As the cat was anuric with severe azotemia, hyperkalemia and fluid overload, intermittent hemodialysis was recommended. Attempts were made to place a hemodialysis catheter into the external jugular veins bilaterally, but after initial successful venipuncture, the instrumentation would not pass into either vein. During fluoroscopic angiography, no internal jugular veins or external jugular veins caudal to the thoracic inlet were visualized and venous drainage from the head occurred via the vertebral veins. Owing to the anomalous anatomy in the cervical region, a hemodialysis catheter could not be placed into either jugular vein. Alternative sites for the placement of an extracorporeal catheter were discussed with the owner, but humane euthanasia was elected. Relevance and novel information To the authors’ knowledge, this is the first report of a cat with bilateral external jugular vein anomalies resulting in blind endings that did not communicate with the vena cava. This was discovered during attempts to place a hemodialysis catheter for the management of anuric renal failure secondary to Lilium species intoxication. While this anatomical variation is likely uncommon, it is an important differential to consider when faced with challenging external jugular vein catheterizations in feline patients

Risk factors associated with progressive increases in serum creatinine concentrations in cats with cancer receiving doxorubicin.

BackgroundAzotemia occurs in cats administered doxorubicin, but risk factors have not been explored.ObjectiveTo determine incidence of progressive increases in serum creatinine concentration in cats with cancer receiving doxorubicin in single or multiagent chemotherapy protocols and associated risk factors.AnimalsSeventy cats with cancer receiving doxorubicin.MethodsA retrospective study (2007-2017) of cats with indices of kidney function recorded before and after doxorubicin administration was reviewed. Cats diagnosed with kidney injury because of known etiologies other than possible doxorubicin toxicosis were excluded. Variables were compared to identify risk factors.ResultsMean age (±SD) was 10.9 years (±3.2). Cancer types included lymphoma (n = 36), sarcoma (n = 19) and carcinoma (n = 14). Chronic kidney disease was present in 29/70 (41%) cats before receiving doxorubicin. Of 70 cats, 24 (34%) developed an increase in serum creatinine concentration ≥0.3 mg/dL and 10 (14%) had an increase ≥50% from baseline. Mean time to increases in serum creatinine concentration ≥0.3 mg/dL from first administration of doxorubicin was 119.3 days (±89.7), with mean 2.8 (±1.2) doses administered. Neutropenia or anemia during chemotherapy and number of radiation therapy treatments under general anesthesia were risk factors for increases in serum creatinine concentration (P &lt; .05). Cats receiving single agent doxorubicin had a higher likelihood of an increase in serum creatinine concentration ≥0.3 mg/dL from baseline than cats receiving CHOP-based chemotherapy protocols (OR 20.0, 95% CI 2.9-100).Conclusions and clinical importanceProgressive increases in serum creatinine concentration from baseline were common in cats receiving doxorubicin and associated risk factors were identified

Urolithiasis in cats: Evaluation of trends in urolith composition and risk factors (2005-2018).

BackgroundUrolithiasis is an important upper and lower urinary tract disease in cats that results in morbidity and mortality.ObjectiveTo describe trends in composition of uroliths in cats and evaluate risk factors related to age, breed, sex, urolith location, and bacterial urolith cultures.Sample populationA total of 3940 uroliths and the cats from which they were obtained.MethodsThe database of the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from cats between January 2005 and December 2018. Mineral type, age, breed, sex, and urolith location and culture results were recorded. Trends were evaluated and variables compared to evaluate risk factors.ResultsA significant decrease in the proportion of calcium oxalate (CaOx)-containing uroliths occurred over time (P = .02), from 50.1% (204/407) of all submissions in 2005 to 37.7% (58/154) in 2018. In contrast, the proportion of struvite-containing uroliths increased significantly (P = .002), from 41.8% (170/407) in 2005 to 54.5% (84/154) in 2018. The proportion of CaOx-containing uroliths in the upper urinary tract was significantly higher compared to the proportion of other urolith types in the upper urinary tract. Urate-containing uroliths were the third most common type (361/3940, 9.2%). Overall, sex and age predispositions were similar to those reported previously.Conclusions and clinical importanceThe decrease in the proportion of CaOx-containing uroliths and increase in the proportion of struvite-containing uroliths warrants investigation. Further education regarding the efficacy of medical dissolution of struvite-containing uroliths is recommended