A 9 year-old male Maltese with dysuria, pollakiuria, and stranguria was brought to the Veterinary Teaching Hospital, Chonnam National University. A right lateral abdominal radiograph was shown that 3 uroliths existed at the caudal aspect of the os penis and 5 uroliths existed in the passage of os penis. Uroliths were extracted by voiding urohydropropulsion and cystotomy in Maltese dog. The complication of cystotomy was hematuria, which might persist up to 2 days postoperatively but dysuria was not observed. So we applied voiding urohydropropulsion and cystotomy, and got a good prognosis. Gross examination of extracted uroliths were separated one from another but it was identified the same componet of calcium oxalate by stone quantitative analysis.
Several suture patterns can be used for cystotomy closure, and a continuous suture pattern is the most commonly used. In this study, the fluid-tight ability and other suitabilities of continuous appositional sutures, such as the simple continuous suture pattern (SC), running suture pattern (RN), and Ford interlocking suture pattern (FI), were compared for cystotomy closure. Cystotomy closure was performed using each suture method in 10 cases of ex vivo swine bladders in each group. Suture time, leakage site, suture length, bursting pressure (BP), bursting volume (BV), and circular bursting wall tension (CBWT) were measured. Suture time and suture length were the shortest in RN and the longest in FI. Leakage occurred in two places: the incision line directly and the hole made by the suture. Leakage occurred through the incision line in 4 bladders of the RN group and 2 bladders of the FI group, but not in the SC group, and in the rest of the bladders, leakage occurred through the suture hole. The values of BP, BV, and CBWT increased in the order of FI, SC, and RN. Suture time and suture length can be considered as factors related to healing and side effects. In this study, leakage through the incision was found in a less appositional area; therefore, leakage through the hole could be considered an indicator of better apposition. Good apposition is one of the conditions required for ideal cystotomy closure. The bursting strength representing the fluid-tight ability can be expressed as the CBWT. RN is expected to be efficient and cause a small degree of foreign body reaction; however, it is expected to be less stable. FI has the greatest fluid-tightness ability, but it has been proposed that side effects due to foreign body reactions most frequently occur in FI. In conclusion, SC, which is expected to have a sufficient degree of fluid-tightness and appropriate recovery, is preferable to other continuous appositional suturing methods for cystotomy closure.
A female Green iguana (Iguana iguana) was brought to the small animal clinic in Hannover Veterinary school because of anorexia and convulsion. Two months ago, the owner bought two iguanas, one female and one male and had to take a female to the one of local small animal clinic because she, born in 19931 didn't eat well and showed the tremor of the legs. The veterinarian suspected it to have a calcium deficiency and gave an injection of calcium and vitamin D3. But still during the last two months, the female iguana did only eat some lettuce while the other male ate lettuce, fruits and commercial cat-food ($Whiskas^{\circledR}$, Effem, Verden). It was not possible to evaluate the rations of these different "food-components". They are kept in the terrarium with water container. By palpation of the abdomen, hard thing like stone was palpated in the mid-region. The blood test wasn't carried out because of the difficulties of getting blood and because of her bad condition. It was firmly diagnosed as cystic calculus through radiography. Since the animal is in shock state already, the prognosis after surgery was bad. It was assumed to be too late to expect its surviving with the surgery carried out or without it. Cystotomy was performed in the cranial ventral paramedian incision in order to preserve the large ventral abdominal vein in the linen alba region. After two stay sutures ("holding suture" ) with 5-0 polyglactin 910 ($Vicryl^{\circledR}, Ethicon$) on the bladder, cystotomy was carried out and the stone inside was removed. Then, the bladder was closed in one-layer sutures. The abdomen was closed in simple interrupted suture with same material after the instillation of 10 ml saline solution into the abdominal cavity. The cystic calculus was in a size of $5.8{\times} 5.O{\times} 3.5 cm$. The analysis of the stone was carried out in two ways which are the infrared spectroscopy of the stone and quick analysis by $Merckognost^{\circledR}$(Diagnostica Merck, Merck). In the result of the infrared spectroscopy, the stone wee composed of 10% ammonium urate and 90% dihydrated uric acid. This iguana wasn't able to survive.n't able to survive.
A 6-year-old castrated male Shih-Tzu was admitted to the Gyeongsang Animal Medical Center with hematuria and vomiting. Serum chemistry indicated increases in blood urea nitrogen and creatinine values. Radiography showed radiopaque materials attached to the ventralis of the inner bladder wall. Penile urethra also was filled with radiopaque materials. Ultrasonography revealed bilateral perineal effusion in the kidney, thinned bladder wall, and materials with acoustic shadowing at the caudal extremity of the os penis. Because urination was not identified by urinary obstruction, cystocentesis was performed. Hematuria was diagnosed by urinalysis, but clear crystals were not identified. Owing to failure of securing patency to the bladder using retrohydropropulsion, cystotomy and urethrotomy with retrohydropropulsion were performed. In this report, we describe the clinical and radiographic findings of urethral plugs in a male Shih-Tzu dog, wherein the urethral plugs were treated successfully with hydropropulsion, cystotomy, and urethrotomy. It provides an option for the treatment of urethral plugs in a dog.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.31
no.2
/
pp.150-160
/
2005
Background: For normalization of displaced anatomical structure by large cyst, two-step procedure (decompression and enucleation afterward) has been recommended. However, the histological transformation after cystotomy for decompression was shown frequently in secondary enucleation. Therefore, analyses about effects and histological changes after decompression have been necessary. Methods: 48 cases diagnosed as large odontogenic cyst in the jaw and treated by decompression and secondary enucleation were retrospectively analyzed in clinical, rediographical, and histological aspects. Results: In dentigerous cyst, decompression was much useful. Impacted permanent teeth were erupted and reduction rate was higher than that of odontogenic keratocyst (OKC) and apical periodontal cyst. In OKC, among the 29 cases, 11 cases showed no-keratosis, proliferation and rete-ridge elongation after decompression. 4 cases showed no-keratosis, only. 7 cases showed orthokeratosis and rete-ridge elongation and 6 cases showed reteridge elongation, only. 1 case had no change. And the recurrence rate for OKCs was 10.3%. For all odontogenic cysts in this study, dysplasia was not found in cystic lining after decompression. Conclusions: This study implied that decompression for large odontogenic cyst was useful treatment modality because it was conservative treatment and recurrence rate was low although long treatment period was required.
2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.
About 8 year-old castrated male Yorkshire terrier was presented for evaluation of dysuria, stranguria, hemtauria, and pollakiuria. On history taking, dysuria first was observed three months ago and these signs were waxed and waned. Physical examination revealed mild left perineal swelling. On routine laboratory examination, no significant findings were identified. Positive contrast urogram identified peritoneal herniation of urinary bladder. Urinalysis showed proteinuria and hematuria. Urine sediment revealed epithelial cells, white blood cells and rod-shaped bacteria. Pseudomonas aeroginosa was isolated from urine obtained through cystocentesis, and had resistance against fourteen antibiotics. Cystitis caused by P. aeruginosa concurrent with cystolithiasis and perineal hernia was diagnosed. Cystotomy, herniorrhaphy and EDTA-Tris solution lavage of bladder were performed. The patient was recovered to normal condition 2 days after treatment. Two weeks later, bacterial culture of urine was negative and any abnormality in ultrasonogram and urinalysis was not observed except calcium oxalate dihydrate crystals.
A Shihtzu (6-year-old, intact female) was referred to Konkuk University Teaching Animal Hospital for cystic calculus and hydronephrosis of right kiney. The dog was suspected to have ureteral rupture and peritonitis. Radiographic findings included cyctic calculi and right kidney enlargement. On ultrasonographic examination hyperechoic mass with severe acoustic shadowing was located in the right proximal ureter which was dilated. Hydronephrosis of the right kidney, right ureteral caculus and cytic calculus were confirmed by radiography and ultrasonography. Cystotomy for removal of calculus in the bladder and ureterotomy for removal of calculus in the right ureter were performed. Excretory urography (EU) performed one month after surgery revealed that the right ureter was homogeneously opacified and decreased to 3 to 6 mm in diameter. Surgical removal of ureteroliths was appropriate treatment for the ureteral and cystic calculi. The result suggests that ureterotomy is effective treament for the dilation and calculi of ureter.
Background: Persistent uroliths after a cystotomy in dogs are a common cause of surgical failure. Objectives: This study examined the following: the success rate of retrograde urohydropropulsion in male dogs using non-enhanced computed tomography (CT), whether the CT mean beam attenuation values in Hounsfield Units (mHU) measured in vivo could predict the urolithiasis composition and whether the selected reconstruction kernel may influence the measured mHU. Methods: All dogs and cats that presented with lower urinary tract uroliths and had a non-enhanced CT preceding surgery were included. In male dogs, CT was performed after retrograde urohydropropulsion to detect the remaining urethral calculi. The percentage and location of persistent calculi were recorded. The images were reconstructed using three kernels, from smooth to ultrasharp, and the calculi mHU were measured. Results: Sixty-five patients were included in the study. The success rate of retrograde urohydropropulsion in the 45 male dogs was 55.6% and 86.7% at the first and second attempts, respectively. The predominant components of the calculi were cystine (20), struvite (15), calcium oxalate (8), and urate (7). The convolution kernel influenced the mHU values (p < 0.05). The difference in mHU regarding the calculus composition was better assessed using the smoother kernel. A mHU greater than 1,000 HU was predictive of calcium oxalate calculi. Conclusions: Non-enhanced CT is useful for controlling the success of retrograde urohydropropulsion. The mHU could allow a prediction of the calculus composition, particularly for calcium oxalate, which may help determine the therapeutic strategy.
A 4-year-old female Korean short hair cat weighing 6.5 kg presented for evaluation of urinary incontinence and stranguria. On physical examination, stranguria was observed concurrently with urinary bladder distention. Abdominal radiographs revealed two small uroliths in the urinary bladder. Urinary bladder sludge was detected on abdominal ultrasound. Urine analysis indicated hematuria and bacteriuria. The cat was treated with a 4-week course of a combination of antibiotics and urinary bladder irrigation using normal saline; however, response to treatment was minimal. Excretory urography was performed to identify a congenital disorder. A small diverticulum, located to the urinary bladder apex, was identified. A tentative diagnosis of a vesicourachal diverticulum was made. Surgical exploration of the abdomen was performed and a triangular-shaped diverticulum was apparent at the urinary bladder apex. Cystotomy was performed to remove two small uroliths. Partial cystectomy was then performed for diverticulectomy. Approximately 2 cm diameter of a part of the apex was removed. Normal urination was regained 5 days postoperatively. The follow-up was completed by physical examination 2 years after surgery. There was no evidence of stranguria and urinary incontinence.
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