Ultrasound-guided transurethral urinary bladder biopsy using an endoscopic biopsy forceps in dogs: 27 cases (2016-2019).

OBJECTIVES: To describe an ultrasound-guided transurethral bladder biopsy technique using endoscopic forceps and its results in dogs of different sizes with different lesion locations. MATERIALS AND METHODS: Medical records of dogs that underwent ultrasound-guided transurethral bladder biopsy with endoscopic forceps were retrospectively reviewed. Patient signalment, lesion location, use of urinary catheter as a guide, outcome of the procedure and histopathology results were retrieved. RESULTS: Twenty-seven dogs underwent this procedure. Biopsy samples were successfully obtained in 23 dogs. Insertion of the endoscopic forceps without a urinary catheter allowed the procedure to be performed in patients with a small urethral diameter without complication. The procedure was unsuccessful in dogs with a urethral diameter smaller than the outer diameter of the biopsy forceps (i.e. 1.8 mm), either due to small patient size or obstructive urethral lesion. All biopsy samples allowed histopathological diagnosis. No complications were reported after the procedure. CLINICAL SIGNIFICANCE: This non-invasive biopsy technique should be considered in patients with bladder lesions in which histopathological diagnosis is needed, especially when endoscopic examination is not feasible. By use of the Doppler mode, biopsy retrieval was safe also when the lesion ​was highly vascularised.

Evaluation of urinary and serum level of chemokine (C-C motif) ligand 2 as a potential biomarker in canine urothelial tumours.

Chemokine (C-C motif) ligand 2 (CCL2) is a chemotactic cytokine recruiting monocytes, releasing growth factors and promoting adhesion in vascular endothelium. Elevated serum and urinary CCL2 levels and expression of its receptor (CCR2) have been associated with tumorigenesis in human urinary malignancies. CCL2 implication has not been investigated in canine urothelial carcinoma. The aim of this study was to evaluate CCL2 serum and urine levels (measured by ELISA) in dogs with urothelial carcinoma or non-neoplastic urinary tract disease. CCL2 serum and urine levels were significantly higher in diseased dogs compared with healthy dogs (P < 0.001). Dogs with carcinoma had significantly higher serum and urine CCL2 levels (P = 0.001) than healthy dogs. Dogs with metastases showed significantly lower serum and urine CCL2 levels compared with the non-metastasised tumour group (P = 0.007). CCL2 as a diagnostic marker for urothelial carcinoma held a sensitivity of 95.2% and a specificity of 38.2% in the urine. As a staging marker, sensitivity was 85.7% and specificity was 57.1% with a positive predictive value of 75.7% and a negative predictive value of 71.9%. Further investigation is needed to define the role of CCL2 as a prognostic marker in canine urothelial carcinoma.

Prevalence, location and concurrent diseases of ultrasonographic cyst-like lesions of abdominal lymph nodes in dogs.

Lymph nodal cyst-like lesions are occasionally identified during abdominal ultrasound in dogs. However, a study evaluating their prevalence and clinical significance is lacking. The aim of this observational cross-sectional study was to evaluate prevalence, most common location and concurrent diseases of cyst-like lymph nodes detected during abdominal ultrasound. Affected lymph nodes, patient signalment and concurrent diseases of dogs with cyst-like lymph nodal lesions having undergone abdominal ultrasound over a one-year period were recorded. Twenty-three affected lymph nodes were observed in 17/553 dogs (prevalence=3 per cent). The most commonly affected was the lumbar lymphocenter (7/23), followed by the coeliac (6/23), the cranial mesenteric (5/23) and the iliosacral (5/23). Twenty-three concurrent diseases were diagnosed in 17 dogs, among which 16/23 were non-neoplastic (70 per cent). The most common concurrent disease was renal insufficiency (8/23), followed by neoplasia (7/23), gastroenteropathy (3/23), benign prostatic disease (2/23), pancreatitis (1/23), peritonitis (1/23) and neurological disease (1/23). No statistical correlation existed between cyst-like lymph nodal lesion and a specific neoplastic or non-neoplastic disease. In conclusion, in the present study, cyst-like lymph nodal lesions have a low prevalence, involve different lymphocenters and were found in dogs affected by different diseases, including both non-neoplastic and neoplastic aetiologies.

Removal of oesophageal foreign bodies: comparison between oesophagoscopy and oesophagotomy in 39 dogs.

OBJECTIVES: To compare complication rates and outcomes after removal of oesophageal foreign bodies by endoscopy or by oesophagotomy. METHODS: Retrospective evaluation of medical records of dogs with oesophageal foreign bodies treated by endoscopy and/or oesophagotomy. Postoperative clinical signs, management, length of hospitalisation, type and rate of complications, and time interval to return to eating conventional diet were compared. RESULTS: Thirty-nine dogs diagnosed with oesophageal foreign bodies between 1999 and 2011 were included in the study. Most common breeds included West Highland white terrier, Jack Russell terrier and shih-tzu. Successful endoscopic removal was possible in 24 out of 32 cases (Group 1), while surgical removal was successful in 15 out of 15 cases (7 of which had unsuccessful attempts at endoscopic removal) (Group 2). Length of hospitalisation, time to removal of gastrostomy tube and time to eat conventional diet did not differ between the groups. After foreign body removal, the incidence of oesophagitis, oesophageal stricture and perforation observed during repeated endoscopy were similar between the groups. CLINICAL SIGNIFICANCE: In this retrospective study, removal of oesophageal foreign bodies either by oesophagoscopy or oesophagotomy had a similar outcome.

Use of tamoxifen in a German shepherd dog with sclerosing encapsulating peritonitis.

A German shepherd dog was diagnosed with sclerosing encapsulating peritonitis after an episode of peritonitis caused by a free intra-abdominal foreign body (stick). The foreign body had initially been treated by surgical removal and abdominal lavage. Postoperatively, peritoneal effusion persisted despite the use of methylprednisolone for 1 month and a second surgical exploration and abdominal lavage. After a third surgery at our institution (to breakdown abdominal adhesions) followed by open abdominal drainage, treatment with tamoxifen orally was initiated and within 2 weeks the dog's condition improved dramatically. Two months later, no fluid was present in the abdomen. The only apparent adverse reaction to tamoxifen therapy was swelling of the vulva. In humans, sclerosing encapsulating peritonitis is a known life-threatening complication following peritoneal dialysis. In veterinary medicine, most animals with sclerosing encapsulating peritonitis die because of chronic weight loss, peritoneal effusion and progression of concurrent disease. This dog's condition was unresponsive to methylprednisolone alone but was successfully treated with aggressive surgery including enterolysis and open abdominal lavage and the addition of tamoxifen.

Acute gaseous peritonitis after rupture of a retroperitoneal rectal diverticulum in a dog.

An 11-year-old, entire male coton de tulear was presented on emergency with acute and severe depression, acute abdominal pain and vomiting of 24 hours duration. Historical complaints included right perineal swelling, dyschezia and tenesmus of 18 months duration. Abdominal ultrasonography and radiography suggested a pneumoperitoneum and positive-contrast colonography showed leakage of contrast medium into the caudal abdomen and the presence of a large retroperitoneal pouch. Exploratory laparotomy allowed the visualisation of faecal leakage from the retroperitoneal space into the peritoneal cavity. Using a perineal approach, a large necrotised rectal diverticulum filled with faeces was found over the retroperitoneal structures. A standard herniorrhaphy was then performed. The dog recovered uneventfully and dyschezia did not recur at the nine month follow-up. Rectal diverticulum rupture associated with peritonitis has not been described in the veterinary literature, to the authors' knowledge, and should be considered as a rare differential diagnosis in dogs being presented with gaseous peritonitis.

Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole.

OBJECTIVES: To evaluate the effectiveness of rhinotomy and surgical debridement associated with topical administration of 2 per cent enilconazole and oral itraconazole in dogs with severe or recurrent sinonasal aspergillosis. METHODS: A standard rhinotomy was performed on seven dogs. In the initial study, the bone flap was left attached cranially and replaced at the end of the procedure. In the main study group, the bone flap was discarded. Nasal passages were debrided and irrigated with enilconazole solution for one hour. Oral itraconazole was administered to four dogs for one month postoperatively. Follow-up rhinoscopy was performed in all dogs. RESULTS: All three dogs in the initial study had recurrence of the disease and two dogs had a second surgery to remove the flap. The main study group included four dogs in which the flap was initially removed, and the two dogs from the initial study that required a second surgery. At follow-up rhinoscopy, five dogs were free of aspergillus but had bacterial or inflammatory rhinitis and one dog had a small aspergilloma but was subsequently asymptomatic. Telephone follow-up revealed that four dogs were asymptomatic, one dog had intermittent sneezing and serous nasal discharge, and one dog had intermittent epistaxis. CLINICAL SIGNIFICANCE: Rhinotomy with removal of the flap combined with one-hour infusion of 2 per cent enilconazole and oral itraconazole resulted in satisfactory outcome in dogs with severe or recurrent aspergillosis.

Resolution of chylothorax after resection of rib chondroma in a dog.

A six-year-old, male dobermann was presented with a history of dyspnoea and bouts of coughing. Radiography and computed tomography of the thorax showed pleural effusion and a well-circumscribed, calcified mass of 10 cm in diameter, appearing to originate from the left first rib. Thoracocentesis revealed that the pleural fluid was chylous in nature. An incisional biopsy was performed, which gave a histological diagnosis of chondroma. Resolution of the chylothorax after en-bloc surgical removal of the tumour suggested that the rib tumour was the initiating cause of the chylothorax. Seventeen months later, rib neoplasia recurred without pleural effusion, and was removed successfully. To the authors' knowledge, rib chondroma, which is an unusual tumour in dogs, has not been previously documented as a cause of chylothorax.

Hemiurothorax following diaphragmatic hernia and kidney prolapse in a cat.

A 3-year-old cat was presented with increasing dyspnoea over the past four days. Unilateral pleural effusion was diagnosed and a modified transudate was drained several times. Surgical exploration revealed intra-thoracic prolapse of the left kidney and partial herniation of the spleen through a dorsal, circumferential diaphragmatic tear. Biochemical analysis of the pleural fluid confirmed urothorax. Due to excessive fibrin deposit on the well-vascularised kidney it was impossible to re-establish left urinary pathways. Left-sided nephrectomy and diaphragmatic herniorrhaphy were performed. Postoperative recovery was uneventful and complete. This is the first report of an urothorax in veterinary medical literature.

Prospective comparison of four sampling methods (cystocentesis, bladder mucosal swab, bladder mucosal biopsy, and urolith culture) to identify urinary tract infections in dogs with urolithiasis.

A prospective study was conducted on 27 dogs with recurrent urinary tract infections (UTIs) and urolithiasis. Four sampling methods (i.e., urine obtained by cystocentesis, bladder mucosal swab, bladder mucosal biopsy, and urolith) were compared to identify UTI. Identical culture results were obtained from urine collected by cystocentesis and from the swab of bladder mucosa. In the presence of a positive urine culture, the same organism also was cultured from the bladder mucosal biopsy and urolith. However, in the presence of a negative urine culture, an organism was cultured from the bladder mucosal biopsy or the urolith in 18.5% of the cases. Therefore, when the culture from urine obtained by cystocentesis is negative, it is recommended that aerobic cultures of a bladder mucosal biopsy and a urolith be performed in cases of urolithiasis.

Effects of age and location on the biomechanical and biochemical properties of canine tracheal ring cartilage in dogs.

OBJECTIVE: To evaluate effects of age (immature vs adult) and location along the trachea on the biomechanical properties (via a tensile stress relaxation test) and biochemical properties (Water content and total proteoglycan content) of canine tracheal ring cartilage. SAMPLE POPULATION: Entire trachea from 8 immature and 8 adult dogs. PROCEDURE: A section of each tracheal ring from 8 immature dogs (6 months old) and 8 adult dogs (2 to 3 years old) was tested biomechanically (maximal stress, equilibrium stress, equilibrium modulus, and percentage of relaxation) and processed for biochemical analysis (water content and total proteoglycan content). Two rings from each trachea were prepared for histologic analysis (H&E or safranin-O staining). RESULTS: Biomechanical and biochemical parameters were not different between cervical and thoracic rings of either age group. Mean maximal stress, equilibrium stress, and equilibrium modulus were significantly higher for adult, compared with immature, dogs. However, percentage of relaxation for adult dogs was significantly lower. Tracheal rings of adult dogs had a significantly higher proteoglycan content and a significantly lower water content than did those of immature dogs. Water content and biomechanical parameters were significantly correlated, and proteoglycan content and biomechanical properties were significantly but weakly correlated. On histologic sectioning, a qualitative decrease in safranin-O staining in the rings of immature dogs also was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Biomechanical and biochemical properties of the canine tracheal ring cartilage are altered with age. However, location of the ring along the trachea did not affect these properties for either age group. Results lend support to the theory that proteoglycan content has some effect on tensile properties of tracheal rings and may explain increased compliance observed in rings from dogs with collapsed trachea.

Evaluation of the cranial rectus abdominus muscle pedicle flap as a blood supply for the caudal superficial epigastric skin flap in dogs.

This study evaluates the cranial rectus abdominus muscle pedicle flap as the sole blood supply for the caudal superficial epigastric skin flap. This flap was composed of a cranially based rectus abdominus muscle pedicle flap that was attached to the caudal superficial epigastric island skin flap (including mammary glands 2 to 5) via the pudendoepigastric trunk. Selective angiography of the cranial epigastric artery in eight cadaver dogs proved that the arterial vasculature in the cranial rectus abdominus was contiguous with that in the caudal superficial epigastric skin flap. In the live dog study, three of six of the flaps failed because of venous insufficiency. Necrosis of mammary gland 2 occurred in two of six flaps. One of six flaps survived with the exception of the cranial most aspect of mammary gland 2. Angiography of the cranial epigastric artery proved that arterial blood supply to these flaps was intact. Histological evaluation of the failed flaps showed full-thickness necrosis of the skin and subcutaneous tissues, the presence of severe congestion, and venous thrombosis. Retrograde venous blood flow through the flap was inconsistent, and hence resulted in failure of this myocutaneous flap. Use of this flap for clinical wound reconstruction cannot be recommended.