Retrospective evaluation of urethral bovine cross-linked collagen implantation for treatment of urinary incontinence in female dogs.

BACKGROUND: Transurethral collagen injections are an alternative treatment for canine urinary incontinence. There is controversy regarding the long-term effectiveness of collagen and the impact urethral coaptation and injection site have on outcome. HYPOTHESIS/OBJECTIVES: To evaluate outcome and client satisfaction after urethral collagen injections, and correlation between degree of urethral coaptation and collagen placement with outcome. ANIMALS: Thirty-six procedures on 31 dogs, 10 with ureteral ectopia. METHODS: Retrospective review of records and video evaluation of injection procedures. Follow-up communication with owners was performed between 1 and 56 months after bovine cross-linked collagen implantation to evaluate duration of continence, need for additional medical therapy, and owner satisfaction. Continence score was evaluated before and after the procedure, and after additional medical therapy, if needed. Injection location and degree of urethral coaptation was assessed with respect to duration of continence. RESULTS: Dogs had a significant increase in continence score after the procedure. Mean (SD) duration of continence in dogs without addition of medication was 16.4 (15.2) months, and 5.2 (4.3) months in dogs needing additional medical therapy. No significant difference was found with respect to degree of coaptation. Median client satisfaction with the procedure was 100%. CONCLUSIONS AND CLINICAL IMPORTANCE: Transurethral collagen implantation may be a viable option for treatment of female dogs with urethral sphincter mechanism incompetence, particularly after medical failure. Duration and degree of improvement are variable. Client satisfaction was excellent despite lack of complete continence in some dogs, and highlights the importance of discussing outcome expectations with owners.

Computed tomography of the brain, liver, and upper abdomen in the staging of small cell carcinoma of the lung.

Computed tomography (CT) examinations of the brain, liver, and upper abdomen were obtained in 60 previously untreated patients with histologically proven small cell carcinoma of the lung (SCCL). These results, together with clinical findings and laboratory investigations including radionuclide scans, determined the final staging of the patients. Computed tomography changed the stage from limited to extensive disease in three patients and from extensive to limited disease in seven patients. Overall, 10 of 60 patients (16%) had their final stage altered by CT. This study indicates that CT examinations may yield valuable information in some cases of small cell lung cancer but that it is of limited value in the routine staging of these patients.