Bilateral caudal superficial epigastric skin flap and perineal urethrostomy for wound reconstruction secondary to traumatic urethral rupture in a cat.

Use of a bilateral caudal superficial epigastric skin flap and perineal urethrostomy for reconstruction of a wound which occurred secondary to rupture of the distal urethra and extravasation of urine is reported. A 10-month-old male neutered Domestic Shorthaired cat was presented with a history of trauma, signs of pain of the hind quarters and anuria. Progression of the clinical signs, including anuria, lethargy, anorexia, and azotemia, prompted referral and investigation 108 hours following the initial injury. Retrograde urethrography indicated a rupture of the distal pelvic urethra with extravasation of urine subcutaneously. Development of extensive skin necrosis of the perineum and rump progressed leaving a large wound defect which was managed with wound debridement and dressing. The wound was closed using staged caudal superficial epigastric skin flaps and perineal urethrostomy as part of the reconstruction.

Evaluation of trends in frequency of urethrostomy for treatment of urethral obstruction in cats.

OBJECTIVE: To determine hospital proportional morbidity rates (HPMR) for urethral obstructions, urethral plugs or urethroliths, and urethrostomies in cats in veterinary teaching hospitals (VTH) in Canada and the United States between 1980 and 1999. DESIGN: Epidemiologic study. ANIMALS: 305,672 cats evaluated at VTH. PROCEDURES: Yearly HPMR were determined for cats with urethral obstructions, urethral plugs or urethroliths, or urethrostomies from data compiled by the Purdue Veterinary Medical Database. The test for a linear trend in proportions was used. RESULTS: Urethral obstructions were reported in 4,683 cats. Yearly HPMR for urethral obstructions declined from 19 cases/1,000 feline evaluations in 1980 to 7 cases/1,000 feline evaluations in 1999. Urethral plugs or urethroliths affected 1,460 cats. Yearly HPMR for urethral plugs or urethroliths decreased from 10 cases/1,000 feline evaluations in 1980 to 2 cases/1,000 feline evaluations in 1999. A total of 2,359 urethrostomies were performed. Yearly HPMR for urethrostomies decreased from 13 cases/1,000 feline evaluations in 1980 to 4 cases/1,000 feline evaluations in 1999. CONCLUSIONS AND CLINICAL RELEVANCE: Frequency of feline urethrostomies performed at VTH in Canada and the United States declined during the past 20 years and paralleled a similar decline in frequency of urethral obstructions and urethral plugs or urethroliths. These trends coincide with widespread use of diets to minimize struvite crystalluria in cats, which is important because struvite has consistently been the predominant mineral in feline urethral plugs during this period.

Perineal urethrostomy.

Perineal urethrostomy can be used successfully in male cats to help manage certain lower urinary tract diseases. Indications and surgical technique are discussed and illustrated. Potential complications encountered with the surgical technique along with methods for preventing and managing are elaborated. With experience, perineal urethrostomy can be performed successfully and with minimal complications.

Risk factors for screw migration after triple pelvic osteotomy.

The objective of this retrospective study was to identify risk factors for screw migration after triple pelvic osteotomy (TPO) in clinical patients. The medical records, radiographs made immediately after surgery, and follow-up radiographs documenting a healed osteotomy were reviewed for 52 dogs treated with unilateral TPO and 38 dogs treated with bilateral TPO. Signalment, surgeon expertise, length of surgery, sequence of surgery in dogs treated bilaterally, use of ischial or ilial wires or both, screw depth in the sacrum, and screw migration were documented for each of the 128 pelvic osteotomies. Screws placed in the first and second plate hole, securing the cranial portion of the plate, loosened most frequently. Factors associated with decreased screw migration included use of an ischial hemicerclage wire and increased depth of sacral purchase with the first and second cranial screws.

Surgical management of urolithiasis in small ruminants.

Twenty-one cases of urolithiasis in small ruminants were examined to evaluate the efficacy of various surgical treatments. Of 21 cases, all but 1 had multiple calculi. Urethral process amputation and medical therapy either did not relieve the obstruction or provided only temporary relief (< 36 hours) in 14 of 16 cases. In 2 cases, obstruction recurred in 1 year and 4 years, respectively, after urethral process amputation. Ten of 13 animals that had perineal urethrostomy (PU) experienced short-term complications, including postoperative hemorrhage, dehiscence of the surgical wound, and subcutaneous accumulation of urine. Urethral stricture occurred in 7 of 9 animals in which follow-up information was obtained, and long-term survival was 55%. Cystotomy alone was performed on 8 of 21 cases, and 7 of 8 (88%) were healthy at the time of follow-up. In order to relieve the obstruction with cystotomy alone, multiple attempts at normograde and retrograde flushing were required. Cystotomy allowed removal of multiple calculi, bidirectional flushing of the urethra, and posed less risk for short-term postoperative complications and urethral stricture. These data suggest that cystotomy was more effective than PU for the management of urolithiasis in small ruminants.