A comparison of 0.375% ropivacaine psoas compartment block and 2% prilocaine spinal anaesthesia in dogs undergoing tibial plateau levelling osteotomy.

BACKGROUND: In dogs undergoing routine elective orthopaedic surgeries carried out as same-day surgeries regional anaesthetic techniques (RATs) should aim to produce analgesia but minimising the postoperative motor dysfunction. Our objective was to compare the perioperative analgesic effects and the time to motor recovery between spinal anaesthesia (SA) with hyperbaric solution of prilocaine 2% (mg = 4 x [0.3 × BW (kg) + 0.05 × SCL (cm)]) and morphine (0.03 mg/kg) and combined ultrasound (US) and electro stimulator-guided psoas compartment and ischiatic nerve block (PB) with ropivacaine 0.375% (0.45 mL/kg). Dogs undergoing tibial plateau levelling osteotomy (TPLO) were randomly assigned to receive either SA or PB. Procedural failure, perioperative rescue analgesia, motor block recovery and complications were recorded. RESULTS: Procedural failure rate (PFR) was 19% (7 out of 36) for SA and 9% (3 out of 32) for PB (p = 0.31). Intraoperative rescue analgesia was administered to 6/29 (21%) SA group dogs and in 15/29 (52%) PB group dogs, respectively (p = 0.03). At 3 h after RAT, percentage of dogs with complete block recovery was 25/29 (86%) and 25/29 (86%) in group SA and PB, respectively (p = 1). Two cases of pruritus and one case of urinary retention were recorded in the SA group. Residual ischiatic nerve block was noted at 12 h after RAT in 2/15 (13%) of dogs in group PB; it completely resolved 24 h after RAT. CONCLUSIONS: SA with prilocaine 2% and PB with ropivacaine 0.37% were found suitable for dogs undergoing same-day TPLO surgery. Pruritus and urinary retention in SA and residual block in both groups might occasionally delay the time of discharge.

Outcomes of nine cats with urinary retention after sacrocaudal luxation managed with long-term urinary diversion.

OBJECTIVE: To document the outcomes of cats with urinary retention (UR) after sacrocaudal luxation (SCL) and managed with a long-term cystostomy (LTC). STUDY DESIGN: Short case series. ANIMALS: Nine client-owned cats with SCL and subsequent UR. METHODS: Nine cats suffering from non-relievable UR secondary to SCL, between March 2013 and December 2020, had a LTC placed 4.5 days post-SCL (mean, range 3.5-6.0), until clinical evidence of normal urination recovery. The bladder was emptied at least twice daily. No antimicrobial was given during LTC. Indication for tube removal was voluntary micturition with complete emptying for a minimum of three consecutive days. Recheck examinations were scheduled for post-SCL days 7 and 14, as well as for LTC tube removal. Minor and major complications and length of LTC use were recorded. RESULTS: The LTC was removed 11-42 days (mean 26 days) after placement. All cats recovered normal micturition spontaneously within 17-47 days post-SCL (mean 30.7 days): 1 cat between the 2nd and 3rd weeks, 5 cats between the 3rd and 4th weeks, and 3 cats >30 days after the trauma. Major complications, such tube dislodgement, occurred in two cats, whereas complications resolving after tube removal were recorded in 6 cats. CONCLUSION: LTC was effective at managing UR post-SCL in 9 cats. All cats recovered normal urinary function within 7 weeks. CLINICAL SIGNIFICANCE: LTC can be an alternative to manual expression or bladder catheterization in cats with temporary UR after SCL.

Three-dimensional bladder ultrasound to measure daily urinary bladder volume in hospitalized dogs.

BACKGROUND: Urinary bladder volume (UBV) and urine residual volume (URV) provide important information for hospitalized dogs and might allow recognition of urine retention. OBJECTIVE: Using 3-dimensional (3D) ultrasound to monitor daily URV is a safe and effective way to recognize urinary retention. ANIMALS: Twenty-five client-owned hospitalized dogs. METHODS: Prospective, observational study. UBV and URV were measured using 3D ultrasound daily at approximately the same time. UBV was measured, the dog was taken for a 5-minute controlled leash walk, then URV was estimated. Concurrent use of opioids, anesthetics, and fluids administered IV were recorded. RESULTS: Daily URVs were >0.4 mL/kg in 22 of 25 dogs on at least 1 day of hospitalization. Seventeen of 25 dogs had an abnormal URV at the time of discharge. Of 18 dogs that were anesthetized while hospitalized, 16 had a URV >0.4 mL/kg with a mean of 4.34 mL/kg (range, 0.5-13.4 mL/kg). No statistical difference in degree of URV was found based on the use of anesthesia, administration of fluids IV, or opioids. Weight was significantly associated with URV; dogs <10 kg had a higher URV per unit mass than dogs >10 kg (P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Use of a 3D ultrasound device to measure daily UBV and URV in hospitalized dogs provides a safe estimate of bladder volume in real-time. Monitoring daily URV might help in early identification of patients that are retaining urine, thereby preventing potential adverse effects of urethral catheterization or prolonged urinary retention.

Myoclonus and hypersensitivity of the hind limbs and tail with urinary retention following neuraxial administration of morphine in a cat.

An adult female domestic shorthair cat developed myoclonus, muscle rigidity, and hypersensitivity of the hind limbs and tail with urinary retention following neuraxial administration of morphine. Myoclonic contractions resolved following treatment with midazolam and a urinary catheter was placed until normal micturition returned. The cat was clinically normal 36 hours after neuraxial morphine injection. The cat underwent a second surgery without neuraxial morphine and control of postoperative pain required more intervention. Key clinical message: Neuraxial morphine may cause myoclonus and urinary retention. The response to pharmacological treatment of myoclonus is varied, but a benzodiazepine drug may be effective.

Myoclonie et hypersensibilité des membres postérieurs et de la queue avec rétention urinaire après administration neuraxiale de morphine chez un chat. Une chatte domestique à poils courts adulte a développé une myoclonie, une rigidité musculaire et une hypersensibilité des membres postérieurs et de la queue avec rétention urinaire après l'administration neuraxiale de morphine. Les contractions myocloniques se sont résolues après un traitement avec du midazolam et un cathéter urinaire a été placé jusqu'à ce que les mictions normales reviennent. Le chat était cliniquement normal 36 heures après l'injection neuraxiale de morphine. Le chat a subi une deuxième intervention chirurgicale sans morphine neuraxiale et le contrôle de la douleur postopératoire a nécessité plus d'intervention.Message clinique clé:La morphine neuraxiale peut provoquer une myoclonie et une rétention urinaire. La réponse au traitement pharmacologique de la myoclonie est variée, mais un médicament à base de benzodiazépine peut être efficace.(Traduit par Dr Serge Messier).

Retrospective evaluation of prazosin and diazepam after thoracolumbar hemilaminectomy in dogs.

Management of urinary retention after spinal cord injury in dogs is often needed and can include use of medications to relax the urethral sphincter. This was a retrospective study evaluating two such medications, prazosin and diazepam, and whether dogs treated with these medications had different lengths of hospitalization, urinary continence levels, or development of bacteriuria compared to dogs not receiving these medications after thoracolumbar hemilaminectomy for intervertebral disc herniation (IVDH). Electronic medical records were searched for dogs that underwent CT or MRI followed by a hemilaminectomy between the 3rd thoracic and 3rd lumbar vertebra for treatment of IVDH. Dogs were grouped based on whether or not they received a medication to aid in urethral sphincter relaxation (either prazosin, diazepam, or both medications). The total length of hospitalization, urinary continence at the time of discharge, and presence of bacteriuria were recorded from the medical file. Medical records from 71 dogs were included in the analysis. There were no significant associations between administration of prazosin and/or diazepam and length of hospitalization or urinary continence scores at the time of discharge from the hospital (P > 0.05).

Urine retention in cattle putatively associated with injection of an ivermectin and closantel anthelmintic formulation into the ischiorectal fossa.

CASE HISTORY: A group of 39, 19-22-month-old Friesian bulls were administered an ivermectin/closantel anthelmintic via intended S/C injection in the ischiorectal fossa on 15 June 2017 (Day 0). Over the next 50 days, 22 affected bulls presented various degrees of anorexia, abdominal pain and urine dribbling. Seventeen bulls were examined by transrectal ultrasonography which revealed urinary bladder distension in all 17, and peritoneal fluid accumulation in some. Overall, eight bulls died or were subjected to euthanasia. On-farm postmortem examination of three bulls revealed urinary bladder rupture. CLINICAL FINDINGS: On Day 50 one affected live bull was admitted to Massey University for further investigation. This bull continuously dribbled urine and had an overtly distended urinary bladder as determined by rectal palpation and ultrasonography. PATHOLOGICAL FINDINGS: Postmortem examination of this bull revealed a markedly distended urinary bladder, massive subcapsular and pericapsular renal oedema with retroperitoneal fluid accumulation, minimal hydronephrosis and no evidence of mechanical urinary outflow obstruction. The right ischiorectal fossa contained multifocal areas of tissue fibrosis that extended into areas innervated by the distal cutaneous branch of the pudendal nerve and the pelvic nerve. Histopathological changes consisted of extensive fibrosis, myonecrosis and neurodegeneration, and evidence of granulation tissue and inflammation at the putative injection site and in surrounding tissues. DIAGNOSIS: A local inflammatory reaction at the presumed injection site together with localised peripheral neurodegeneration and myelopathy may have led to detrusor-sphincter dyssynergia causing urine retention. CLINICAL RELEVANCE: These cases of urine retention and bladder rupture in cattle were of putative iatrogenic origin. Veterinarians should be aware of this rare complication after S/C injections in the ischiorectal fossa.

Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats.

OBJECTIVE To evaluate the effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction (UO) and durations of urinary catheter retention and hospitalization for male cats. DESIGN Randomized controlled clinical trial. ANIMALS 137 male cats with UO. PROCEDURES Following random allocation, cats either did (flush group; n = 69) or did not (no-flush group; 68) undergo urinary bladder lavage with saline (0.9% NaCl) solution after alleviation of the obstruction and placement of a urethral catheter. Signalment, prior history of UO, presence of crystalluria, difficulty of urinary tract catheterization, in-hospital UO recurrence rate, and durations of urinary catheter retention and hospitalization were compared between the flush and no-flush groups. RESULTS Baseline characteristics did not differ significantly between the 2 treatment groups. The in-hospital UO recurrence rate (9/69 [13%]) and median durations of urinary catheter retention (37 hours; range, 3 to 172 hours) and hospitalization (3 days; range, 0.5 to 12 days) for the flush group did not differ significantly from the in-hospital UO recurrence rate (13/68 [19%]) and median durations of urinary catheter retention (36 hours; range, 1 to 117 hours) and hospitalization (3 days; range, 1 to 9 days) for the no-flush group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, for male cats with UO, urinary bladder lavage at the time of urethral catheterization had no significant effect on in-hospital recurrence rate of the condition, duration of urinary catheter retention, or duration of hospitalization; however, additional studies are necessary to validate or refute these findings.

Ultrasonographic evaluation of the canine urinary bladder following cystotomy for treatment of urolithiasis.

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis. DESIGN Prospective, longitudinal study. ANIMALS 18 client-owned dogs. PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening. RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery). CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

Neurogenic urinary retention in cats following severe cluster seizures.

Case series summary Four cats that presented with severe cluster seizures developed neurogenic urinary retention in the postictal phase. None of the cats had previous seizures. Micturition was reported as normal in all cats for 3 or more years before seizure onset. All cats required a continuous rate infusion of propofol to control the seizure activity. In all cats manual bladder expression was performed every 8 h until recovery of normal micturition. One cat was started on phenoxybenzamine to reduce internal urethral sphincter tone. All cats recovered normal micturition within 4 weeks of the last cluster of seizures. Relevance and novel information Transient neurogenic urinary retention has not previously been reported in cats or dogs following severe cluster seizures. Urinary retention should be considered a potential postictal deficit, requiring prompt recognition and treatment to avoid urinary tract infection and detrusor muscle atony.

Incidence of delayed hair re-growth, pruritus, and urinary retention after epidural anaesthesia in dogs.

OBJECTIVE: Delayed hair re-growth, pruritus and urinary retention are known complications after epidural anaesthesia in dogs. The aim of this study was to prospectively evaluate the effect of epidurally administered drugs on the occurrence of these complications in dogs. MATERIAL AND METHODS: Ninety dogs were included in this study. Eighty client-owned dogs undergoing surgery were randomly assigned to one of three epidural treatment groups: either morphine and bupivacaine (MB), bupivacaine (B), or saline solution 0.9% (S) was administered epidurally to these patients. Ten dogs were only clipped in the lumbosacral area (C). Follow-up started 4 weeks after clipping and was performed every 4-5 weeks in cases of delayed hair re-growth or pruritus. Hair re-growth in the lumbosacral area was observed and compared to hair re-growth in the surgical field and the fentanyl patch area. Cytological analysis and a trichogram were performed if hair re-growth was delayed after 6 months. Time interval to first urination postoperatively was recorded (n = 80). RESULTS: Hair re-growth was delayed in 11 dogs (12.2%; B: n = 7, S: n = 2, MB: n = 1, C: n = 1) with no differences between groups. Pruritus was evident in two dogs (2.2%; MB: n = 1, S: n = 1). After 6 months, hair had started to re-grow in all but one dog (B). After 10 months the coat of this dog had re-grown. Time to first urination did not differ between groups. CONCLUSION AND CLINICAL RELEVANCE: No direct correlation between the particular drugs injected epidurally and delayed hair re-growth, pruritus and urinary retention could be shown. Dog owners should be informed that hair re-growth after epidural anaesthesia could be markedly delayed.

Effect of epidural analgesia with opioids on the prevalence of urinary retention in dogs undergoing surgery for cranial cruciate ligament rupture.

OBJECTIVE: To determine whether epidural administration of opioids was associated with clinically important urinary retention in dogs undergoing elective orthopedic procedures. DESIGN: Retrospective cohort study. ANIMALS: 179 client-owned dogs undergoing elective surgery for cranial cruciate ligament rupture. PROCEDURES: Medical records of 179 dogs that underwent surgical correction for cranial cruciate rupture between January 2009 and October 2012 were reviewed; 120 received epidural administration of opioids and 59 did not. Signalment, type of procedure, administration of epidural analgesia, time to first postanesthetic urination, and number of urinations during the first 24 hours were evaluated and compared between groups. RESULTS: Administration of preservative-free morphine into the epidural space was not significantly associated with time to first urination following anesthetic recovery or the total number of urinations within the first 24 hours of anesthetic recovery. Administration of a hydromorphone bolus IV following surgery was significantly associated with urinary retention, compared with administration of either morphine boluses or fentanyl constant rate infusions following surgery. No other variables were significantly associated with urinary retention. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of preservative-free morphine into the epidural space was not associated with clinically important urinary retention in dogs undergoing elective orthopedic procedures. Systemic administration of opioids may be associated with urinary retention.

An unusual case of urinary retention and ulcerative cystitis in a horse, sequelae of pelvic abscessation, and adhesions.

A 21-year-old Quarter horse gelding was presented with stranguria and incontinence of 10 days duration. Despite catheterization and antibiotic therapy, the horse was euthanized. Necropsy revealed posterior abdominal and pelvic abscessation with adhesions of the urinary bladder and severe ulcerative cystitis.

Cas inhabituel de rétention urinaire et de cystite ulcérative chez un cheval, séquelles d'un abcès pelvien et adhérences. Un hongre Quarter horse âgé de 21 ans a été présenté avec de la strangurie et de l'incontinence depuis 10 jours. Malgré le cathétérisme et la thérapie antibiotique, le cheval a été euthanasié. La nécropsie a révélé un abcès pelvien avec des adhérences de la vessie urinaire et une grave cystite ulcérative.(Traduit par Isabelle Vallières).

Comparison of terazosin and prazosin for treatment of vesico-urethral reflex dyssynergia in dogs.

Nineteen dogs with vesico-urethral reflex dyssynergia (VURD) were treated with prazosin or terazosin 0.5 mg/kg twice daily to compare efficacy and side effects. Dogs were referred because of signs of (partial) urethral obstruction. Physical examination, abdominal ultrasonography, urinalysis and a radiographic contrast study of bladder and urethra (urethrocystography) were routinely performed. If no mechanical causes of obstruction or disease of the distal urinary tract were observed, the diagnosis VURD was presumed and the dogs were included in our study. Follow-up information was obtained from owners or referring veterinarians. Significantly more side effects were seen in the dogs treated with terazosin (n=14; 93 per cent) compared with the dogs treated with prazosin (n=5; 20 per cent; P=0.002). Effects of the treatment were comparable between prazosin and terazosin. Labradors and dogs that were castrated surgically had a significant better survival (P<0.01) compared with other breeds and animals that were castrated chemically. There was a moderate to good effect in 60 per cent of the dogs treated with prazosin, and in 64 per cent of the dogs treated with terazosin.

Use of an implanted sacral nerve stimulator to restore urine voiding in chronically paraplegic dogs.

BACKGROUND: Loss of urinary control after spinal cord injury increases risk of urinary tract disease and is problematical for owners of affected dogs. OBJECTIVES: To design, implant, and test a sacral nerve stimulating device for controlling urine voiding in paraplegic dogs. ANIMALS: Nine pet dogs with severe thoracolumbar spinal cord injury causing paraplegia, loss of hindquarter sensation, and incontinence for more than 3 months. The procedure was offered prospectively to owners of suitable candidates after the irreversibility of the incontinence had been ascertained. METHODS: Open label clinical study. Surgically implantable electrode "books" were designed for insertion and retention of mixed sacral nerves. Sacral nerves were accessed via laminectomy and stimulated to test their ability to elicit detrusor contraction and then inserted into the electrode book, which was attached to a subcutaneously implanted, externally activated receiver. RESULTS: In 8/9 dogs, S2 nerves elicited the largest increases in intravesicular pressure with minimum stimulation and were placed in electrode books. Voiding efficiency was >90% in 8 of the 9 implanted dogs. No important detrimental effects of the procedure were observed. CONCLUSIONS AND CLINICAL IMPORTANCE: This sacral nerve stimulating implant is a simple and apparently effective neuroprosthetic device that restores urine voiding in paraplegic dogs.

Surgical procedures used for post-traumatic neurogenic bladder in a cat: report case / Procedimentos cirúrgicos utilizados no tratamento da bexiga neurogênica em um gato: relato de caso

A 1-year-old castrated crossbred male cat was referred to the Veterinary Teaching Hospital for evaluation of urinary retention associated with a subluxation at T12-T13 caused by a car accident. Urethral sphincter denervation by transection of hypogastric and pudendal nerves was performed to allow bladder emptying, but after three months post operation the cat had a urinary retention recurrence. Endoscopic urethral sphincterotomy was done resulting in urinary incontinence for four months.

Um gato de um ano de idade, macho, castrado, sem raça definida, foi encaminhado ao Hospital Veterinário Escola para avaliação de retenção urinária associada à subluxação nas vértebras T12-T13, que foi causada por um acidente automobilístico. Realizou-se a denervação do esfíncter uretral, por transecção dos nervos pudendo e hipogástrico, para permitir o esvaziamento da bexiga, porém três meses após a cirurgia inicial o animal apresentou recorrência da retenção urinária. Esfincterotomia endoscópica uretral foi então realizada, resultando em incontinência urinária por quatro meses.

Suspected epidural morphine analgesia induced chronic urinary and bowel dysfunction in a cat.

A 12-year-old male castrated domestic shorthair developed chronic urinary retention, constipation and a decreased perineal reflex following a single lumbo-sacral epidural injection of morphine during general anesthesia. Similar adverse effects have been reported in humans following epidural analgesia, but this is the first reported case of both urinary and bowel dysfunction in a cat purportedly from an epidural. The cat was medically managed with manual bladder expressions, intermittent enemas, and various medications including bethanechol, cisapride and stool softeners. The cat continues to have long-term neurologic dysfunction 15 months post-onset. This case report describes a rare but serious potential risk of lumbo-sacral epidural injections in cats.

Epidural spinal myelolipoma in a dog.

Epidural spinal myelolipoma was diagnosed in a 13-year-old, male Siberian husky that was referred for evaluation of progressive pelvic limb paresis and urinary incontinence. An epidural mass was detected by magnetic resonance imaging and computed tomography. The mass was removed and identified histopathologically as an epidural myelolipoma. Pelvic limb paresis improved after surgery, but urinary retention associated with neurological bladder dysfunction persisted.

Myoclonus and urinary retention following subarachnoid morphine injection in a dog.

A 5-year-old German Shepherd dog which presented for total hip replacement developed myoclonus and urinary retention after the subarachnoid injection of preservative-free morphine. Myoclonus was resistant to treatment, except pentobarbital anesthesia. Urinary retention was treated with bethanechol and subsided within a few days. Involuntary muscular activity can result from the epidural, subarachnoid or systemic injection of various opioid drugs, or as a result of the toxic or irritant effect of preservatives or autologous blood. The latter were not causative factors in this case. Opioid agonist inhibition of central inhibitory neurotransmitter action may have explained the myoclonus. Postoperative urinary retention was attributed to the spinal action of morphine inhibiting efferent parasympathetic nervous activity.

Urine volume estimations in dogs recovering from intervertebral disc prolapse surgery.

Ultrasonographic estimations of residual bladder urine volume (expressed as a percentage of the estimated bladder volume before micturition--the "percentage residual urine") and calculations of the amount of urine voided were performed in 15 dogs before and up to 25 days after surgery for thoracolumbar disc prolapse. The percentage residual urine was influenced by the grade of disc prolapse (F = 9.223; p < 0.01). Over the first four days after surgery, there was a significant change in percentage residual urine (F = 3.995; p < 0.05) and an increase in the calculated amount of urine voided (F = 12.305; p < 0.01). It is suggested that ultrasonographic estimation of percentage residual urine may be valuable in monitoring the progress of dogs undergoing treatment for thoracolumbar disc disease.