Objective To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic‐guided laser ablation (CLA) in female dogs. Study design Retrospective study from 2011 to 2018. Animals Twenty‐five female dogs. Methods Data collected included signalment, clinicopathologic data, procedural data, complications, and short‐term and long‐term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent). Results Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One‐month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05). Conclusion Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy. Clinical significance Cystoscopic‐guided laser ablation should be preferred to correct iEU to prevent short‐term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.
CASE DESCRIPTION A 10-month-old male crossbred dog presented with a 4-week history of polyuria and polydipsia and a 6-month history of vomiting. CLINICAL FINDINGS Clinical examination revealed abdominal pain and right-sided nephromegaly. Biochemistry was within normal limits. Diagnostic imaging showed a well-defined, unilateral renal mass containing anechoic fluid consistent with a simple renal cyst (SRC). TREATMENT AND OUTCOME The cyst was drained under ultrasonographic guidance but recurred 3 months later, concomitant with recurrence of the previously reported clinical signs. The cyst was then deroofed, fulgurated, and omentalized under laparoscopy by use of a 3-port technique. The resected cystic wall was histopathologically consistent with an SRC, presumptively congenital. The dog showed a good recovery with resolution of clinical signs. Renal function was normal at last follow-up, conducted 2 years postoperatively, without evidence of recurrent disease. CLINICAL RELEVANCE To our knowledge, this was the first report of a symptomatic juvenile SRC of presumptively congenital origin in a dog treated successfully by laparoscopic deroofing, fulguration, and omentalization. The polyuria, polydipsia, chronic vomiting, and abdominal pain may all have been related to space-occupying effects of the cyst, as these symptoms resolved post-treatment. Results of long-term follow-up advocate for this durable cure of SRC by use of laparoscopic procedures, especially when compared to simple drainage of the cyst, as the latter initially failed in the present case.
La paralysie laryngée est une cause fréquente d’obstruction des voies aériennes supérieures chez le chien et dans une moindre mesure chez le chat. Les animaux atteints sont préférentiellement des chiens de grande race d’âge avancé. La paralysie laryngée résulte d’une atteinte neuromusculaire du larynx. Rarement congénitale, elle est plus fréquemment acquise et peut être le reflet d’une cause sous-jacente systémique telle qu’une polyneuropathie. Les animaux sont présentés pour des anomalies respiratoires non spécifiques (stridor, intolérance à l’effort, dyspnée, toux, changement de voix et pouvant aller jusqu’à une cyanose et des pertes de connaissance) qui sont en général peu visibles jusqu’à ce que l’atteinte soit bilatérale. Le diagnostic de certitude se fait par observation directe du larynx par laryngoscopie sous sédation : un défaut d’abduction d’un ou des deux cartilages aryténoïdes est alors visible pendant l’inspiration, faisant obstacle au passage de l’air. Un traitement médical doit être instauré rapidement suivi d’une prise en charge chirurgicale, la procédure recommandée étant une latéralisation cricoaryténoïdienne unilatérale. Le pronostic après intervention est généralement bon à excellent malgré un risque de bronchopneumonie par fausse déglutition à vie.
La trachéostomie temporaire assure le rétablissement de la perméabilité des voies respiratoires en cas d’obstruction aiguë ou anticipée des voies respiratoires hautes. Les indications les plus fréquentes regroupent donc le syndrome obstructif des races brachycéphales, la paralysie laryngée, les traumatismes cervicaux, les corps étrangers laryngés, l’œdème laryngé et les néoplasies pharyngées, laryngées ou trachéales supérieures. L’abord chirurgical et la technique de mise en place sont relativement aisés mais plusieurs astuces doivent être adoptées pour faciliter la gestion postopératoire des animaux en soins intensifs. En effet, des complications à court terme très fréquentes, comme les obstructions et délogements de sonde, peuvent survenir brutalement et s’avérer mortelles. Dans ce sens, l’utilisation de sondes à double lumière et le fait de réserver le gonflement des ballonnets aux cas nécessitant une ventilation mécanique facilitent grandement la gestion postopératoire et diminuent la survenue de complications. En général, la surveillance rapprochée et le retrait de la sonde dès que possible confèrent aux animaux opérés d’une trachéostomie temporaire un bon pronostic, bien que celui-ci reste dépendant de la condition initiale et de la survenue de complications à long terme comme les sténoses trachéales.
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