Encrusted Cystitis with Suspected Ureteral Obstruction Following Cystoscopic-Guided Laser Ablation of Ectopic Ureters in a Dog

Abstract

A 1 yr old 30 kg spayed female Labrador retriever presented for stranguria and hematuria 3 wk after cystoscopic laser ablation for ectopic ureters. Encrusted cystitis was diagnosed based on ultrasonography, cystoscopy, urinalysis, and culture of Corynebacterium urealyticum from the urine. Unilateral hydronephrosis and hydroureter were suspected to be secondary to obstruction at the trigone. The dog was treated with focal debridement of plaques at the left ureter, urinary acidification, and long-term antibiotic therapy with complete recovery. This is the first report of encrusted cystitis as a complication of cystoscopic-guided laser ablation for ectopic ureters, and suggests cystoscopic debridement may be useful if ureteral obstruction occurs.

Clinical description of Corynebacterium urealyticum urinary tract infections in 11 dogs and 10 cats

“…In humans, most CU-UTIs occur in immunocompromised patients with underlying urological disease and in patients with urological manipulations, previous UTIs, prolonged hospitalisation or after treatment with broad-spectrum antibiotics (Aguado et al 1987, Soriano et al 1990). In the veterinary literature, all animals described as having CU-UTI had similar predisposing factors (Elad et al 1992, Gomez et al 1995, Suarez et al 2002 Bailiff et al 2005, Cavana et al 2008, Briscoe et al 2010, Duffy & Gallagher 2018. The present study supports this observation; among our population, many animals combined several predisposing factors.…”

“…In a previous case series of eight dogs, all 10 isolates grown from urine samples were susceptible (n=8) or partially susceptible (n=2) to chloramphenicol (Bailiff et al 2005). In a recent case report, a dog was treated with focal debridement of plaques and long-term chloramphenicol therapy and showed complete clinical resolution (Duffy & Gallagher 2018) (Duffy & Gallagher 2018). Consequently, chloramphenicol appears to be a good choice for treating CU-UTI.…”

“…Cystoscopic debridement of plaque lesions in dogs has been reported and might represent a less‐invasive alternative (Bailiff et al . , Duffy & Gallagher ).…”

“…). In a recent case report, a dog was treated with focal debridement of plaques and long‐term chloramphenicol therapy and showed complete clinical resolution (Duffy & Gallagher ) (Duffy & Gallagher ). Consequently, chloramphenicol appears to be a good choice for treating CU‐UTI.…”

“…Fewer than 15 animals with Corynebacterium urealyticum urinary tract infection (CU-UTI) have been described in the peerreviewed veterinary literature, and the largest case series described only seven animals: five dogs and two cats (Bailiff et al 2005). In previous reports, all animals had a factor that may have predisposed to the CU-UTI (Elad et al 1992, Gomez et al 1995, Suarez et al 2002, Bailiff et al 2005, Cavana et al 2008, Briscoe et al 2010, Raab et al 2015, Duffy & Gallagher 2018. Although the typical clinical presentation of encrusted cystitis due to CU has been previously described in veterinary patients, large case series describing or evaluating predisposing factors, clinicopathological findings, ultrasonographic abnormalities, antimicrobial susceptibility and therapeutic outcome are lacking.…”