Canine silica urolithiasis. Risk factors, detection, treatment, and prevention

Uroliths containing 70% or greater silica comprise approximately 1% of the canine uroliths submitted to the Minnesota Urolith Center. Male dogs are far more commonly affected than females. In our series, 84 different breeds were affected. Currently available data suggest dietary factors play a role in their formation. Diagnosis is facilitated by the characteristic jackstone configuration of silica uroliths, but must be confirmed by quantitative analysis. Voiding urohydropropulsion or surgery are currently the most practical methods of removal of silica uroliths.

Canine and feline nephrolithiasis. Epidemiology, detection, and management

Calcium oxalate (39%) and struvite (33%) were the predominant mineral types in canine nephroliths submitted to the Minnesota Urolith Center. Urate salts (12%) and calcium phosphate (2%) occurred less frequently. Provided they are not causing obstruction, struvite nephroliths may be dissolved with medical protocols. Although there are no dissolution protocols for nephroliths containing calcium, risk-benefit ratios should be considered before proceeding with surgery.

Voiding urohydropropulsion. Lessons from 5 years of experience

Voiding urohydropropulsion is a nonsurgical method of removing uroliths from the urinary bladder. Any urocystolith of sufficient size to pass through the distended urethral lumen can be safely and effectively removed by this technique. Compared to cystotomy, voiding urohydropropulsion offers several advantages: urolith removal can be performed in minutes, anesthetic period is shorter, postprocedural dysuria and hematuria are less severe, and it provides greater success for complete removal of small urocystoliths. This technique is not suitable for removal of large urocystoliths or uroliths that become lodged in the urethral lumen.

Canine calcium oxalate urolithiasis. Case-based applications of therapeutic principles

The case study presented here illustrates the diagnosis and management of calcium oxalate urolithiasis in a Bichon Frise, a breed at increased risk for this type of stone. If the Bichon Frise had persistent hypercalcemia, we would have evaluated serum concentrations of ionized calcium, parathyroid hormone, and vitamin D to identify an underlying cause. Because his urine was alkaline, additional potassium citrate was not provided. Likewise, as a fortified diet was fed to him, vitamin B6 therapy was not considered. This case study illustrates the benefits of radiographic evaluation immediately following surgery and during follow-up examinations. If we had postponed radiographs until the patient developed clinical signs, additional surgical procedures may have been required.

Canine retrograde urohydropropulsion. Lessons from 25 years of experience

Uroliths are commonly voided into the urethra where they often lodge adjacent to the os penis in male dogs. Urethral patency can, with few exceptions, be restored by flushing uroliths back into the bladder lumen by retrograde urohydropropulsion. To be consistently successful, one must be familiar with the concepts of the procedure and each step of the technique.

Canine cystine urolithiasis. Cause, detection, treatment, and prevention

Cystine uroliths are a sequela to cystinuria, an inherited renal tubular defect in reabsorption of cystine and some other amino acids. At the Minnesota Urolith Center, 67 breeds of dogs were identified, including English Bulldogs, Dachshunds, Mastiffs, and Newfoundlands. In some dogs, the severity of cystinuria may decline with advancing age. Current recommendations for dissolution of cystine uroliths include various combinations of diet modification, diuresis administration of 2-MPG, and alkalinization of urine.

Treatment of asymptomatic internal resorption of a maxillary premolar tooth in a military working dog

An asymptomatic pink discoloration of a maxillary right fourth premolar tooth was discovered during a routine oral examination on a 9 year-old Belgian Malinois dog. A radiolucent lesion was seen in the pulpal chamber on radiographic examination. The lesion had perforated the mesiobuccal root of the tooth. The primary differential diagnosis was idiopathic internal resorption. The tooth was treated by partial resection (removal of the mesiobuccal root and associated crown). A vital pulpotomy and amalgam restoration was performed on the remaining tooth structure. A follow-up 1 year later demonstrated a successful treatment outcome. The animal was asymptomatic and able to perform military duties. Clinical and radiographic signs of healing were evident and the tooth was functional.

Nutritional support for dogs and cats with hepatobiliary disease

Nutritional intake in the patient with hepatobiliary disease provides the cornerstone of balanced medical care. Optimal recommendations require consideration of general nutritional principles, special species requirements and contemporary needs uniquely related to the patient's medical problem. Although general recommendations follow well-established guidelines developed to meet metabolic requirements for normal health, there is little information regarding altered requirements in animals that are ill. Consequently, recommendations for animals have been derived empirically from studies completed in humans, most work having been done in patients with end stage cirrhosis or liver failure complicated by hepatic encephalopathy. This is problematic because most veterinary patients with liver disease are not in hepatic failure and do not suffer from hepatic encephalopathy. Iatrogenic malnutrition can develop in patients when protein-restricted diets are inappropriately recommended. Insufficient energy intake and negative nitrogen balance can complicate a patient's condition, impairing tissue regeneration and recovery from disease. This paper reviews strategies that can be used to individualize nutritional management in small companion animals with hepatobiliary disease. Consideration is given to both the known and controversial issues regarding energy requirements, dietary energy distribution, vitamin and micronutrient supplementation, the special requirements of the cat with hepatic lipidosis, as well as strategies effective for palliation of hepatic encephalopathy.

Diet and large intestinal disease in dogs and cats

Large intestinal disease, and more especially colitis, is a commonly seen problem in small animal practice. Although colitis is most frequently diagnosed in dogs, it is becoming increasing common in cats. The etiology of colitis is not known, but there is general agreement that an immune-mediated response to luminal antigen is involved. In particular, parasites, bacteria and dietary factors may be involved. In approximately 10% of dogs presented with typical signs of colitis, no pathologic lesion will be found on investigation. These dogs have a functional diarrhea associated with some stress factor and are thought to have irritable bowel syndrome (IBS). This condition is most frequently observed in working dogs, although highly nervous and excitable dogs may also exhibit similar clinical signs. Until the underlying etiology of colitis is determined, treatment regimens will remain symptomatic. Recent studies have placed considerable importance on the value of diet in the prevention, immediate and long-term therapy of colitis in dogs and cats. In particular the value of "novel" protein diets, fermentable fiber and polyunsaturated fatty acids is receiving the most attention. It is now possible to maintain patients in long-term remission and to modify the severity and chronicity of colitis by using diet alone. This paper will review the subject of dietary management of colitis and IBS and present results from the author's clinical research program.

Survival in dogs with nasal adenocarcinoma: 64 cases (1981-1995)

Case records of 64 dogs with nasal adenocarcinoma were reviewed. The effects of age, gender, tumor stage, presence of metastatic lesions, and treatment method on survival time were examined. Surgery groups included rhinotomy (n = 9), transnasal curettage (n = 29), and no surgery (n = 26). Chemotherapy groups included fluorouracil-cyclophosphamide combination therapy (n = 15), mitoxantrone (n = 7), and no chemotherapy (n = 42). Fifty-three dogs received fractionated cobalt 60 radiation therapy. Surgical procedure, chemotherapy group, and stage of primary tumor were not significantly associated with survival time (P > .05). Dogs that received radiation therapy had a significantly longer median survival time (424 days) than dogs that did not (126 days)(P = .0001). The presence of either regional lymph node or pulmonary metastasis was associated with significantly shorter median survival time (109 days) when compared to dogs without metastases (393 days)(P = .0125). When only dogs that had received radiation therapy were considered, neither surgical treatment nor chemotherapy group was associated with significant changes in median survival time. An alternate staging system emphasizing the presence or absence of metastases is proposed.

Comminuted supracondylar humeral fractures repaired with a modified type I external skeletal fixator construct

Highly comminuted supracondylar humeral fractures were stabilised in six large-breed dogs with a modified type I external fixator using a craniomedial acrylic connecting column and an intramedullary pin which was incorporated into the connecting frame. This construct provided sufficient stability to allow satisfactory bone healing in five of the six dogs, while premature removal of the intramedullary pin and external fixator resulted in subsequent refracture of the humerus in the remaining dog. Limb function at the time of final assessment was considered excellent in two dogs, good in three dogs and poor in one dog. The craniomedial acrylic connecting column simplified application of this modified type I(a) configuration to the humerus by reducing the number of clamps required; the acrylic column also facilitated contouring of the craniomedial connecting column to the brachium and was readily extended proximally to engage the intramedullary pin. In addition, the acrylic connecting column allowed placement of intramedullary pins of varying diameter.

Gastroesophageal intussusception in a Labrador retriever

A 14-month-old, intact male Labrador retriever was referred for evaluation of vomiting and regurgitation. A diagnosis of gastroesophageal intussusception with aspiration pneumonia was made. The patient responded favorably to aggressive surgical and medical management. The guarded to poor prognosis for gastroesophageal intussusception makes the successful outcome of this case unique.

Diagnosis and treatment of systemic hypertension

Systemic hypertension is often observed in dogs and cats with chronic renal failure and other metabolic and endocrinological abnormalities. High systemic arterial blood pressure has been associated with chronic renal failure, ocular injury, neurologic complications, and cardiovascular changes. Recent advances in our knowledge of the prevalence and consequences of systemic hypertension dictate that proper diagnosis and treatment of this problem should become a component of routine therapy for many of our patients.

Cervical spinal cord compression caused by cryptococcosis in a dog: successful treatment with surgery and fluconazole

A six-year-old, male Doberman pinscher was presented for acute onset of upper motor neuron tetraparesis. An extradural compressive lesion compatible with intervertebral disk rupture at the sixth to seventh cervical (C6-C7) disk space was evident on myelography. A large, gelatinous mass of pure cryptococcal organisms causing spinal cord compression was identified upon exploratory surgery. Removal of the mass caused relief of clinical signs. No evidence of involvement of other organ systems was found; however, serum and cerebrospinal fluid titers were positive for cryptococcal infection. The dog was treated with fluconazole (5.5 mg/kg body weight, per os sid) until serum titers for cryptococcal infection were negative at seven months postsurgery. To the authors' knowledge, this is the only report of a dog with cryptococcosis treated successfully using fluconazole as a sole agent.

[Ehrlichia canis infections of dogs in Germany. Epidemiology, diagnosis, therapy and prophylaxis]

Between January and December 1997 infections with Ehrlichia canis were detected in 211 dogs in Germany. Of the 53 epidemiologically evaluable dogs, 19 animals born and raised in Germany had travelled with their owners abroad in endemic areas, 30 dogs originated from there and four dogs had never left Germany. As regards to the possible location of infection it has been registered that most dogs had been taken to countries of the Mediterranean Sea (Spain, France, Italy, Greece) or had been imported from there. On inquiry, ticks had been forwarded from four dogs only, which were determined as Rhipicephalus sanguineus. The subsequent serological investigation of these four dogs revealed a Rickettsia conorii infection in two of them.

Critical care cardiology

Emergency management of the patient with cardiac disease is an important part of veterinary practice. Although the causes of cardiac disease may be diverse, the understanding of basic pathophysiology will enable the clinician to formulate a rational diagnostic and therapeutic plan. The veterinary clinician must be able to triage the emergency patient, assess the clinical condition, and provide appropriate therapy. Close monitoring of the critically ill patient is crucial to patient survival and will help tailor therapy.

[Percutaneous pericardiotomy with balloon catheter in the treatment of malignant pericardial effusion in dogs]

INTRODUCTION

Cardiac tamponade is an emergency clinical condition both in man and the dog. Neoplastic pericardial effusion caused by primary or metastatic tumors is one of the most frequent causes in the dog. The frequent relapses after pericardiocentesis have led to developing different procedures for pericardial removal or fenestration to improve the quality of life in both terminal and treated patients. The often critical condition of these patients calls for procedures causing as little surgical stress as possibile, which is the case of percutaneous pericardial balloon dilatation. We report our experience with this procedure in the first two dogs whose long-term follow-up is available.

MATERIAL AND METHODS

Dogs need a short general anesthesia for restraining problems, while in man a slight sedation is sufficient. The anatomy being different, the percutaneous approach is intercostal in the dog and transdiaphragmatic in man. Echocardiographic guidance and fluoroscopic control are necessary during the procedure in both species. We report the clinical history of two dogs with neoplastic pericardial effusion, primary in one case and metastatic in the other. Both dogs were treated with pericardial balloon dilation.

DISCUSSION AND CONCLUSIONS

Our experience in the dog and in man shows that percutaneous pericardial balloon dilation causes less patient stress than thoracotomic or thoracoscopic pericardiectomy. Moreover, the surgical cost is lower and hospitalization time is reduced. On the other hand, the surgical methods permit bioptic sampling and better and more thorough studies of chest structures. We suggest percutaneous pericardiectomy as a valid alternative to surgery to treat chronic benign pericarditis, which obviously needs further confirmation from dedicated studies.

Periodontal healing of canine experimental grade-III furcation defects treated with autologous fibrinogen and absorbable barrier membrane

OBJECTIVE

To determine the effects of autologous fibrinogen (AF) and absorbable barrier membrane (ABM) on periodontal healing of canine experimental grade-III furcation defects.

ANIMALS

18 conditioned, laboratory-source, adult Beagles.

PROCEDURE

Defects were developed bilaterally at the second and fourth premolars and maintained for 12 weeks. Defects were treated with AF, ABM, AF and ABM, or debridement. Digital subtraction radiography, histologic evaluation, and histomorphometric analysis of defect healing was done at 1, 3, and 6 months after treatment to determine percentage increases in bone volume, height, area, and length of periodontal regeneration along the perimeter of the defect.

RESULTS

Comparison of defects at post-treatment intervals indicated significantly greater healing of debridement and AF-treated defects, compared with ABM-treated defects at 3 months; however, by 6 months, there were no significant differences in defect healing for all histomorphometric variables. Defects treated with ABM were associated with significantly less root ankylosis than other treatments. Defects treated with debridement had significantly greater increases in bone volume at 6 months after treatment, compared with groups treated with ABM. There was a significant correlation between regenerated bone area, bone volume, and periodontal regeneration for all treatments at 3 and 6 months after treatment.

CONCLUSION AND CLINICAL RELEVANCE

Use of AF and ABM did not enhance the amount of periodontal healing, compared with debridement only. The ABM-treated defects were essentially devoid of root ankylosis. Grade-III furcation defects may respond equally well to conservative periodontal surgery or guided tissue regenerative techniques. The prevention of root ankylosis is a substantial benefit favoring this latter method of treatment.