Management of urethral sphincter mechanism incompetence in a male dog with laparoscopic-guided deferentopexy

Laparoscopic Castration Using Bipolar Forceps vs. Orchiectomy in Dogs: A Comparison of Two Techniques

Simple Summary

Castration of dogs is one of the most often performed surgeries in veterinary medicine. Minimally invasive techniques used in human medicine are now being used in animals. We compared the feasibility and effects on pain and inflammation of a new laparoscopic technique with the classical castration technique. The animals in which the new technique was applied showed less pain and inflammation then the other group. Our results suggest that this is a feasible alternative to classical castration.

Abstract

This paper aimed to study the feasibility of a new laparoscopic castration technique in male dogs, evaluate the pain associated with it, and compare it with the classical orchiectomy. Surgical times, pain scores, blood and salivary cortisol, and CRP were recorded and compared between the two groups. The use of high-frequency bipolar forceps allowed quick and uneventful laparoscopic procedures. The laparoscopic group had significantly lower pain scores, cortisol, and PCR values than the orchiectomy group. No complications were seen in any group. Our results suggest that this laparoscopic castration is a safe and beneficial surgical alternative to traditional orchiectomy in dogs.

Clinical assessment of testosterone analogues for urethral sphincter mechanism incompetence in ten spayed female dogs

Urethral sphincter mechanism incompetence (USMI) is a common cause of urinary incontinence in dogs. Although estrogen is often prescribed for the medical therapy of USMI for spayed female dogs, they are known to have limited effectiveness and potential adverse effects. In castrated male dogs with USMI, testosterone reagents have been attempted besides estrogen. In this study, the effect of testosterone drugs, mainly methyltestosterone, on spayed female dogs with USMI was retrospectively evaluated. Ten spayed female dogs with USMI were included. Diagnosis of USMI was based on the results of the dogs’ medical history, clinical signs, and no abnormalities in physical examinations, urinalysis, ultrasonography, X-ray imaging, and neurological examinations. Methyltestosterone was administered at doses of 0.32–1.27 mg/kg BW p.o. semel in die (sid.) to twice a week. Nine of the ten dogs had good or excellent responses 2 to 4 weeks after the start of treatment. The minimum effective dose was 0.32 mg/kg/day. Although no severe adverse symptoms occurred in any dog, a mild increase in alanine aminotransferase was temporally observed at doses of 1.0 and 1.1 mg/kg/day in the two dogs. After dose reduction or withdrawal, two of eight dogs had recurrence of urinary incontinence. Resumption of testosterone treatment clearly improved the symptoms in the two dogs. These results indicate that testosterone reagents might be an option for treating USMI in spayed female dogs as well.

Computed Tomography Determined Changes in Position of the Urogenital System After CO2 Insufflation to Determine Optimal Positioning for Abdominal Laparoscopy

OBJECTIVE

To evaluate changes, using computed tomography (CT), in position of the urogenital system before and after CO2 abdominal insufflation for the most commonly used body positions to determine the optimal laparoscopic approach.

STUDY DESIGN

Experimental study.

ANIMALS

Healthy intact female Beagles (n = 6) of similar age, weight, and body condition score.

METHODS

Dogs had urinalysis, peripheral blood smear, and abdominal ultrasonography. Pre-insufflation (PrI) CT scans were performed in ventrodorsal routine (VDR), ventrodorsal Trendelenburg (VDT), left lateral (LL) and right lateral (RL) recumbency, and repeated post insufflation (PoI). Pre-determined measurements were made on PrI and PoI scans and differences compared.

RESULTS

The position of the uterus and ovaries was mainly determined by gravitational effects and the attachment of the suspensory ligament. VDT provided best exposure of the uterine body. The kidneys remained in the non-dependent part of the abdomen when the dog was positioned in the opposite lateral position. The bladder remained in the ventral part of the abdomen in all positions.

CONCLUSIONS

The best approach to the kidney and associated ovary and uterine horn would be the opposite lateral position to the side being approached. For ovariohysterectomy, this would require the dog to be rotated into each lateral position for the left and right uterine horn and ovary. VDT was best to access the bladder and uterine body.

Prostatopexy as a treatment for urethral sphincter mechanism incompetence in male dogs

OBJECTIVES

The incidence of urinary incontinence due to urethral sphincter mechanism incompetence (USMI) in male dogs is relatively rare compared with the incidence in bitches, but the medical management of USMI in male dogs is less rewarding than in bitches. Attempts have been made to manage this condition surgically using either urethral bulking agents such as Teflon or by relocating the intrapelvic bladder neck to an intra-abdominal position by vas deferentopexy. This paper reports the response to prostatopexy in male dogs with USMI.

METHODS

The response to prostatopexy was determined in nine severely incontinent male dogs with USMI that were followed up for periods ranging from 10 months to five years (mean 2.3 years).

RESULTS

One dog was cured, four were improved, and no improvement in the frequency or degree of urinary incontinence occurred in the remaining four animals. No complications were seen in any of the dogs.

CLINICAL SIGNIFICANCE

Prostatopexy may provide a further method of treating male dogs with USMI that do not respond to medical therapy.

Use of laparoscopic-assisted jejunostomy for fecal diversion in the management of a rectocutaneous fistula in a dog

A 2-year-old female Siberian Husky was referred for evaluation of a rectocutaneous fistula of unknown etiology. On evaluation, a rectal tear and an associated perivulvar abscess and draining tract were identified. Several attempts were made to repair the rectocutaneous fistula and associated rectal tear. Primary repair and fascia lata graft repair failed. Successful management was achieved via a laparoscopic-assisted end-on jejunostomy for fecal diversion, and the wound healed readily by second intention. During the period of hospitalization, the dog lost a considerable amount of weight. Particular care should be taken regarding fluid therapy, administration of antimicrobials, and adequate nutrition in patients with rectocutaneous fistulas. Overall, the use of laparoscopic-assisted end-on jejunostomy for fecal diversion in the management of rectocutaneous fistulas in dogs appears to be feasible; end-on or loop jejunostomy may also be an option for the treatment of other diseases of the distal portion of the gastrointestinal tract.