Resection of urachal anomalies in dogs with recurrent lower urinary tract disease

Obstructive struvite ureterolithiasis in 4-month-old intact male Bernese mountain dog

A 4-month-old, 7 kg, intact male, Bernese mountain dog was presented for obstructive struvite ureterolithiasis. Multiple urethroliths, ureteroliths, and urocystoliths were present. Based on an abdominal ultrasound, there was severe left hydronephrosis and hydroureter from distal ureterolith obstruction, just proximal to the vesicoureteral junction. The dog was not azotemic. Successful treatment was accomplished via ventral cystotomy. Bladder wall culture revealed a methicillin-resistant Staphylococcus spp. No predisposing cause was identified. There are no known genetic predispositions in Bernese mountain dogs for struvite urolithiasis. The urinary tract infection resolved with surgical retrieval of the uroliths and antibiotic treatment. The dog remained clinically normal after the cystotomy but developed a subclinical urinary tract infection 4 mo post-operatively. Key clinical message: Urolithiasis is rare in pediatric veterinary patients. To the authors' knowledge, this is the first report of obstructive ureterolithiasis in a puppy. There is no known genetic predisposition for urolithiasis in Bernese mountain dogs.

A rare urachal abscess in a young bull with conservative management

Background

The urachus is an embryonic remnant occurring as a result of the involution of the allantoic duct and the ventral cloaca. This canal becomes progressively obliterated after birth. It uncommonly persists to different degrees after birth.

Case Description

A young bull was presented with distended abdomen and clinical signs of chocking, with low-grade fever, loss of appetite, frothy mouth arched back. On the first inspection, the animal was suspected to have simple indigestion. The treatment was attempted in this stage by introducing a stomach tube but only little relief was achieved. Therefore, 5 days later, an exploratory laparotomy was done and a big balloon-like cyst structure extended ventro-latrally in the abdominal cavity was noticed. That structure was located on the floor of the abdominal cavity extending from the pelvic rim caudally to the umbilical region cranially. The structure was then incised and evacuated and a rubber tube was fixed for constant drainage for up to one month later. The bull was followed-up and made a good recovery after a month post-surgery.

Conclusion

We found that urachal abscess could be treated simply via surgical evacuation of the abscess and proper drainage for some time with a very promising outcome. Additionally, this affection can be diagnosed based on history, clinical signs, and exploratory surgery, when relatively modern diagnostic techniques are not available.

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009-2019)

This retrospective study investigated the prevalence of different urachal anomalies (UA) in cats (n = 60) and dogs (n = 38) and their association with clinical symptoms and urinalysis alterations. Among UA, the vesicourachal diverticulum was the most prevalent UA diagnosed in both cats (96.7%) and dogs (89.5%): the intramural vesicourachal diverticulum was diagnosed in 76.7% of cats and 71.1% of dogs, followed by extramural vesicourachal diverticulum (20.0% and 18.4% respectively). In both cats and dogs, bladder wall diffuse or regional thickening was the most prevalent alteration. The most common alterations of the urinary bladder content were urolithiasis sediment in cats (33.3%) and in dogs (31.6%). Dogs with UA were more often asymptomatic (p = 0.01). No difference was found in cats. Stranguria, hematuria, and urethral obstruction were the most frequently reported clinical signs, while hematuria and leukocyturia were the most prevalent abnormalities at urinalysis. In conclusion, our study confirmed UA as uncommon, and often incidental findings, with a high prevalence of animals without clinical signs.

Resection of urachal anomalies in dogs with recurrent lower urinary tract disease

Objective

To determine whether surgical removal of urachal anomalies improves the outcomes of dogs with recurrent lower urinary tract disease (LUTD) and bacterial urinary tract infection (BUTI).

Study design

Retrospective study.

Animals

Thirty‐three dogs with urachal anomalies and recurrent LUTD or BUTI.

Methods

Medical records of dogs with LUTD or BUTI and a diagnosis of urachal anomaly treated by partial cystectomy were reviewed. A minimum follow‐up of 9 months was required for inclusion.

Results

Median age at onset of clinical signs was 12 months (range, 1 month to 10 years). Urachal anomalies were detected with histopathology in 20 of 28 (71%) dogs. At a median follow‐up of 22 months (range, 9‐114), 21 of 28 (64%) dogs were free of signs of LUTD. Nine (27%) dogs exhibited reduced signs of LUTD; in three (9%) dogs, no clinical improvement was observed. Among the 25 dogs with confirmed preoperative BUTI, 22 clinically improved with surgery.

Conclusion

Partial cystectomy reduced the long‐term severity of clinical signs and risk of recurrence of LUTD or BUTI in dogs with confirmed or suspected urachal anomalies.

Clinical significance

Partial cystectomy should be considered as an adjunct to the treatment of LUTD and BUTI in dogs.