1
|
Hildebrandt I, Culp WTN, Griffin MA. A Systematic Review of Canine Cystectomy: Indications, Techniques, and Outcomes. Animals (Basel) 2023; 13:2896. [PMID: 37760296 PMCID: PMC10525623 DOI: 10.3390/ani13182896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/30/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
This review provides a summary of the literature encompassing partial and total cystectomy procedures in dogs and subsequent conclusions that can be drawn. Surgical excision as a component of treatment for lower urinary tract neoplasia in dogs may enhance survival time and result in acceptable quality of life, though risk for surgical complications is substantial, particularly following total cystectomy procedures. However, for dogs with urothelial carcinoma, cystectomy is generally not considered curative and disease progression is common. Appropriate case selection and thorough preoperative discussion with owners regarding potential risks and benefits of cystectomy are imperative for successful outcomes.
Collapse
Affiliation(s)
- Isabella Hildebrandt
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St., Philadelphia, PA 19104, USA
| | - William T. N. Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, One Garrod Avenue, Davis, CA 95616, USA
| | - Maureen A. Griffin
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St., Philadelphia, PA 19104, USA
| |
Collapse
|
2
|
Augmentation cystoplasty in dogs: A comparative study of different tunica vaginalis grafts. Vet Anim Sci 2022; 16:100247. [PMID: 35345763 PMCID: PMC8957053 DOI: 10.1016/j.vas.2022.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022] Open
Abstract
Tunica vaginalis allograft and sheep tunica vaginalis decellularized extracellular matrix successfully rebuilt the bladder wall with minor complications in dogs. Sheep tunica vaginalis xenograft has disappointing results in the canine model since the bladders became contracted with decreased capacity. Tunica vaginalis grafts represent a simple and low-cost choice for augmentation cystoplasty in dogs.
In veterinary practice, numerous urological disorders that cause bladder dysfunction necessitate augmentation cystoplasty (AC). The purpose of this study is to evaluate the dog tunica vaginalis allograft (DTVA), sheep tunica vaginalis xenograft (STVX) and sheep tunica vaginalis decellularized extracellular matrix (STVDEM) as graft materials for urinary bladder (UB) reconstruction following a 45±5% cystectomy model in dogs. In this study, 18 adult apparently healthy mongrel dogs of both sexes were divided into three groups (6 dogs each): the DTVA group, the STVX group, and the STVDEM group. The evaluation of the AC in different groups was carried out using clinical, hematological, serum biochemical, urine, ultrasonographic, retrograde positive cystogram, and histopathological analysis all over the study period of 12 weeks. The dogs in all groups survived the procedures, except three dogs died from both STVX and DTVA groups. The mean bladder capacity indicated that the DTVA and STVX groups had regained 82.22% and 68.62%, respectively, of their preoperative baseline capacity. Interestingly, the STVDEM group's bladder capacity increased to 113.70%. Although histological analysis revealed that the three grafts successfully rebuilt the bladder wall, the STVDEM demonstrated well-organized and well-differentiated epithelial and muscular tissues that resembled, but were not identical to, native UB tissues. As a result, STVDEM is proposed as an ideal and potential acellular graft for UB reconstruction in dogs, whereas DTVA and STVX could be employed in emergencies requiring UB reconstruction.
Collapse
|
3
|
Gonçalves R, Wade J, Fransson B, Ngwenyama T. Augmentation enterocystoplasty in a polytrauma dog with extensive bladder necrosis. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ronald Gonçalves
- College of Veterinary Clinical Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - Jennifer Wade
- Department of Veterinary Clinical Sciences Washington State University Pullman Washington USA
| | - Boel Fransson
- Department of Veterinary Clinical Sciences Washington State University Pullman Washington USA
| | - Thandeka Ngwenyama
- Department of Veterinary Clinical Sciences Oregon State University Corvallis Oregon USA
| |
Collapse
|
4
|
Bourbos A, Liotta AP, Piola V, Cinti F, Pisani G. Urinary bladder torsion in a dog with an extraluminal tumor of the bladder apex. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Alexandros Bourbos
- Clinica veterinaria Pisani Carli Chiodo ‐ Surgery Ortonovo Italy
- Staff Clinician in Small Animal Surgery Langford Veterinary Services ‐ Surgery Langford Small Animal Referral Hospital Bristol Bristol UK
| | - Annalisa Pia Liotta
- Diagnostic Imaging Centro Diagnostico Veterinario TAC Luni Mare s.r.l. ‐ Diagnostic imaging section La Spezia Italy
| | - Valentina Piola
- Vet Ct Specialists St John's Innovation Centre Vet Ct Specialists Ltd Cambridge UK
| | - Filippo Cinti
- Clinica Veterinaria Pisani Carli Chiodo ‐ Surgery Luni Italy
- Surgery Eastcott Veterinary Referrals ‐ Surgery Swindon UK
| | - Guido Pisani
- Clinica Veterinaria Pisani Carli Chiodo ‐ Surgery Luni Italy
| |
Collapse
|
5
|
Lorange M, Smeak DD. Comparison of a simple continuous versus simple interrupted suture pattern for the repair of a large, open duodenal defect with a jejunal serosal patch in a canine cadaveric model. Am J Vet Res 2020; 81:985-991. [PMID: 33251840 DOI: 10.2460/ajvr.81.12.985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether jejunal serosal patches could securely seal large, open defects in duodenal segments harvested from canine cadavers and to compare intraluminal pressures at which leakage first occurred and maximal intraluminal pressures for repaired duodenal segments between 2 suture patterns. SAMPLE Duodenal and jejunal segments from 9 canine cadavers. PROCEDURES 20 constructs were created through repair of large, open duodenal defects with circumferential suturing of an intact jejunal segment (jejunal serosal patch). Constructs were randomly assigned to have the serosal patch anastomosed to the duodenal segment by a simple continuous or simple interrupted suture pattern. The pressure at which the first leakage was observed and the maximum pressure obtained during testing were recorded and compared between suture patterns. RESULTS Initial leakage pressure was significantly higher with the simple interrupted pattern (mean ± SD, 68.89 ± 5.62 mm Hg), compared with the simple continuous pattern (59.8 ± 20.03 mm Hg). Maximum intraluminal pressures did not significantly differ between the simple interrupted (91 ± 8.27 mm Hg) and simple continuous patterns (90.7 ± 16.91 mm Hg). All constructs, regardless of suture pattern, withstood supraphysiologic pressures. CONCLUSIONS AND CLINICAL RELEVANCE Jejunal serosal patches adequately sealed large, open duodenal defects and prevented leakage in these constructs. Constructs with simple continuous or simple interrupted suture patterns withstood physiologic and supraphysiologic intraluminal pressures, although constructs with a simple interrupted suture pattern initially leaked at higher pressures. (Am J Vet Res 2020;81:985-991).
Collapse
|
6
|
Skinner OT, Boston SE, Maxwell PL. Interventions and experience after complicated total cystectomy in a dog with transitional cell carcinoma. Vet Surg 2019; 49:811-817. [PMID: 31602683 DOI: 10.1111/vsu.13330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/20/2019] [Accepted: 09/07/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report surgical and postoperative management of complicated total cystectomy in a dog with transitional cell carcinoma (TCC). STUDY DESIGN Case report. ANIMALS One male neutered Shetland sheepdog. METHODS The dog was presented after a 1-month history of stranguria, unresponsive to oral antibiotic therapy. A craniodorsal bladder mass was identified by computed tomography (CT), and partial cystectomy was performed with 1-cm gross lateral margins (day 1). Results of histopathology provided evidence for a diagnosis of TCC, and the dog was treated with adjuvant mitoxantrone. The dog presented with uroperitoneum on day 67 after recurrence and spontaneous perforation. Total cystectomy and ureterourethral anastomosis were performed. Ureteral obstruction developed after removal of catheters that had been placed intraoperatively. Surgical revision included resection of the anastomosis site, bilateral ureteral stenting, and transection and reorientation of the distal urethra to facilitate tension-free closure. Postoperative leakage was managed with bilateral percutaneous nephrostomy tube placement. RESULTS The dog was discharged on day 88. Adjuvant treatment with vinblastine was pursued. Local recurrence was noted at day 154. Subcutaneous ureteral bypass was performed on day 247 to manage repeat obstruction. Repeated urinary tract infections were subsequently encountered. The dog was euthanized on day 368 because of abdominal discomfort and inappetence, with evidence of progressive urethral, ureteric, and abdominal wall TCC. CONCLUSION Complicated cystectomy can be managed to provide survival comparable to previous reports regarding total cystectomy. CLINICAL SIGNIFICANCE Nephrostomy tube placement, ureteral stenting, and subcutaneous ureteral bypass may be considered to manage complicated cystectomy. Preemptive stenting or urinary diversion may help prevent complications.
Collapse
Affiliation(s)
- Owen T Skinner
- University of Missouri Veterinary Health Center, Columbia, Missouri
| | - Sarah E Boston
- University of Florida Small Animal Hospital, Gainesville, Florida
| | - Paige L Maxwell
- University of Florida Small Animal Hospital, Gainesville, Florida
| |
Collapse
|
7
|
Maxwell EA, Allen L. Jejunocystoplasty and Bilateral Ureteral Reimplantation in a Dog Following Total Cystectomy. J Am Anim Hosp Assoc 2018; 54:e54601. [PMID: 30272476 DOI: 10.5326/jaaha-ms-6627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 6 yr old Boston terrier presented with acute onset of vomiting and anuria 4 days following a caesarian section and ovariohysterectomy for treatment of dystocia. A total cystectomy with ligation of both ureters was diagnosed via exploratory laparotomy surgery. A jejunocystoplasty was performed in addition to a bilateral reimplantation of the ureters into the reconstructed bladder and proximal urethra. Postoperative complications included a retained ureteral stent, persistent pyelectasia, persistent hydroureters, recurrent urinary tract infections, and intermittent urinary incontinence. Four years postoperation, the dog is doing clinically well with intermittent urinary incontinence and periodic urinary tract infections. Jejunocystoplasty with bilateral ureteral reimplantation should be considered as a treatment option for dogs following total cystectomy that occurred because of a surgical error. Owners should be informed of potential complications prior to surgery.
Collapse
Affiliation(s)
- Elizabeth A Maxwell
- From University of Illinois at Urbana-Champaign, Department of Veterinary Medicine, Urbana, Illinois (E.A.M.); and Wheat Ridge Animal Hospital and Veterinary Specialists, Wheat Ridge, Colorado (L.A.)
| | - Larie Allen
- From University of Illinois at Urbana-Champaign, Department of Veterinary Medicine, Urbana, Illinois (E.A.M.); and Wheat Ridge Animal Hospital and Veterinary Specialists, Wheat Ridge, Colorado (L.A.)
| |
Collapse
|
8
|
Ricciardi M, Campanella A, Martino R. Computed tomographic features of urinary bladder torsion in two dogs. J Small Anim Pract 2017; 59:188-195. [DOI: 10.1111/jsap.12694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 07/29/2016] [Accepted: 08/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ricciardi
- Pingry Veterinary Hospital, via Medaglie d'Oro 5; Bari 70126 Italy
| | - A. Campanella
- Pingry Veterinary Hospital, via Medaglie d'Oro 5; Bari 70126 Italy
| | - R. Martino
- Pingry Veterinary Hospital, via Medaglie d'Oro 5; Bari 70126 Italy
| |
Collapse
|
9
|
Spiller PR, Gomes LG, Monzem S, Ducatti KR, Dower NMB, Pizzinatto FD, Ribeiro AP, Souza RLD. Evaluation of intraluminal pressure in cystorrhaphies with and without intestinal serosal patch supplementation from canine cadavers. Acta Cir Bras 2015; 30:704-8. [PMID: 26560429 DOI: 10.1590/s0102-865020150100000008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/14/2015] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the maximal intraluminal pressure (MIP) supported by canine cadaveric urinary bladders that underwent cystotomy followed by cystorraphy, with and without serosal patching-supplementation. METHODS Two groups (n=8 each) were formed, and in one (conventional) the cystotomy was closed with cushing pattern. In the other group (serosal), the same procedure was performed, and a piece of jejunum was used for the construction of the serosal patching over the cystorraphy. MIP was measured by means of an invasive blood pressure transducer with closed stopcock attached to a multiparameter monitor. At the end of each measurement, the bladder body circumference was assessed. RESULTS Mean ± SD MIP sustained for the conventional and serosal groups were 28.88 ± 5.08 and 65.38 ± 10.99 mmHg, respectively (p < 0.0001). Bladder circumference did not change significantly between groups (p = 0.35) and did not correlate with MIP assessed in conventional (p = 0.27; r = 0.4379) and serosal groups (p = 0.37; r = -0.3637). CONCLUSION Serosal patch-supplemented cystorraphies were able to sustain intraluminal pressures 55.8% higher, than nonsupplemented cystorraphies in specimens from canine cadavers.
Collapse
|
10
|
James DR, Collins D, Johnson PJ, Marchevsky AM. Chronic urinary bladder torsion causing urinary incontinence in a cat. JFMS Open Rep 2015; 1:2055116915603384. [PMID: 28491385 PMCID: PMC5362012 DOI: 10.1177/2055116915603384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 11/23/2022] Open
Abstract
Case summary A 10-month-old female spayed domestic shorthair cat was presented for urinary incontinence. The cat was azotaemic, and ultrasound examination identified hydroureter and hydronephrosis. Subsequent computed tomography (CT) contrast pyelography allowed a diagnosis of urinary bladder torsion. Surgical findings and treatment are described. Postoperatively, incontinence and azotaemia resolved, and marked improvements were documented with ultrasound and CT in urinary tract structural abnormalities. Relevance and novel information To our knowledge, urinary bladder torsion has not been previously reported in the cat. This case most probably occurred as a complication of ovariohysterectomy, as has been reported in the dog; however, the presenting sign of chronic urinary incontinence is unique. Response to surgical correction was favourable.
Collapse
Affiliation(s)
- Daniel R James
- Department of Small Animal Surgery, Small Animal Specialist Hospital, Sydney, Australia
| | - David Collins
- Department of Small Animal Internal Medicine, Small Animal Specialist Hospital, Sydney, Australia
| | | | - Andrew M Marchevsky
- Department of Small Animal Surgery, Small Animal Specialist Hospital, Sydney, Australia
| |
Collapse
|
11
|
Abdelrhman MA, Seddek AM, Bakr HA, Elnesr KA. Full-thickness hysterocystoplasty for management of a large bladder defect: experimental study in goats. J Vet Med Sci 2013; 75:767-71. [PMID: 23363769 DOI: 10.1292/jvms.12-0298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The uterine tissue of three healthy nonpregnant goats was evaluated experimentally as a graft for closure of a bladder defect. Goats were subjected to ovariectomy, and then one detubularized uterine horn was used as a graft to close a large defect in the ventral aspect of the bladder. Follow up included monthly radiographic and ultrasonographic examinations and evaluations of kidney function and electrolytes changes for six months. The goats were euthanized after six months, and both the bladder and the graft were examined macroscopically and histologically. The technique required less invasive procedures than those described with alternative techniques of cystoplasty, achieved a high survival rate without life-threatening complications post surgery, was associated with no significant changes in kidney function and electrolytes levels, showed proper healing of the transplanted graft by regeneration rather than repair without scaring or fibrosis and with complete covering of the graft by a healthy urothelium and was associated with no malignant transformation. Hysterocystoplasty is a non-invasive, non-life-threatening technique due to the close position of the bladder to the uterus, and proper healing of the graft reflects absence of pressure on its blood supply. It is an acceptable alternative technique for closure of a large bladder defect and avoids disadvantages of alternative techniques of cystoplasty. It might be accepted by owners of pets, and further studies in clinical cases of dogs are advised.
Collapse
Affiliation(s)
- Mohamed Abdelfattah Abdelrhman
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Beni-Suef University, P. O. Box 62511, Beni-Suef, Egypt
| | | | | | | |
Collapse
|
12
|
McLoughlin MA. Complications of lower urinary tract surgery in small animals. Vet Clin North Am Small Anim Pract 2011; 41:889-913, v. [PMID: 21889691 DOI: 10.1016/j.cvsm.2011.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Surgical procedures of the lower urinary tract are commonly performed in small animal practice. Cystotomy for removal of uroliths and urethrostomy diverting urine outflow due to urethral obstruction are the most commonly performed surgical procedures of the bladder and urethra respectively. Surgical procedures of the lower urinary tract are typically associated with few complications, including leakage of urine, loss of luminal diameter (stricture or stenosis), urine outflow obstruction, tissue devitalization, denervation, urinary incontinence, urinary tract infection, and death. Complications can result from inappropriate or inadequate diagnosis, localization, and surgical planning; failure to respect regional anatomy, and other causes.
Collapse
Affiliation(s)
- Mary A McLoughlin
- Department of Veterinary Clinical Sciences, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43210, USA.
| |
Collapse
|
13
|
Elwood C, Devauchelle P, Elliott J, Freiche V, German AJ, Gualtieri M, Hall E, den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K. Emesis in dogs: a review. J Small Anim Pract 2010; 51:4-22. [PMID: 20137004 PMCID: PMC7167204 DOI: 10.1111/j.1748-5827.2009.00820.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2009] [Indexed: 11/26/2022]
Abstract
Emesis is a common presenting sign in small animal practice. It requires a rational approach to management that is based upon a sound understanding of pathophysiology combined with logical decision making. This review, which assesses the weight of available evidence, outlines the physiology of the vomiting reflex, causes of emesis, the consequences of emesis and the approach to clinical management of the vomiting dog. The applicability of diagnostic testing modalities and the merit of traditional approaches to management, such as dietary changes, are discussed. The role and usefulness of both traditional and novel anti-emetic drugs is examined, including in specific circumstances such as following cytotoxic drug treatment. The review also examines areas in which common clinical practice is not necessarily supported by objective evidence and, as such, highlights questions worthy of further clinical research.
Collapse
Affiliation(s)
- C Elwood
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire SG5 3HR
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|