Holmium:YAG Laser Lithotripsy for Urolithiasis in Horses

Background: Laser lithotripsy has been used as an alternative to surgical removal of uroliths.
Objective: To describe the procedure and efficacy of laser lithotripsy for removal of lower urinary tract uroliths in horses. Additionally, the ultrastructure and the differences in mineralogy and microstructure from 1 successful and 1 unsuccessful laser lithotripsy case are described.
Animals: Six client-owned horses with 7 episodes of naturally occurring urocystoliths, urethroliths, or both.
Methods: Retrospective study of all horses treated between 2006 and 2008 by laser lithotripsy. All horses were sedated followed by laser lithotripsy. Quantitative urolith analysis was performed in all cases. Ultrastructure and microstructure analyses were performed on uroliths from 2 horses.
Results: Procedural success was achieved in 5 of 7 laser lithotripsy procedures. No complications occurred as a result of laser lithotripsy. One horse developed uroabdomen likely as a result of manual lithotrite disruption of the bladder after failure of laser lithotripsy. There were differences in microstructure between 1 urolith that was successfully fragmented by laser lithotripsy and 1 urolith that was resistant to laser fragmentation.
Conclusions and Clinical Importance: Laser lithotripsy is an effective procedure for removal of some urocystoliths, urethroliths, or both in horses.     

Bilateral ureterocystostomy to correct left ureteral atresia and right ureteral ectopia in an 8-month-old standardbred filly

OBJECTIVES: To report the diagnosis and outcome after surgical correction of bilateral distal ureteral anomalies in a Standardbred filly. STUDY DESIGN: Clinical case report. ANIMAL: An 8-month-old, 310 kg Standardbred filly with left ureteral atresia and right ureteral ectopia. METHODS: The filly was admitted for evaluation of incontinence since birth and severe urine scalding of the hindquarters. Diagnosis was made by both direct (cystoscopy and vaginoscopy) and indirect (intravenous pyelography, ultrasonography, and scintigraphy) evaluation of the ureters and bladder. The filly had left ureteral atresia, hydronephrosis, and decreased left-sided renal function and right ureteral ectopia before surgery. Surgical correction was performed on the left by an end-to-side stapled anastomosis technique and on the right by a side-to-side hand-sewn anastomosis technique. RESULTS: Surgical correction was successful. The filly had no postoperative complications and remained continent 18 months after surgery. Left renal function improved. CONCLUSION: Ureteral anomalies can be successfully repaired in larger (>300 kg) foals and some renal function may be restored after surgical correction. CLINICAL RELEVANCE: Scintigraphy should be considered in diagnosis of ureteral anomalies, assessing renal function, and determining prognosis for horses with hydronephrosis caused by ureteral ectopia and atresia.     

Differences in the expression of luteinizing hormone and follicle-stimulating hormone receptors in the lower urinary tract between intact and gonadectomised male and female dogs

Receptors for LH (LHR) and FSH (FSHR) are expressed in the canine lower urinary tract (LUT). As gonadectomy results in an increase in plasma LH and FSH, the objective of this study was to determine whether there are any differences in the expression of LHR and FSHR in the LUT between intact and gonadectomised dogs. Four regions of the LUT, i.e. body and neck of the bladder as well as proximal and distal urethra, were collected from 20 healthy dogs (5 intact males, 5 intact anoestrous females, 4 castrated males and 6 spayed females). The mRNA and protein expression of receptors was determined by in situ hybridization and immunohistochemistry, respectively, and assessed semi-quantitatively incorporating both the distribution and the intensity of specific staining. Expression of LHR and FSHR was present in all tissue layers (epithelium, sub-epithelial stroma and muscle) of each region with different levels of the expression. Overall mRNA and protein expression for both LHR and FSHR was significantly (P < 0.001) lower in gonadectomised dogs. Intact dogs had more (P < 0.05) LHR and FSHR mRNA and protein in all tissue layers of the four regions, except for LHR mRNA expression in the sub-epithelial stroma where no differences were observed between the two statuses. Decreases in LHR and FSHR mRNA and protein in gonadectomised dogs appeared to be more consistent in spayed bitches compared to castrated males. Lower expression of LHR and FSHR observed in gonadectomised dogs may adversely affect the normal canine LUT function.     

Congenital Ureteral Ectopia in Continent and Incontinent‐Related Entlebucher Mountain Dogs: 13 Cases (2006–2009)

Background: Ectopic ureters (EUs) associated with varying combinations of urinary incontinence, hydronephrosis, and urinary tract infection have been identified in related North American Entlebucher Mountain Dogs. Objectives: To characterize the disease phenotype in affected dogs and evaluate possible modes of inheritance. Animals: Twenty client‐owned Entlebucher Mountain Dogs. Nine dogs had clinical signs of urinary tract disease. Methods: Prospective case series in which 17 dogs were evaluated with excretory urography, ultrasonography, and urethrocystoscopy. Three additional dogs were evaluated by necropsy alone. Clinical and pedigree histories from 165 North American Entlebuchers were compiled for analysis. Results: Eleven female and 2 male dogs were found to have EUs. Six females and 1 male were continent. Bilateral intravesicular ectopic ureters (IVEUs) were identified in 9 dogs, bilateral extravesicular ectopic ureters (EVEUs) in 3 dogs, and 1 dog had IVEU and EVEU. Hydronephrosis was identified in 5 dogs, 3 of which had bilateral IVEUs. Two necropsied dogs had bilateral hydronephrosis with presumed ureterovesical junction obstruction associated with chronic granulation tissue or lymphoplasmacytic inflammation. Twenty‐six dogs with EUs were identified in the pedigree. Because of incomplete penetrance, mode of inheritance could not be determined. Conclusions and Clinical Importance: Ureteral ectopia is common in North American Entlebucher Mountain Dogs and clinical signs alone could not reliably predict disease phenotype. EVEUs were associated with urinary incontinence and occasionally hydronephrosis. IVEUs were clinically silent or associated with hydronephrosis. Further analyses are necessary to confirm and characterize the hereditary nature of the disorder.