Urinary Bladder Marsupialization for Treatment of Obstructive Urolithiasis in Male Goats

Objectives —To describe a surgical procedure for urinary bladder marsupialization and to report the results obtained from its use in the treatment of obstructive urolithiasis in male goats.
Study Design —Retrospective evaluation.
Animals or Sample Population—Male goats with obstructive urolithiasis.
Methods —Medical records of male goats that had urinary bladder marsupialization for the treatment of obstructive urolithiasis were reviewed. Data retrieved from the medical records included signalment, postoperative treatment, duration of hospitalization, and short-term and long-term complications. Median values for measured variables were calculated.
Results —A total of 18 of 19 goats survived. Urinary flow was re-established in all 19 goats at the conclusion of surgery. Short-term postoperative complications (bladder mucosal prolapse and death) were observed in 2 goats. Long-term postoperative complications (cystitis and fibrotic stomal closure) occurred in 2 animals. Median duration of hospitalization was 4 days. At the time of follow-up, mild urine scald was reported for all goats. Clinical signs of upper urinary tract disease or obstruction were not reported. A total of 15 of 17 owners were satisfied with the procedure.
Conclusions —Urinary bladder marsupialization provided long-term resolution of urinary outflow obstruction in all goats with acceptable morbidity.
Clinical Relevance —Urinary bladder marsupialization is a procedure that provides a good prognosis for long-term resolution of obstructive urolithiasis in male goats.     

Urethroscopy and laser lithotripsy for the diagnosis and treatment of obstructive urolithiasis in goats and pot-bellied pigs

OBJECTIVE: To explore the use of urethral endoscopy and laser lithotripsy in the diagnosis and management of urolithiasis in goats and pot-bellied pigs. DESIGN: Prospective clinical study. ANIMALS: 16 male goats and 6 male pot-bellied pigs with dysuria. PROCEDURE: Abdominal ultrasonography and urethral endoscopy were performed on all 22 animals. Endoscopic-guided holmium:yttrium-aluminum-garnet laser lithotripsy was performed in 3 goats and 2 pot-bellied pigs. RESULTS: Urolithiasis was identified in 15 goats and 5 pot-bellied pigs. Primary urinary bladder paralysis and cystitis were identified in the remaining pot-bellied pig and goat. Mean bladder diameters of obstructed small- and large-breed goats were 7 and 9.5 cm, respectively. The mean bladder diameter of obstructed pot-bellied pigs was 9.5 cm. Five of 20 animals with obstructive urolithiasis had severe urethral necrosis or stricture formation at the time of urethroscopy. All of these animals were euthanatized within 6 months because of persistent dysuria. When used, laser lithotripsy successfully fractured the distally located obstructing stones in the 3 goats and 2 pot-bellied pigs. CONCLUSIONS AND CLINICAL RELEVANCE: Urethral endoscopy is useful for evaluating urethral patency in goats and pot-bellied pigs. Examination of the urethral mucosa following relief of urethral obstructions aids in the assessment of the long-term prognosis for urethral stricture. Urethral endoscopy also expands the therapeutic options for management of urolithiasis by providing a route for conducting laser lithotripsy. Laser lithotripsy proved to be safe and effective for clearing distally located calculi refractory to removal by traditional urethral flushing. Lithotripsy application is restricted to calculi lodged in the urethra.     

CT features of malignant tubular genital tract tumors in seven goats

Neoplasia of the tubular genital tract in goats, while rarely described, is most commonly reported as uterine adenocarcinoma, leiomyoma, or leiomyosarcoma. In this retrospective, single-center, case series, medical records were searched for goats with a computed tomography (CT) diagnosis of tubular genital mass and a definitive histologic (surgical biopsy or necropsy) diagnosis of malignant neoplasia. Data recorded from CT images were presence of peritoneal/retroperitoneal fluid, urinary tract obstruction, abdominal lymphadenomegaly, additional abdominal nodules/masses, and pulmonary nodules. For masses, maximum cross-sectional area, contrast enhancement, and uterine luminal fluid accumulation were also recorded. Seven goats met the inclusion criteria (leiomyosarcoma n = 5, adenocarcinoma n = 2). Both goats with adenocarcinoma had upper urinary tract obstruction, moderate to severe regional lymphadenopathy, peritoneal fluid, and peritoneal or hepatic nodules/masses; one goat with adenocarcinoma was discharged and subsequently euthanized, and the other had palliative mass debulking and was lost to follow up. Goats with leiomyosarcoma had infrequent, mild peritoneal fluid and mild sublumbar lymphadenopathy. Of the goats with leiomyosarcoma, two were euthanized at or near the time of CT imaging, two were euthanized at the time of surgery due to perceived mass non-resectability, and one had mass regression approximately four months post ovariohysterectomy but was subsequently lost to follow up. Five goats had pulmonary nodules, three of which had pathologic confirmation (pulmonary metastasis in a single patient with adenocarcinoma, and lungworm granulomas in two goats with leiomyosarcoma). Severe sublumbar lymphadenopathy and obstructive uropathy were sequelae in the two caprine patients with genital adenocarcinoma, and in none with leiomyosarcoma.     

Clinicopathologic analysis of herpesvirus-induced urinary tract infection in specific-pathogen-free cats given methylprednisolone

The clinicopathologic manifestations of bovid herpesvirus-4 (BHV-4; FCAHV strain)-induced infection of the lower portion of the urinary tract were characterized in 12 adult neutered male and 6 female specific-pathogen-free cats, and were compared with those in 12 neutered male control cats. Six neutered male and 6 female cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with BHV-4. Six neutered male control cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with uninfected tissue culture control inoculum. Six additional neutered male control cats were exposed only to uninfected tissue culture control inoculum. All cats were observed for 90 days following inoculation. Dysuria and gross hematuria were observed in only 1 BHV-4-exposed cat. Radiographic abnormalities of the lower portion of the urinary tract were not observed. Microscopic hematuria, crystalluria, and lipiduria were identified with similar frequency in BHV-4-exposed and control cats. Results of urine culturing for bacteria, mycoplasma, ureaplasma, and viruses were negative. Viruses were not isolated from blood leukocytes collected from exposed or control cats. Three to 6 weeks after inoculation, high concentrations of BHV-4 serum antibodies were detected in all exposed cats by an indirect fluorescent antibody test. Light microscopic examination of the urinary tract revealed multifocal lymphoid cystitis in 2 BHV-4-exposed cats. Except for suppurative bronchitis in 1 BHV-4-exposed cat given glucocorticoids, morphologic differences in urinary and extraurinary tissues were not observed. In urinary bladder tissue collected 90 days after inoculation, BHV-4 was reisolated from urinary bladder explants of all but 1 exposed cat. Virus was also isolated from a kidney explant of 1 exposed male cat, and spleen cell co-cultures of 1 exposed female cat given glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)     

Experimental studies on the pathogenicity of Mycoplasma ovipneumoniae and Mycoplasma arginini for the respiratory tract of goats.

Mycoplasma ovipneumoniae and Mycoplasma arginini were the species of Mollicutes most commonly isolated from 175 goats with respiratory disease in Ontario. The pathogenicity of M. ovipneumoniae, strain B321B and M. arginini, strain D53e, was assessed in goats following endobronchial inoculation. One out of three two year old goats developed fever after inoculation with a pure culture of strain B321B, and it had extensive subacute fibrinous pleuritis when necropsied three weeks later. Neither of the remaining goats had lesions in the respiratory tract. Mycoplasma ovipneumoniae was recovered from one of the animals four days after inoculation, but not at necropsy from any of the goats, at which time a marked humoral immune response with growth inhibiting antibodies was detected. In a second experiment three four to five week old goats were inoculated with the same strain and three other goats were given placebo treatment. One experimental goat developed fever and coughing, and it had extensive subacute fibrinous pleuritis in the right side and pneumonia. Another goat had focal pneumonia in the left diaphragmatic lobe. Microscopically there was subacute hyperplastic suppurative bronchiolitis, atelectasis and nonsuppurative alveolitis. The infected animals did not clear the mycoplasma and not all of them produced antibodies. Mycoplasma arginini, strain D53e, did not induce lesions in any of four goat kids within 14 days after inoculation but did cause transient elevations in rectal temperature, circulating monocytes, circulating neutrophils and blood fibrinogen. Mycoplasma arginini was infective and immunogenic for all inoculated animals and showed a particular affinity for the tonsil. Thus, this study provides the first evidence that M. ovipneumoniae is pathogenic for goats causing pneumonia and pleuritis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Caprine obstructive urolithiasis: requirement for 2nd surgical intervention and mortality after percutaneous tube cystostomy, surgical tube cystostomy, or urinary bladder marsupialization

OBJECTIVES: To determine the requirement for 2nd surgical interventions and mortality after 3 different surgical techniques (percutaneous tube cystostomy [10 goats], surgical tube cystostomy [25 goats], urinary bladder marsupialization [10 goats]) for caprine obstructive urolithiasis, and to determine whether pre- or 24-hour postoperative physical examination findings or serum chemistry results could be used as predictors of mortality. STUDY DESIGN: Retrospective study. ANIMALS: Male goats (45) with obstructive urolithiasis. METHODS: Medical records for all male goats admitted and operated for obstructive urolithiasis between 1993 and 2003 were reviewed. Data retrieved included signalment, pre- and 24-hour postoperative values for temperature, pulse, respiratory rate, packed cell volume, serum K(+), serum creatinine, and blood urea nitrogen [BUN]. The type of initial surgical procedure, time to 2nd surgical intervention, time to death, and duration and cost of hospitalization were also obtained. RESULTS: Percutaneous tube cystostomy was associated with a significantly increased requirement for (5.6-fold increased hazard) and decreased time to a 2nd intervention (P=.002). There were no differences between the 3 procedures for time to mortality. Increased BUN and respiratory rate at admission were associated with increased mortality (hazards ratio of 4.8 and 5.0, respectively). Urinary bladder marsupialization was associated with significantly decreased hospitalization time (P=.02) and cost (P=.04) compared with surgical tube cystostomy and percutaneous tube cystostomy. CONCLUSION: Surgical tube cystostomy and bladder marsupialization are both acceptable surgical methods for treatment of caprine obstructive urolithiasis. Each procedure has inherent complications that should be discussed with the owner before choosing the surgical treatment. CLINICAL RELEVANCE: There are acceptable options for treatment of caprine obstructive urolithiasis; however, percutaneous tube cystostomy should be avoided.     

Effect of Therapy on Susceptibility to Urinary Tract Infection in Male Cats with Indwelling Urethral Catheters

Indwelling urinary catheters with a closed urine collection system were maintained in 30 male cats for 3 days after induction of irritant cystitis. All cats received subcutaneous fluids during the 3 days the catheters were in place. The effects of four different treatment regimens on urinary tract infection rates, incidence of urethral obstruction, and development of urinary tract lesions over a 10-day period were compared with results in a nontreated group. Treatments were 1) amoxicillin for 5 days PO; 2) prednisolone for 5 days PO; 3) both amoxicillin and prednisolone for 5 days PO; and 4) dimethylsulfoxide (DMSO) for 3 days intravesicularly. Euthanasia was done before the end of the 10-day experimental period if the cats had two bouts of urethral obstruction or if the cats became uremic for causes unrelated to urethral obstruction. Seven cats were euthanatized before the conclusion of the experiment. These cats had been treated with prednisolone, prednisolone and amoxicillin, or DMSO. All cats that received amoxicillin alone or no therapy survived the 10-day period. Mortality was due to repeated urethral obstruction or to uremia associated with pyelonephritis or papillitis. Urinary tract infection rate was similar in all groups. The group treated with prednisolone alone had the highest incidence of renal infection. Inflammatory lesions in the lower urinary tract were similar in all groups. In conclusion, persistent urinary tract infection often develops in cats with cystitis after indwelling urethral catheterization even when closed systems of urine drainage are used.(ABSTRACT TRUNCATED AT 250 WORDS)     

Tube Cystostomy for Treatment of Obstructive Urolithiasis in Small Ruminants

Tube cystostomy was used to treat 13 goats and two sheep with obstructive urolithiasis. The cystostomy tube was intermittently occluded 3 to 4 days after placement to determine if urine could be voided through the urethra. If the animal showed no discomfort during urination after the cystostomy tube had been occluded for several days, the tube was removed. This procedure was successful in relieving urethral obstruction in 12 animals. The mean time until the animal could urinate freely and until the cystostomy tube was removed was 11.5 and 14.4 days respectively. Follow-up was available for 10 animals; seven were alive with no recurrence of urinary obstruction. One goat died from causes unrelated to urinary obstruction 1 year postoperatively. One goat died from unknown causes, and one goat died after urinary obstruction recurred.     

Presumptive pseudohypoaldosteronism secondary to chronic urinary tract obstruction from sloughed urinary bladder mucosa and urinary tract infection in a cat

Objective – To describe a case of presumptive secondary pseudohypoaldosteronism (PHA) in a cat with urinary tract infection and chronic urethral obstruction. The obstruction was believed to have resulted from sloughed urinary bladder mucosa secondary to pressure necrosis. Case Summary – A 5‐year‐old, 4 kg, castrated male Siamese cat presented for vomiting and stranguria. Medical history included a perineal urethrostomy for urethral obstruction. Physical examination revealed a large, painful, nonexpressible urinary bladder. Point‐of‐care testing demonstrated electrolyte derangements consistent with a postrenal azotemia and metabolic acidosis. Results of urine culture was positive for bacterial growth. Diagnostic imaging revealed presence of retroperitoneal fluid, marked urinary bladder wall thickening, bilateral hydroureter, mild bilateral pyelectasia, and small nephroliths. The patient was treated for a urinary tract obstruction and infection. In the 3 weeks following initial discharge, the patient was evaluated on multiple occasions for lethargy, intermittent vomiting, inappropriate urination, and progressive polyuria and polydipsia. Although the urinary bladder was easily expressed during repeat examinations, it was persistently distended and subjectively thickened upon palpation. Repeat ultrasound of the urinary tract showed evidence of sloughed tissue in the bladder lumen, likely secondary to chronic urethral obstruction and pressure necrosis. A cystotomy was performed to remove the necrotic tissue, and a revised perineal urethrostomy was done due to a partial urethral stricture. Bladder biopsies were obtained at this time. Postoperatively, the cat was reported by the owners to be urinating normally but continued to be polyuric and polydipsic in the week following discharge. One week after surgery, the cat presented in hypovolemic shock with laboratory findings consistent with a presumptive diagnosis of secondary PHA. New or Unique Information Provided – PHA has not been reported previously in a cat. This case report suggests that aldosterone resistance should be considered in cats with consistent laboratory findings and a history of documented obstructive uropathy and urinary tract infection.     

Urinary acidification in the prevention and treatment of feline struvite urolithiasis

Two groups of 12 cats were fed ad libitum an experimental dry expanded ration high in magnesium (0.37%, dry matter basis) and similar to most commercial dry cat foods in all other nutrients. The diet of one of the groups contained 1.5% ammonium chloride, which was added to the diet before processing. Urethral obstruction developed twice in 7 of the 12 cats fed the ration without ammonium chloride. Of the 5 remaining cats in that group, 2 had calculi in the urinary bladder and urethra at necropsy. In contrast, only 2 of the 12 cats fed the ration containing ammonium chloride had urethral blockage once; neither cat had another blockage. Both cats had been catheterized twice as paired controls before urethral obstruction. One of these 2 cats died from a urinary tract infection apparently introduced through the indwelling catheter, and at necropsy there were 2 small calculi in the urethra. At the end of the study, only 1 other cat fed the ammonium chloride diet had a calculus in the urinary bladder at necropsy; this cat had not had a urethral obstruction throughout the study. After each cat had 2 urethral blockages, its diet was changed. Four cats were fed the ration containing ammonium chloride and 3, a dry, commercial ration. Of the 4 cats fed the diet containing ammonium chloride, none developed another urethral obstruction within 6 months, and at necropsy, no calculi were in the urinary bladder or urethra. Two of the 3 cats fed the commercial ration experienced urethral blockage within 3 months. These 2 cats were then fed the diet containing ammonium chloride.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intersexuality in goats

Six cases of intersex goats were investigated. Five of these animals had testicular tissues (testes) situated prepubically inside a skin pouch. The testicular tissues of the sixth goat were attached to the sides of the urinary bladder. All of the four animals that were studied by radiography, surgical exploration and/or pathology had uterine tubular structures but no ovarian tissues were found in them. Thus at least four of these goats were male pseudohermaphrodites.     

Intersexuality in goats

Six cases of intersex goats were investigated. Five of these animals had testicular tissues (testes) situated prepubically inside a skin pouch. The testicular tissues of the sixth goat were attached to the sides of the urinary bladder. All of the four animals that were studied by radiography, surgical exploration and/or pathology had uterine tubular structures but no ovarian tissues were found in them. Thus at least four of these goats were male pseudohermaphrodites.     

Percutaneous tube cystostomy and vesicular irrigation for treatment of obstructive urolithiasis in a goat

Treatment of a 3-month-old male goat with obstructive urolithiasis by means of percutaneous tube cystostomy and vesicular irrigation with a chemolysis solution is described. The cystostomy tube was inserted percutaneously with ultrasonographic guidance. Patency of the urethra was reestablished with no clinical evidence of urethral stricture or recurrence of obstruction during the following 12 months. Results in this goat suggest that percutaneous tube cystostomy may be an economical alternative to surgical cystostomy tube placement. Chemical dissolution of calcium phosphate uroliths with a commercially available compound appears to be feasible in goats.     

Experimental contagious caprine pleuropneumonia: a long term study on the course of infection and pathology in a flock of goats infected with Mycoplasma capricolum subsp. capripneumoniae

Contagious caprine pleuropneumonia (CCPP) is a major threat to goat farming in parts of Africa and Asia. It classically causes acute high morbidity and mortality early in infection, but little is known of its long term epizootiology and course. In this study, 10 goats were inoculated with Mycoplasma capricolum subsp. capripneumoniae (M. capripneumoniae) and then mixed with 15 goats for contact transmission. The disease course was monitored in each goat for 56-105 days, whereafter the goats were killed and necropsied. Varying features signifying infection occurred in altogether 17 goats (7 inoculated, 10 in-contact). Clinical signs were severe in 8 goats but no fatalities occurred. Only 6 goats had serum antibody titres against M. capripneumoniae in ELISA. Fourteen goats (5 inoculated, 9 in-contact) had chronic pleuropulmonary lesions compatible with CCPP at necropsy and 7 of those showed M. capripneumoniae antigen in the lung by immunohistochemistry. Neither cultivation nor PCR tests were positive for the agent in any goat. The results indicate that the clinical course of CCPP in a flock may be comparatively mild, M. capripneumoniae-associated lung lesions may be present at a late stage of infection, and chronic infection may occur without a significant serological response.     

Emphysematous cystitis and bladder trigone diverticulum in a dog

A 14-month-old, male German shepherd dog was evaluated for chronic, recurrent Escherichia coli urinary tract infection. An initial diagnosis of emphysematous cystitis was made, which resolved with appropriate antibacterial therapy. The urinary tract infection, however, did not resolve and on further investigation a bladder trigone diverticulum was evident, thought to be congenital in origin. This report describes the apparent ultrasonographic and radiological changes, and surgical repair of the diverticulum, and reviews the literature with regard to both congenital bladder trigone diverticulum and emphysematous cystitis. The former has never been documented in the dog and the latter is an unusual finding in a non-diabetic dog.     

Use of a toxoid vaccine to protect goats against intradermal challenge exposure to Corynebacterium pseudotuberculosis

Two groups of male, 9-week-old goats (5 goats/group) were vaccinated subcutaneously with formalized exotoxin of Corynebacterium pseudotuberculosis, with Freund's incomplete adjuvant. Each goat was given 2 vaccinations, 2 weeks apart. At each vaccination, each group 1 goat was given 0.5 ml of toxoid, and each group 2 goat was given 1 ml of toxoid. Twenty days after the 2nd vaccination, vaccinated goats and 5 nonvaccinated 12-week-old goats (controls) were inoculated intradermally (challenge exposed) with live C pseudotuberculosis, monitored for 13 weeks, and euthanatized. At necropsy, 5 of the 10 vaccinated goats did not have C pseudotuberculosis lesions, 3 had abscesses limited to the inoculation site and draining lymph node, and 2 had disseminated bacterial lesions. Of the 5 nonvaccinated controls, 4 had disseminated abscesses and 1 had a single abscess in an internal node. Serologically, 9 of the 10 vaccinated goats developed positive (greater than or equal to 1:8) antibody titers against the exotoxin within 1 week after inoculation; the 10th goat seroconverted 2 weeks after inoculation, whereas control goats required 3 weeks to develop a positive antibody response. Therefore, early during an infection with C pseudotuberculosis, antibodies against the exotoxin may protect a goat against spread of the organism. All goats were injected intradermally before challenge exposure, 10 days after challenge exposure, and at 4, 8, and 12 weeks after challenge exposure with a skin-test reagent composed of fragmented bacterial cells.(ABSTRACT TRUNCATED AT 250 WORDS)     

Symptomatic Capillaria plica infection in a young European cat

An 8-month-old owned European cat showing abdominal pain, fever, distended painful bladder and urinary blockage was presented. Intravenous fluids were immediately administered and, after sedation, a urinary catheter was applied. Blood and urine analysis revealed cystitis and a moderate-to-severe degree of renal failure. About 20 thread-like nematodes, identified as Capillaria plica larvae and fragments of adult stages, were found in the urine sediment. After treatment with an oral formulation of fenbendazole at 25 mg/kg q 12 h for 10 days, urinary signs and bladder worms disappeared. Cases of Capillaria species bladder worms in cats are rarely reported and most infected cats show no clinical signs, presumably because of a low parasite burden. In the present study, feline capillariosis was associated to urethral obstruction, severe difficulties in urination, cystitis and renal failures.     

Evaluation of a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs

OBJECTIVE: To evaluate a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs. ANIMALS: 6 healthy mixed-breed dogs. PROCEDURE: Dogs were anesthetized, and cystitis was induced by infusing a solution of salicylic acid in ethanol into the bladder, followed by an inoculum containing field isolates of P. mirabilis and P. aeruginosa. Dogs were examined daily for 21 days after induction of cystitis. On day 21, dogs were euthanatized, and urinary bladder, renal pelvis, and prostate specimens were submitted for bacterial culture. RESULTS: After induction of cystitis, all dogs had evidence of thickening of the bladder wall, dysuria, tenesmus, and hematuria. Urinalysis revealed proteinuria, hematuria, and pyuria. All urine samples obtained on day 21 yielded growth of P. mirabilis, but P. aeruginosa was not cultured from any of these samples. Proteus mirabilis was isolated from bladder, renal pelvis, or prostate specimens from 4 dogs; P. aeruginosa was not isolated from any of the tissue specimens. CONCLUSION: Results suggest that the method used in the present study fails to induce dual infection of the urinary bladder with P. mirabilis and P. aeruginosa. The inability to establish a persistent dual infection with this method may have been a result of insufficient pathogenicity of the Pseudomonas isolate or an inadequacy of the experimental design.     

A technique for resection of invasive tumors involving the trigone area of the bladder in dogs: preliminary results in two dogs

Objective— To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life-threatening urinary tract obstruction.
Study Design— Clinical case reports.
Animals— Dogs (n=2) with bladder tumors.
Methods— Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.
Results— Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.
Conclusion— En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.
Clinical Relevance— In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion.