Use of a biodegradable self-expanding stent in the management of a benign oesophageal stricture in a cat

An 11-year-old domestic shorthair cat presented with a six-week history of regurgitation following a dental procedure. Endoscopy identified a single oesophageal stricture in the cervical oesophagus. Stricture reformation occurred following endoscopic balloon catheter dilation on two occasions. Following a third balloon dilation a biodegradable polydioxanone self-expanding stent was placed across the stricture site. Following the implantation the cat was able to eat soft canned food orally without regurgitation. Fluoroscopic examination performed four months after placement indicated that the stent was no longer present and the cervical oesophagus was able to pass boluses of canned food with no signs of obstruction.     

Recurrent single oesophageal stricture treated with a self-expanding stent in a cat

A 1-year-old, female spayed domestic shorthair cat was presented with a 4-week history of dysphagia and regurgitation soon after oral treatment with clindamycin. Fluoroscopic and endoscopic examinations confirmed the presence of a single cervical oesophageal stricture 4 cm caudal to the pharynx. A fluoroscopically and endoscopically guided balloon dilation was performed six times consecutively over a period of 3 weeks as reformation of the stricture appeared within 3-7 days. Feeding via percutaneous endoscopic gastrostomy-tube as long-term management of the condition was declined by the owner. A self-expanding metal oesophageal stent with the following dimension was subsequently implanted: fully open diameter 16 mm, length 30 mm. After stent implantation, the cat was fed on mashed canned food and did not show any clinical signs for 12 months. Twelve months post-implantation the cat was no longer able to eat even liquid food, became lethargic and the owner opted for euthanasia. On post-mortem examination the stent surfaces were overgrown by oesophageal mucosa by approximately 50%. Stent obstruction was detected and caused by swallowed hair which also seemed to have hampered mucosal integration in the distal part of the stent.     

Wedge meatoplasty as a treatment for stricture of the urethral meatus in a cat

A three-and-a-half-year-old male neutered Siamese cat presented with idiopathic feline lower urinary tract inflammation and dysuria, which appeared to be caused by stricture of the urethral meatus. Wedge meatoplasty was performed, which relieved the cat's dysuria and restored a normal urine stream. To my knowledge, this is the first report of meatoplasty as a treatment for stricture of the urethral meatus in a cat.     

Fluoroscopic stent placement for the relief of malignant urethral obstruction in a cat

The clinical features and interventional therapy in the case of a female cat with urinary tract obstruction secondary to neoplasia are presented. This form of neoplasia in cats is rare and therapeutic intervention to relieve urinary tract obstruction caused by malignancy has been described only once. This is the first report of a self-expandable metallic stent placed in a feline urethra to relieve obstruction caused by malignancy and the first report of the use of a unique composite metallic stent (Platinol™) in a cat. In conclusion, the palliative stenting of the feline urethra may be a valid therapeutic intervention for malignancies. Further studies are required to determine the optimal size and type of stent that will provide the greatest benefit.     

Use of a self-expanding occluding stent for nonsurgical closure of patent ductus arteriosus in dogs

OBJECTIVE: To evaluate the clinical application of a catheter-delivered, self-expanding occluding stent for closure of patent ductus arteriosus (PDA) in dogs. DESIGN: Prospective study. ANIMALS: 23 client-owned dogs weighing at least 3 kg (6.6 lb). PROCEDURE: Dogs were evaluated by physical examination, electrocardiography, thoracic radiography, and 2-dimensional, M-mode, spectral and color-flow Doppler echocardiography to confirm the diagnosis and obtain baseline measures. Shunt severity and ductal size and anatomy were established by means of angiography. With fluoroscopic guidance, the occluding stent, attached to a delivery cable, was maneuvered though the right side of the heart into the ductus via a prepositioned introducer sheath. After angiographic verification of appropriate stent placement, the delivery cable was detached, and the introducer sheath was withdrawn. Closure of the PDA was evaluated by means of angiography 15 minutes after stent deployment and by echocardiography 1 and 3 months after the procedure. RESULTS: There were no operative deaths. There were 2 deployment failures, both attributable to avoidable operator errors. Angiography performed after stent deployment indicated PDA closure in 13 of 20 (65%) dogs. There were 2 postoperative deaths in dogs with heart failure; both deaths were thought to be unrelated to use of the occluding stent. Complete PDA closure, determined by Doppler color-flow echocardiography, was evident in 17 of 19 dogs within 3 months and in 1 additional dog within 1 year of stent deployment, resulting in closure in 18 of 19 dogs completing the study protocol. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a catheter-delivered occluding stent can be used successfully to close PDAs in dogs.     

Balloon dilation of a urethral stricture in a dog

A 2-year-old male neutered Scottish Terrier presented with dysuria caused by complete urethral obstruction due to a stricture secondary to catheter-induced trauma. The urethral obstruction was resolved by balloon dilation of the stricture under fluoroscopic guidance.     

Use of trilostane for the treatment of pituitary-dependent hyperadrenocorticism in a cat

Hyperadrenocorticism occurs much less frequently in cats than in dogs and, at present, is more difficult to manage successfully. This report documents the use of the steroid synthesis inhibitor trilostane for the treatment of hyperadrenocorticism in a domestic shorthaired cat with pituitary-dependent disease. Although trilostane was able to alleviate the severity of the clinical signs and was well tolerated, the cat subsequently died of renal failure secondary to a fungal infection of the urinary tract.     

Cystoscopic-guided balloon dilation of a urethral stricture in a female dog

A 9-year-old, spayed female, Labrador retriever was referred for evaluation of dysuria. Cystoscopic examination revealed a urethral stricture in the proximal urethra that was dilated by use of an angioplasty balloon (Gruntzig angioplasty balloon) under cystoscopic guidance. Following the procedure, the dysuria resolved.     

Use of a mucosal advancement flap for the treatment of nasopharyngeal stenosis in a cat

A three-and-a-half-year-old male neutered domestic short-haired cat was presented with a three-year history of stertor and intermittent open-mouth breathing. No airflow was detected from either nostril when checked using a cold slide test. Oropharyngeal swabs were positive for calicivirus, while skull radiographs were suggestive of a dorsal deviation of the soft palate. The diagnosis of nasopharyngeal stenosis was confirmed via cannulation of the nasal passages and direct examination of the oropharynx under general anaesthesia. A midline approach through the soft palate was used to excise the adhesions. The resulting defect was reconstructed by advancement of a mucosal flap elevated from the dorsal nasopharynx and laryngopharynx. The cat was free of clinical signs 28 months later.     

Use of human immunoglobulin for treatment of severe erythema multiforme in a cat

A 5-month old female domestic shorthair cat developed lethargy and severe ulcerative skin lesions that covered more than half of its body after routine administration of rabies vaccine, anthelmintic, and ear medication. Clinical and histologic findings were consistent with a severe cutaneous drug reaction or erythema multiforme. The cat's condition continued to deteriorate despite drug withdrawal and supportive care. Administration of human intravenous immunoglobulin was well tolerated by the cat and led to rapid resolution of ulcerative cutaneous lesions, accompanied by substantial improvement in the cat's demeanor within 8 days. Human intravenous immunoglobulin appears to be a novel promising treatment for life-threatening cutaneous drug reactions.     

Use of bisphosphonates to treat severe idiopathic hypercalcaemia in a young Ragdoll cat

A 3-year-old Ragdoll cat was referred for investigation of polyuria, polydipsia, vomiting, weight loss and hypercalcaemia. Serum biochemical abnormalities included total and ionised hypercalcaemia and hypophosphataemia. Following clinical investigations a diagnosis of idiopathic hypercalcaemia was made. Because of the severity of the hypercalcaemia and the associated clinical signs, treatment for hypercalcaemia was commenced with pamidronate. Major electrolyte abnormalities were detected but, remarkably, were accompanied by minimal clinical signs. The cat was subsequently treated with oral alendronate and is clinically normal 15 months later. Reports of the use of bisphosphonates in cats are limited and close monitoring of patients is recommended.     

Polyarthritis in a young cat

A 3-year-old cat had polyarthritis involving both tarsal joints and the right carpal joint. The condition was associated with pyrexia and regional lymphadenopathy. The aetiology of the arthritis was not determined, but no bacterial or mycoplasmal agent could be isolated from the synovial fluid obtained from one of the affected joints. Prednisolone, administered on a reducing dosage schedule, induced lasting remission of the clinical signs.     

Traumatic urethral avulsion at the preputial fornix in a cat

A cat with pelvic fractures from being hit by a car had voided no urine in 13 hours despite iv administration of fluids. Abdominal radiography had revealed the pelvic fractures and apparently intact urinary bladder. Urine did not flow from a urethral catheter, and contrast radiography revealed the catheter to be extra-urethral within the penis. Intravenous pyelography revealed intact ureters and urinary bladder; celiotomy confirmed intact urinary bladder. Cystotomy and normograde urethral catheterization allowed localization of the ruptured urethra within the deep subcutaneous tissues of the caudal portion of the abdomen. After closure of the cystotomy and celiotomy incisions, perineal urethrostomy was performed.