Management of traumatic urethral rupture in 11 cats using primary alignment with a urethral catheter

OBJECTIVE: To assess the management of traumatic urethral ruptures using a systematic attempt at urethral catheterisation. METHODS: Eleven cats that had been diagnosed with a traumatic urethral rupture over a five-year period were included in this study. Rupture was assessed by positive-contrast retrograde urethrography. An attempt was made to manage these ruptures by placing an indwelling urethral catheter. RESULTS: The placement of an indwelling urethral catheter, could be performed in 10 out of 11 cats, which indicated a partial rupture. In one cat, catheterisation was not possible because of complete urethral rupture. A urethral catheter was placed into the urinary bladder via the urethra in five animals. In the other five animals, urethral catheterization required cystotomy using a modified 'inside to outside' technique. Urethral catheter removal occurred between five and 14 days after placement. Urethral healing was accomplished in all cases of catheterisation with a good outcome in eight of the 10 cats. Two cats showed clinical signs related to stricture formation during the follow-up period (seven to 72 months). Retrograde urethrography provided a definitive diagnosis of partial rupture in only six of the 10 cases of partial rupture. CLINICAL SIGNIFICANCE: Results suggested that primary alignment with the placement of a urethral catheter should be attempted for the management of traumatic urethral ruptures in cats. Gentle urethral catheterisation seems to be an effective procedure for diagnosing and dealing with partial urethral rupture in cats. Clinical stricture formation can occur, but the risk does not seem to be high. Further studies are warranted in order to define the ideal duration for maintenance of an indwelling urethral catheter in cases of traumatic partial urethral rupture.     

Vaginourethroplasty as a salvage procedure for management of traumatic urethral rupture in a cat

This report describes a cat that suffered pelvic urethral rupture associated with multiple pelvic fractures. A vaginourethroplasty was performed as a salvage procedure, via intrapelvic anastomosis of the proximal urethra to the caudal vagina, following failure of a primary urethral anastomosis. Urinary diversion was achieved via tube cystostomy and a vagino-urethral catheter was maintained for 3 days postoperatively. Anterograde cystourethrography was performed at 7 days and 14 days postoperatively. Absence of contrast leakage from the vagino-urethral anastomosis was documented at 14 days postoperatively and the tube cystostomy was removed. An Escherichia coli urinary tract infection was treated following removal of the tube cystostomy and subsequent urine culture revealed no evidence of urinary tract infection. The cat retained normal urinary continence and elimination behaviour during the 7-month follow-up period. Vaginourethroplasty could be considered as a salvage option for management of traumatic pelvic urethral rupture in the neutered female cat.     

Spinal trauma. Pathophysiology and management of traumatic spinal injuries.

Spinal trauma can originate from internal or external sources. Injuries to the spinal cord can be classified as either concussive or compressive and concussive. The pathophysiologic events surrounding spinal cord injury include the primary injury (compression, concussion) and numerous secondary injury mechanisms (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free radicles, neurotransmitter and electrolyte alterations in cell membrane permeability, excitotoxic amino acids, and various other biochemical factors that collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray and white matter. Management of acute spinal cord injuries includes the use of a high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium prednisolone and methylprednisolone, at recommended doses, act as oxygen radical scavengers and are anti-inflammatory. Additional considerations are the stability of the vertebral column, other conditions associated with trauma (i.e., pneumothorax), and the presence or absence of spinal cord compression, which may warrant surgical therapy. Vertebral fractures or luxations can occur in any area of the spine but most commonly occur at the junction of mobile and immobile segments. Dorsal and dorsolateral surgical approaches are applicable to the lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the cervical spine. Indications for surgical intervention include spinal cord compression and vertebral instability. Instability can be determined from the type of fracture, how many of the three compartments of the vertebrae are disrupted, and on occasion, by carefully positioned stress studies of fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral cervical slot) is employed when compression of the spinal cord exists. The hemilaminectomy (unilateral or bilateral) causes less instability than dorsal laminectomy and therefore should be used when practical. The preferred approach for atlantoaxial subluxation is ventral, and the cross pinning, vertebral fusion technique is used for stabilization. Fracture luxations of C-2 are repaired with small plates on the ventral vertebral body. The thoracic and upper lumbar spine is stabilized with dorsal fixation techniques or combined dorsal spinal plate/vertebral body plate fixation. Several methods of fixation can be used with lower lumbar or lumbosacral fractures, including the modified segmental technique and the combined dorsal spinal plate/Kirschner-Ehmer technique.     

Catheter-induced urethral trauma in cats with urethral obstruction

Fifteen cats were evaluated with urethral obstruction. Penile trauma by catheterization was the major indication for perineal urethrostomy. Ten cats had developed a urethral stricture and five had rupture of the urethra following medical management. All cats had abnormalities in penis and/or prepuce and/or scrotal sacs including hyperemia or swelling. Perineal urethrostomy was performed in all cases and they were evaluated for 6 months after surgery. Few complications were noted. Urinary tract infection was the most frequent complication observed. The clients considered their cats to have a good quality of life following surgery.     

Frequency of traumatic cow injuries in relation to housing systems in Swiss organic dairy herds

A study was performed to estimate the extent of cow injuries as an indicator of animal welfare in organic dairy farms in Switzerland. The study was conducted during the winter feeding period of 1997/98 and was part of a larger project on animal health, nutrition and production in certified organic dairy herds in Switzerland. Potential predictors of injuries related to animal housing were quantified and relations between occurrence of injuries and nutritional status and production were evaluated. The investigation was designed as a cross-sectional study and included a representative sample of 152 farms and 1856 cows. Every farm was visited once and each cow was scored for claw-, skin- and joint-lesions and body condition. Statistical analyses were performed appropriate for a stratified and one-stage cluster sample weighted for the entire population of organic dairy farms in Switzerland. Possible individual and environmental predictors of cow injuries were analysed using multinomial logit models for ordinal outcomes. The overall frequencies of injuries were 10.4% for joint lesions, 12.8% for soft-tissue injuries and 3.6% for claw lesions. Most joint injuries (84.9%) were observed at the hock joint, 9.4% at the carpus and 3.1% at the knee joint. The analysis of the association between frequency of injuries and potential predictors revealed heterogeneous results and the risk profiles were different between the categories of injuries measured in the study. These observations support the assumption that variations in type and severity of injuries are due to specific differences of animal management, housing design and due to different characteristics of individual cows.     

Functional urethral obstruction in 3 dogs: clinical and urethral pressure profile findings

Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed.     

Static hydraulic urethral sphincter for treatment of urethral sphincter mechanism incompetence in 11 dogs

Objective : To review the postoperative results and complications associated with urethral sphincter mechanism incompetence managed with a static hydraulic urethral sphincter. Methods : Case records and a telephone owner questionnaire were retrospectively used to assess postoperative urinary continence scores (1 – dripping constantly to 10 – completely dry) and presence and frequency of complications. Results : Eleven spayed females were included. Median continence score/10 (range) awarded preoperatively was 3 (2 to 6), and scores at two weeks, three and six months were 8 (4 to 10), 9 (4 to 10) and 8 (4 to 10), respectively. At the last survey, the median continence score of 9 (5 to 10) was significantly better (P=0·004) than before surgery. Complete continence was achieved in 36·4% of dogs. The median (range) follow‐up time was 412 (118 to 749) days. Complications occurred in 9 of 11 dogs and included dysuria (n=7), bacterial cystitis (n=7), longer urination time (n=8), urinary retention (n=3), haematuria (n=1), pain (n=3) and incisional seroma (n=3). Clinical Significance : Static hydraulic urethral sphincter was frequently associated with minor complications but no major complications (i.e. those requiring further surgery). Continence scores were significantly improved compared with those before surgery, with the possibility of further improvement following inflation of the sphincter.     

Managing parasiticide resistance

Resistance to antiparasitic drugs is all too common in parasites of veterinary interest. The fact that resistance has arisen in so many different species of parasite and hosts against so many different drugs and in so many geographic areas suggests that the resistances may have common features. Such features may be useful in generating ideas for resistance management. Although describing the nature and presence of resistance remains an important objective, there is now a pressing need to develop improved methods of detection of resistance and to devise schemes for integrated parasite management (IPM). Multidisciplinary teams of researchers and extension workers are exploring new ways to deal with the problem of resistance.