Coccygeal epidural with local anesthetic for catheterization and pain management in the treatment of feline urethral obstruction

Objective – To describe the technique for performing a coccygeal epidural injection of local anesthetic to facilitate catheterization in male cats with urethral obstructions using low‐dose sedation. Significance – Prompt diagnosis and relief of urethral obstructions is important as many cats may have developed marked metabolic abnormalities at the time of presentation. General anesthesia in these patients may be associated with significant risk for complications. Pain management is also an essential treatment goal, and this technique relieves urethral and penile pain during the unblocking process. Conclusion – Coccygeal epidurals can be used safely to provide analgesia to the penis and urethra and to the authors' knowledge, is a novel treatment modality to aid in the relief of urethral obstructions in male cats.     

Semen collection by urethral catheterization and electro-ejaculation with different voltages,and the effect of holding temperature and cooling rate before cryopreservation on semen quality in the Japanese macaque (Macaca fuscata)

In the Japanese macaque, semen has been collected by electro-ejaculation (EE), using the higher voltage stimuli compared to other species including genus Macaca. Semen coagulates immediately after ejaculation, which makes difficult to produce high-quality semen for artificial insemination. Recently, semen collection using urethral catheterization (UC) has been reported in carnivore and this technique may allow semen collection without coagulation in a less invasive manner. Further, the temporal preservation temperature and cooling rate of semen during cryopreservation affect post thawing sperm quality. In this study, to improve semen quality and quantity, as well as the animal welfare, semen collection was performed by EE with high (5–15 V) or low (3–6 V) voltage, UC and a combination of the two (EE-UC). It has been suggested that a high voltage is necessary for semen collection, but 10 V stimulation was effective enough and 15 V is for additional sperm collection. Also, liquid semen was collected by EE-UC and this could increase the total number of sperm. Further, to improve the post thawing sperm motility, semen was kept at four temperatures (4, 15, 25 and 37°C) for 60 min, and processed with two cooling procedures (slow cooling before second dilution and fast cooling after second dilution). Holding semen at 25°C and fast cooling after the second dilution maintained progressive motile sperm rate. The present results will contribute to the improvement of semen collection and animal welfare of Japanese macaques.     

Retrograde CT urethrography using a power injector quantitatively reveals effects of bladder distension on urethral size in healthy male Beagle dogs

Quantitative analysis of the normal retrograde urethrogram is well reported in radiography, but studies on CT urethrography are lacking. Recently, a method of retrograde CT urethrography using a power injector was described. The purpose of the current, prospective, analytical study was to quantify the urethral size of five, healthy, intact, male Beagle dogs using retrograde CT urethrography and a power injector. With the injection rate of the power injector set at 0.3 mL/s, 1 mL/kg of diluted contrast medium (15 mg I/mL) was injected, and a CT examination was performed. The state of the initial urethrogram taken was defined as “empty bladder.” The same procedures were repeated with the injection of an additional 1 mL/kg of diluted contrast medium until the ureteral reflux was seen (distended bladder). There was a significant difference in volumes between the empty and distended bladder, but the membranous urethra showed the least difference (P = .0044) among the three regions (P < .0001 for the prostatic and penile urethra). Urethral diameters at six sites were measured from sagittal images, and the sites of measurements were adopted from the earlier radiographic studies. The most significant difference in the urethral diameters between the empty and distended bladder occurred at the cranial and middle prostatic urethra (P < .0001). The results of this study can be useful for interpreting the results of retrograde CT urethrography. Care must be taken when narrowing is suspected at the prostatic urethra, and if necessary, further distension of the urinary bladder should be tried.     

Bronchogenic adenocarcinoma in a cat: an unusual case of metastasis to the skin

A 6-year-old, spayed, female, domestic shorthair cat was presented for decreased activity. A nodular lesion was found in the skin extending into the subcutaneous tissue of the right abdominal flank. On lateral and ventrodorsal radiographs of the thorax, an opacity involving the entire right caudal lung lobe and pleural effusion were noted. Cytologic evaluation of cells in the thoracic fluid and in the mass revealed a population of atypical epipthelial cells with marked anisocytosis and high N:C ratios, organized in acinar-like clusters. Multinucleated cells and several mitotic figures were found. The cytologic interpretation was carcinoma. Because of the progressive severity of clinical signs, the cat was euthanized. Histologic evaluation of tissues obtained at necropsy indicated a bronchogenic adenocarcinoma in the lung, with metastasis to the skin of the right flank, but no involvement of the digits. Based on immunohistochemical stains, the neoplastic cells strongly co-expressed cytokeratin and vimentin, and were negative for S-100 and actin-specific antigen. Bronchogenic adenocarcinoma is an uncommon neoplasm in cats, and the digits are the most common sites of metastasis. This case was unusual in that the skin of the abdominal wall was the primary site of metastasis, with no involvement of the digits.     

Chronic spinal epidural abscess in a cat: a case report with an unusual imaging finding

A 1-year-old domestic shorthair cat was evaluated for a chronic history of back pain, dysuria, and paraplegia. Radiographic and computed tomographic examinations showed circumferential widening of the vertebral canal at T13 and T14. A spinal epidural abscess (SEA) compressing the spinal cord from the level of T11 to L1 was suspected following intravenous contrast administration, and was confirmed by surgical exploration and histopathological analysis. The cat recovered its motor and bladder functions following surgical decompression and antibiotic therapy. SEA is a neurological emergency requiring prompt treatment. However, the present case had a prolonged disease course and pressure atrophy of the vertebrae was strongly suspected. To our knowledge, this imaging finding has not been reported in dogs or cats with SEA.     

Laser treatment of urethral defects in geldings and stallions used as the primary treatment or in combination with a temporary subischial incision: Eight cases (2003–2011)

Two geldings with haematuria and 6 stallions with haemospermia presented for evaluation between 2003 and 2011 to the Iowa State University Lloyd Veterinary Medical Center. Both geldings presented for haemorrhage at the end of urination. All stallions presented for evaluation of infertility following natural service or artificial insemination that was related to haemospermia. Urethroscopy identified a urethral defect in all 8 horses. Both geldings possessed a urethral rent. One stallion possessed a urethral varicosity while the remaining 5 possessed a urethral rent. Two geldings and 2 stallions received only laser treatment. The remaining 4 stallions received concurrent laser treatment with a temporary subischial incision (TSI) into the corpus spongiosum penis. All 6 stallions received 8 weeks of sexual rest after the completion of the surgical/laser treatment. Laser treatment alone was successful in resolving haematuria in one of 2 geldings. In the stallion group, all 4 horses with a urethral rent receiving laser treatment concurrent with a TSI resolved haemospermia. Of the remaining stallions, one with a urethral varicosity resolved clinical signs with only laser treatment and one stallion with a urethral rent received only laser treatment and haemospermia recurred. We conclude that laser treatment of a urethral rent in geldings can result in resolution of haematuria. Laser treatment used in combination with a TSI may result in improved success when compared to surgery alone. Laser treatment alone can result in resolution of a urethral varicosity.     

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.     

Neodymium:yttrium-aluminum-garnet laser ablation of a urethral web to relieve urinary outflow obstruction in a horse.

An 8-year-old Hanoverian gelding was examined because of urine dribbling and urethral obstruction. Mild proprioceptive deficits of the left hind limb were evident during neurologic examination. Ultrasonography per rectum revealed dilatation of the pelvic portion of the urethra. Endoscopy of the urethra revealed 2 webs of tissue: 1 was located 10 cm proximal to the external urethral opening; the other was located 65 cm proximal to the external urethral opening and prevented passage of the endoscope into the urinary bladder. The mass was ablated with a neodymium:yttrium-aluminum-garnet laser, using a transendoscopic noncontact technique. On follow-up examination 6 months after laser surgery, an endoscope could easily be passed into the bladder, and no urethral web was seen. The horse was able to void a stream of urine but continued to dribble urine intermittently. The proximal location of the urethral lesion in this horse would have made use of traditional surgical methods problematic, whereas transendoscopic laser photoablation was easy and effective.