Presumptive migrating gall bladder mucocoele in two dogs with gall bladder rupture

A 10‐year‐old neutered female soft‐coated wheaten terrier and a 10‐year‐old, entire female Pomeranian were presented for vomiting and anorexia. Using ultrasound, an oval structure with a stellate, kiwifruit‐like appearance typical of a gall bladder mucocoele was observed in the caudal abdomen of the soft‐coated wheaten terrier and adjacent to the liver in the Pomeranian. There was also a moderate volume of abdominal effusion in both dogs. Cytology of the peritoneal fluid indicated a sterile exudative process but varied between the two dogs, with an absence of bile pigment in the soft‐coated wheaten terrier and marked bile peritonitis in the Pomeranian. An entire free‐floating ectopic mucocoele was confirmed via exploratory laparotomy with concomitant gall bladder rupture and common bile duct obstruction. Both dogs recovered completely after surgery. This is the first report of cases of gall bladder rupture with entire free‐floating gall bladder mucocoeles in dogs.     

Computed tomographic retrograde positive contrast cystography and computed tomographic excretory urography characterization of a urinary bladder diverticulum in a dog

A one‐year‐old intact male German shepherd dog was referred with a 3‐month history of dysuria and pollakiuria. Physical examination revealed a large firm mass in the caudal abdomen. Findings from survey radiography, negative contrast cystography, computed tomographic (CT) retrograde positive contrast cystography, and CT excretory urography were consistent with a large urinary bladder diverticulum. An exploratory laparotomy revealed a normal wall appearance in the ventral compartment (true bladder) and marked thinning of the wall in the dorsal compartment (diverticulum). Both ureters inserted into the ventral compartment. The dorsal compartment was excised and histopathology confirmed the diagnosis of urinary bladder diverticulum.     

Resection of a ceruminous adenocarcinoma in a horse by a modified vertical ear canal ablation

A 13‐year‐old Swedish Warmblood mare was presented for evaluation of a mass on the medial aspect of the left vertical ear canal. The mass was initially resected using monopolar loop diathermy. Histopathological diagnosis of the excisional biopsy was a low‐grade malignant ceruminous adenocarcinoma. The clinical and histopathological features of this previously unreported neoplasm in the horse are described. A modified vertical ear canal ablation was performed in order to remove the base of the neoplasm with adequate free margins. The surgical technique is described. No recurrence was noted 2 years after surgery and the appearance and function of the pinna were retained.     

IMAGING DIAGNOSIS—BILATERAL ORTHOTOPIC URETEROCELES IN A DOG

A 5‐year‐old neutered male Akita had a 5‐month history of hematuria. Bilateral orthotopic ureteroceles were diagnosed using a combination of sonography, computed tomography (CT), and radiography. With CT excretory urography, the ureteroceles appeared as two intraluminal cystic structures in the vesicoureteral region of the urinary bladder, which directly communicated with dilated ureters. Unlike the other imaging modalities CT excretory urography provided a definitive diagnosis by confirming the communication between the hydroureters and the cystic dilations in the caudodorsal aspect of the urinary bladder.     

Transitional cell carcinoma of the urinary bladder in a 12‐year‐old Belgian Warmblood gelding

A 12‐year‐old Belgian Warmblood gelding was examined for haematuria and dysuria of 24 h duration. Cystoscopy revealed an intraluminal multinodular soft tissue mass originating from the dorsal bladder neck. Histopathological examination of biopsies identified transitional cell carcinoma. The bladder mass was surgically debulked via a temporary perineal urethrotomy. The horse commenced treatment with oral piroxicam. Follow‐up examination 18 months post operatively revealed no evidence of tumour recurrence. Neoplasia of the equine bladder is uncommon and this case describes the successful short‐term outcome of treatment of a transitional cell carcinoma by surgical debulking and oral piroxicam.     

Gall bladder rupture associated with cholecystitis in a domestic ferret (Mustela putorius)

A six‐year‐old neutered female albino ferret was presented with an acute episode of lethargy and anorexia. Clinical examination revealed marked cranial abdominal pain. A severe neutrophilic leukocytosis was present. Abdominal ultrasound was consistent with a diffuse peritonitis and severe bile duct inflammation. Cytology of the abdominal effusion revealed bile peritonitis. An exploratory laparotomy was performed and the gall bladder appeared inflamed with multiple perforations. A cholecystectomy was performed. The ferret recovered without complication. Bacteriological culture of the bile and gall bladder yielded a pure growth of Pseudomonas aeruginosa. Histopathological analysis of the gall bladder and liver was consistent with a marked cholecystitis and cholangiohepatitis. On the basis of sensitivity testing, the ferret was treated with marbofloxacin for one month. No complications or reoccurrence were seen up to 1 year after the diagnosis. To the author's knowledge, this is the first report of bile peritonitis secondary to gall bladder rupture in a ferret.     

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.     

Laparoscopic Cystotomy for Removal of a Large Bladder Polyp in a Juvenile Alpaca with Polypoid Cystitis

Objective: To describe a method for laparoscopic cystotomy in an alpaca. Study Design: Case report. Animals: Female alpaca. Methods: An 8‐month‐old female alpaca was admitted with a 6‐week history of straining to urinate and vulvar swelling. Transrectal ultrasound examination revealed a 1.5 × 1.5 × 2 cm polyp within the bladder. Results: The mass was excised using laparoscopic cystotomy. Leakage from the cystotomy site resolved over 12 days using a Foley catheter. The alpaca was healthy and urinating normally at 9 months after surgery. Conclusion: Minimally invasive surgery by laparoscopic cystotomy can be used to remove large urinary polyps in alpacas. Clinical Relevance: Urinary bladder polyps should be considered as differential diagnosis in alpacas with stranguria.     

Partial mandibular condylectomy and temporal bone resection for chronic,destructive, septic arthritis of the temporomandibular joint in a horse

Sepsis of the temporomandibular joint (TMJ) of the horse is rare. This case report describes the use of radiography, ultrasonography and computed tomography to diagnose sepsis of the TMJ in a 2‐year‐old Thoroughbred filly. The mandibular condyle and temporal bone were partially resected to successfully remove necrotic tissue within and surrounding the TMJ. Sepsis resolved and the horse returned to race training. Follow‐up computed tomography examination showed generation of a mandibular ‘pseudocondyle’ at 8 months post operatively.     

Ultrasonography of a ureteral and bladder fungal granuloma caused by Scedosporium apiospermum in a basset hound

A 5‐year‐old, spayed female, Basset Hound was referred for evaluation of a urinary bladder mass. Ultrasonographic images revealed a large, inhomogeneous, hypoechoic mass associated with the dorsal wall of the neck of the urinary bladder and left ureter. Partial cystectomy and left ureteral reimplantation were performed. Histopathology showed a severe inflammatory mass lesion forming multiple granulomas. A DNA sequencing test revealed Scedosporium apiospermum as the causative agent. Susceptibility tests on the isolated strain indicated susceptibility to voriconazole. To the authors’ knowledge, this is the first report describing S. apiospermum as a cause of granulomas involving the canine ureterovesicular junction.     

Collateral ligament reconstruction in two horses following traumatic avulsion fracture using a knotless suture anchor construct

This case report describes a technique for repair of medial collateral ligament avulsions in two horses. Both horses sustained traumatic injuries resulting in avulsion fractures at the origin of their medial tarsal and carpal collateral ligaments. This report describes the use of a knotless suture anchor to mechanically reconstruct medial collateral ligament avulsion injuries in two horses. The first horse, a 9‐year‐old Hannovarian Warmblood gelding presented for an acute nonweightbearing lameness in the right hindlimb. The injury was localised to the medial malleolus of the tibia and an avulsion fracture of the origin of the short medial collateral ligament of the tibiotarsal joint with disruption of the ligament was found on radiographs and ultrasound. The horse was taken to surgery and a reconstruction of the short medial collateral ligament was performed with a modified single row construct using a biocompatible, multistrand, long chain ultra‐high molecular weight polyethylene braided composite suture tape (2 mm Fibertape) and a single knotless suture anchor (5.5 × 19.1 mm PEEK SwivelLock C). The second horse, a 5‐year‐old Thoroughbred gelding presented for an acute nonweightbearing lameness in the left forelimb. The injury was localised to the medial styloid process of the radius and an avulsion fracture of the origin of the medial collateral ligament of the antebrachial carpal joint was found on radiographs and ultrasound. The horse was taken to surgery and a similar reconstruction procedure was performed to the collateral ligament. Both horses were recovered in a Robert Jones bandage without the use of casts or splints and recovered without incident. Both horses are sound and returned to previous level of athletic performance at 18 months and 8 months, respectively.     

Ectopic Bone as a Nidus for Calcium Oxalate Urocystolithiasis in a Cat

A 7‐year‐old female spayed domestic shorthair cat was referred to the urology service for nonsurgical urocystolith removal. A urolith was attached to the urothelium by ectopic bone. Interventional removal without surgery was successful. Follow‐up evaluation 3 years after urolith removal revealed recurrent uroliths, bladder wall mineralization, and marked renal mineralization. This case illustrates the metaplastic potential of the urothelium and that ectopic bone should be included among the pathological factors that promote lithogenesis.     

Resection cystoplasty of a squamous cell carcinoma in a mare

A 22‐year‐old Arabian mare was examined for evaluation of haematuria of 2 months' duration. Complete blood cell count and chemistry revealed anaemia of chronic disease (i.e. normocytic, normochromic) and hypoproteinaemia. Cystoscopy revealed a haemorrhagic mass protruding into the lumen of the urinary bladder in the apical region. The mass was surgically removed by partial cystectomy performed through a caudal ventral midline laparotomy. Histological examination of the mass confirmed the diagnosis of squamous cell carcinoma. Tumours of the equine urinary bladder are rare, and when a partial cystectomy is indicated, a caudal ventral midline laparotomy may provide adequate surgical exposure even in adult horses.     

Partial ostectomy of the dens to correct atlantoaxial subluxation in a pony

Objective: To report a surgical technique that allows decompression and anatomic re‐alignment for management of subluxation of the atlantoaxial articulation. Study Design: Clinical report. Animals: Four‐year‐old Welsh Section B pony gelding. Methods: Attempts at closed reduction of subluxation of the atlantoaxial articulation under general anesthesia were unsuccessful, so a ventral surgical approach allowing partial ostectomy of the dens of the axis was used to facilitate reduction. Result: Recovery from surgery was uneventful and the pony remained comfortable without neurologic deficits. Both neck stiffness and ataxia resolved. Radiographic examination at 5 days and 6 months postoperatively showed normal anatomic position of the dens of the axis and stabilization of the atlantoaxial joint. Conclusion: Partial ostectomy of the dens using a ventral approach can be used to facilitate reduction of atlantoaxial subluxation.     

Type IV rectal prolapse secondary to a long‐standing urinary bladder lithiasis in a donkey

Rectal prolapse has been attributed to conditions generating tenesmus or increasing abdominal pressure in both horses and donkeys. This report presents the case of a 7‐year‐old gelded donkey that sustained a type IV rectal prolapse secondary to a long‐standing cystic calculus after several episodes of intermittent mucosal prolapse. Rectal prolapse was addressed first on an emergency basis by colorectostomy. After medical stabilisation, pain and straining management with repeated epidural drug administrations, a laparoscopic‐assisted cystotomy was performed one week later to remove the calculus. The donkey was discharged and resumed his normal life at pasture.     

Use of Electrohydraulic Lithotripsy in 28 Dogs with Bladder and Urethral Calculi

Background: Electrohydraulic lithotripsy (EHL) has been used as an alternative to cystotomy in human medicine to remove urinary calculi. This prospective study evaluated the efficacy and safety of EHL to remove urinary calculi in dogs. Hypothesis: EHL is an efficient and safe method of treatment of bladder and urethral calculi in dogs. Methods: Dogs presented between January 1, 2005 and June 1, 2007 with lower urinary tract calculi diagnosed by radiographs or ultrasound examination were included in the study. Physical examination, CBC, biochemistry, urinalysis, and urine culture were performed at presentation. EHL and voiding urohydropulsion were performed under general anesthesia. Patients received IV fluids for 12 hours after which they were rechecked by ultrasound examination and discharged with antibiotics and anti‐inflammatory drugs for 5 days. All patients were reevaluated 1, 3, and 6 months after presentation by physical examination, urinalysis, and ultrasonography. Results: Twenty‐eight dogs (19 males, 9 females) presented with bladder or urethral calculi or both underwent lithotripsy. Their median weight was 8.3 kg. Calcium oxalate calculi were present in 22 dogs, struvite in 4, and mixed calculi in 2. Fragmentation was done in the bladder (23 dogs) and in the urethra (12 dogs). Calculus‐free rate was higher for urethral than for bladder calculi in males and higher for bladder calculi in females than in males. No major complications were reported. Twelve dogs relapsed within 6 months. Conclusions: Results of this study support the use of EHL as a minimally invasive treatment for bladder calculi in females and for urethral calculi in male dogs.     

Iatrogenic fracture of the premaxilla during standing exodontia

This case report describes a 17‐year‐old horse that presented with a history of oral dysphagia secondary to buccal slab fractures and apical infection in two cheek teeth. During standing surgery to remove the diseased cheek teeth, the horse sustained a bilateral comminuted fracture of the premaxilla. An audible crack was followed by bilateral epistaxis. Subsequent radiography revealed minimal displacement at the fracture sites and the horse responded well to conservative management without the need for additional fixation techniques. One year later, the fracture appeared completely healed on repeat radiography. This is an uncommon complication of standing dental procedures necessitating the use of a speculum but is noteworthy and may be important to consider and inform owners in such aged cases.     

Diagnosis and treatment of biaxial keratomas in the left fore foot of a 15‐year‐old Clydesdale mare

A 15‐year‐old Clydesdale mare presented for further diagnostics and treatment of waxing and waning lameness and recurrent subsolar abscesses. Radiographs and computed tomography revealed biaxial masses extending from the hoof capsule, causing bone resorption of the distal phalanx. Surgery was performed to remove the masses and post operative care included regional limb perfusions, systemic antibiotics and therapeutic shoeing. Histopathology was consistent with the diagnosis of keratoma for each of the masses; this is the first case of confirmed biaxial keratomas. Two months after surgery the horse is sound at the walk and is expected to return to full function within the next year.     

Bilateral dentigerous cysts (heterotopic polyodontia) in a yearling Standardbred colt

This article describes the occurrence of bilateral dentigerous cysts in a 1‐year‐old entire male Standardbred horse. Computer tomography (CT) with a positive contrast CT fistulogram was used to accurately define the anatomy of the cysts preoperatively. Conventional surgical techniques were used to remove the cysts under general anaesthesia. The CT studies were able to precisely define the margins of the cysts and facilitated uncomplicated surgical excision. Follow‐up examination of the animal revealed excellent cosmesis at the surgical site. Histology was used to confirm the diagnosis of bilateral dentigerous cysts. Preoperative CT studies are invaluable to precisely define the anatomical locations of the dental anomalies associated with dentigerous cysts and thereby allow confident and uncomplicated excision. Dentigerous cysts may occur bilaterally in horses.     

Bilateral ovarian leiomyoma treated by standing laparoscopic ovariectomy

An 11‐year‐old Warmblood mare presented to a referral facility due to behavioural problems. A hormonal profile performed prior to referral included increased systemic concentrations of testosterone and progesterone but a low concentration of inhibin. Transrectal ultrasound revealed ovaries consistent with a normal cycling mare. At the request of the owner, standing bilateral laparoscopic ovariectomy was performed without complication. Both ovaries were submitted for histopathological examination which revealed bilateral ovarian leiomyoma.