Cystourethropexy to Correct Refractory Urinary Incontinence Due to Urethral Sphincter Mechanism Incompetence Preliminary Results in Ten Bitches

Cystourethropexy was performed in 10 bitches with refractory urinary incontinence due to urethral sphincter mechanism incompetence. All animals had an abnormally shaped vesico-urethral junction. The bladder neck was located in the pelvic canal in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two cases and markedly improved incontinence in two cases. Surgery combined with medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using a sustained-action preparation) restored urinary continence in four cases and markedly improved continence in one case. Surgery, with medical therapy, was completely ineffective in one case. No major complications were encountered in any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall and neck revealed the presence of a single, perinuclear, clear vacuole in the cytoplasm of smooth muscle fibers. Electron microscopic examination showed that the vacuoles represented a dilatation of normal membrane organelles. Such abnormalities have the potential to alter the smooth muscle motility. This study indicates that cystourethropexy alone restored urinary continence only temporarily in the majority of the patients. The significance and frequency of the histopathologic findings requires further investigation.     

Clinical and Pathologic Effects of a Modified Technique for Application of Spiral Prostheses to the Cervical Trachea of Dogs

A modified surgical technique for application of extraluminal polypropylene spiral prostheses (PSP) to the trachea was developed. A portion of the segmental blood supply to the collapsed segment of trachea was maintained by fenestrating rather than completely dissecting the right lateral pedicle. Polypropylene spiral prostheses were applied to the cervical trachea of 12 dogs (group I) via the modified technique and to 12 dogs (group II) with the identical surgical dissection but without PSP applied. Clinical abnormalities included mild coughing in group I dogs and swelling of the incisions in both groups. Limited necrosis and moderate degeneration and inflammation were observed histologically in both groups. Pathologic changes were worse in the caudal cervical segment of the trachea. Mucosal regeneration was present on day 10 in both groups. Transmural tracheal necrosis was not observed. The modified technique for application of PSP is recommended by the authors because it provides adequate surgical exposure and the blood supply preserved by segmentally dissecting the right lateral pedicle is adequate to maintain tracheal viability.     

Surgical Stabilization of the Equine Cervical Spine

The Cloward technique for intervertebral fusion was utilized on 12 horses ranging from 3 months to 2 years of age. Of the 12 horses, 9 had been diagnosed as having equine cervical vertebral malformation (CVM) or "wobbles," and 3 were normal controls. A large hole was drilled from the ventral border of the vertebral bodies spanning the intervertebral disc and the vertebral end plates of the 2 articulating vertebrae. Frozen homologous bone dowels of slightly larger diameter from equine cadaver ilia were inserted in the holes. No adverse postoperative complication arose. Clinical improvement was seen in all horses with CVM. Three months postoperatively, partial or complete fusion was evident radiographically in 11 of the 12 horses. Necropsies were performed 3–6 months postoperatively to evaluate the quality of the fusion. Cadaver manipulation demonstrated reduced intervertebral movement at the operative site in all cases. The articulations of the equine cervical spine can be operatively fused by the Cloward technique, and surgically induced trauma is minimal. This technique can be used for stabilizing subluxations and may be applicable for treating fractures and osteolytic processes that have weakened vertebrae.