RESUMO

The Prune-Belly (Eagle-Barrett) syndrome (PBS) is a congenital and genetically heterogeneous disease, more prevalent in males, defined by the clinical triad (1) deficiency of abdominal muscles, (2) bilateral cryptorchidism, and (3) urinary tract abnormalities. The abdomen of an infant with PBS has a typical appearance, similar to the aspect of a prune, which gives it its name. Although the etiology of this disorder is still unknown, numerous theories, mutations, and genetic disturbances have been proposed to explain the origin of PBS. Prognosis can differ a lot from one patient to another, since this condition has a wide spectrum of clinical presentation. Despite being a rare condition, the importance of PBS should not be underestimated, in the light of the potential of the disorder to lead to chronic kidney disease and other severe complications. In that regard, this review gathers the most up-to-date knowledge about the etiopathogenesis, clinical features, diagnosis, management and prognosis of PBS.

RESUMO

SUMMARY OBJECTIVE: We aimed to determine which method gives the most consistent results between urethral monopolar cauterization and standard urethral partial ligation methods for the urethral obstruction model. METHODS: Thirty male rats were randomly divided into control, partial ligation, and monopolar cauterization groups. Six weeks after experimental procedures, the experimental groups were evaluated cystometrically, biochemically, and histologically. RESULTS: According to the cystometric results, bladder capacity, baseline bladder pressure, and compliance data of the monopolar cauterization group were higher than those of the partial ligation and monopolar cauterization groups (p<0.05 and p<0.01, respectively). As a biochemical evaluation, malondialdehyde levels in bladder tissues of group control were higher than partial ligation and monopolar cauterization groups (p<0.05 and p<0.01, respectively). The collagen type I level of the control group was higher than the partial ligation and monopolar cauterization groups (p<0.01 and p<0.05, respectively). Collagen type III levels of the monopolar cauterization group were higher than those of the control group (p<0.01), but the Collagen type I/Collagen type III and transforming growth factor-β levels of the monopolar cauterization group were significantly lower than those of the control group (p<0.001). As a histological evaluation (hematoxylin and eosin), fibrosis in the lamina propria was more prominent in the monopolar cauterization group than in the control group (p<0.05). In addition, the muscular thickness was higher in the monopolar cauterization group compared with control and partial ligation groups (p<0.001 and p<0.01, respectively). CONCLUSION: The needle-tipped monopolar cauterization of the posterior urethra may be the method of choice for creating a chronic infravesical obstruction model of infravesical obstruction in male rats.

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Obstructive urolithiasis is common in farmed sheep and has a multifactorial etiology, but inadequate nutritional management is considered the most relevant condition for its occurrence. The objectives of this study were to verify the influence of two diets with different concentrations of calcium (Ca) and phosphorus (P) on the development of obstructive urolithiasis, and to describe the clinical and anatomopathological findings of the urinary system in sheep. Thirty male crossbred Santa Inês and Ile de France lambs were randomly distributed into two groups: Group 1 (G1, n = 15) - Ca: 1.9:1 P and 0.42% P; Group 2 (G2, n = 15) - Ca: P 1.5:1 and 0.65% P. The diets consisting of Coast-cross hay, soybean meal, wheat, and corn were provided for 90 consecutive days with water ad libitum. After the diagnosis of the disease, the lambs were subjected to clinical and surgical treatment, when necessary. Urolithiasis was detected in 36.7% (11/30) of lambs, 26.7% were asymptomatic and 10% (3/30) had urethral obstruction. A lamb was unobstructed after amputation of the urethral process and urethral catheterization, one died of bladder and uroperitoneum rupture, and another was sacrificed after the failure of perineal urethrostomy and cystostomy. The most frequent renal histopathological changes were vascular congestion, dilation, and tubular degeneration. Proteins in the tubular lumen were more pronounced in G2. The diets were rich in concentrate and had adequate Ca:P ratios, but caused calculogenesis, showing that excess minerals and a small amount of roughage can cause disease in the herd.

A urolitíase obstrutiva é frequente na ovinocultura e possui etiologia multifatorial, porém o manejo nutricional inadequado é considerado o mais relevante para sua ocorrência. Os objetivos deste estudo foram verificar a influência de duas dietas com diferentes proporções e concentrações de cálcio (Ca) e fósforo (P) no desenvolvimento da urolitíase obstrutiva, e descrever os achados clínicos e anatomopatológicos do sistema urinário de ovinos. Utilizaram-se 30 cordeiros, machos, mestiços das raças Santa Inês e Ile de France, que foram aleatoriamente distribuídos em dois grupos: Grupo 1 (G1, n=15) - Ca:P de 1,9:1 e 0,42% de P; Grupo 2 (G2, n=15) - Ca:P de 1,5:1 e 0,65% de P. As dietas foram fornecidas por 90 dias consecutivos com feno de Coast-cross, farelo de soja, trigo e milho, e água ad libitum. Após o diagnóstico da doença, os cordeiros foram submetidos ao tratamento clínico e cirúrgico, quando necessário. A urolitíase foi detectada em 36,7% (11/30) dos cordeiros, sendo 26,7% assintomáticos e 10% (3/30) apresentaram obstrução uretral. Um cordeiro foi desobstruído após amputação do processo uretral e sondagem uretral; outro foi a óbito por ruptura vesical e uroperitôneo; outro foi sacrificado após uretrostomia perineal e cistostomia sem sucesso. Em ambos os grupos, as alterações histopatológicas renais mais frequentes foram congestão vascular, dilatação e degeneração tubular. A presença de proteínas na luz tubular foi mais pronunciada no G2. As dietas fornecidas, ricas em concentrado, embora com relação Ca:P adequadas, provocaram a calculogênese, o que comprovou que o excesso de minerais e pouca quantidade de volumoso podem causar a enfermidade no rebanho.

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RESUMO

A urolitíase obstrutiva é frequente na ovinocultura e possui etiologia multifatorial, porém o manejo nutricional inadequado é considerado o mais relevante para sua ocorrência. Os objetivos deste estudo foram verificar a influência de duas dietas com diferentes proporções e concentrações de cálcio (Ca) e fósforo (P) no desenvolvimento da urolitíase obstrutiva, e descrever os achados clínicos e anatomopatológicos do sistema urinário de ovinos. Utilizaram-se 30 cordeiros, machos, mestiços das raças Santa Inês e Ile de France, que foram aleatoriamente distribuídos em dois grupos: Grupo 1 (G1, n=15) - Ca:P de 1,9:1 e 0,42% de P; Grupo 2 (G2, n=15) - Ca:P de 1,5:1 e 0,65% de P. As dietas foram fornecidas por 90 dias consecutivos com feno de Coast-cross, farelo de soja, trigo e milho, e água ad libitum. Após o diagnóstico da doença, os cordeiros foram submetidos ao tratamento clínico e cirúrgico, quando necessário. A urolitíase foi detectada em 36,7% (11/30) dos cordeiros, sendo 26,7% assintomáticos e 10% (3/30) apresentaram obstrução uretral. Um cordeiro foi desobstruído após amputação do processo uretral e sondagem uretral; outro foi a óbito por ruptura vesical e uroperitôneo; outro foi sacrificado após uretrostomia perineal e cistostomia sem sucesso. Em ambos os grupos, as alterações histopatológicas renais mais frequentes foram congestão vascular, dilatação e degeneração tubular. A presença de proteínas na luz tubular foi mais pronunciada no G2. As dietas fornecidas, ricas em concentrado, embora com relação Ca:P adequadas, provocaram a calculogênese, o que comprovou que o excesso de minerais e pouca quantidade de volumoso podem causar a enfermidade no rebanho.

Obstructive urolithiasis is common in farmed sheep and has a multifactorial etiology, but inadequate nutritional management is considered the most relevant condition for its occurrence. The objectives of this study were to verify the influence of two diets with different concentrations of calcium (Ca) and phosphorus (P) on the development of obstructive urolithiasis, and to describe the clinical and anatomopathological findings of the urinary system in sheep. Thirty male crossbred Santa Inês and Ile de France lambs were randomly distributed into two groups: Group 1 (G1, n = 15) - Ca: 1.9:1 P and 0.42% P; Group 2 (G2, n = 15) - Ca: P 1.5:1 and 0.65% P. The diets consisting of Coast-cross hay, soybean meal, wheat, and corn were provided for 90 consecutive days with water ad libitum. After the diagnosis of the disease, the lambs were subjected to clinical and surgical treatment, when necessary. Urolithiasis was detected in 36.7% (11/30) of lambs, 26.7% were asymptomatic and 10% (3/30) had urethral obstruction. A lamb was unobstructed after amputation of the urethral process and urethral catheterization, one died of bladder and uroperitoneum rupture, and another was sacrificed after the failure of perineal urethrostomy and cystostomy. The most frequent renal histopathological changes were vascular congestion, dilation, and tubular degeneration. Proteins in the tubular lumen were more pronounced in G2. The diets were rich in concentrate and had adequate Ca:P ratios, but caused calculogenesis, showing that excess minerals and a small amount of roughage can cause disease in the herd.

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RESUMO

Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...(AU)

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OBJECTIVE: To describe the clinical presentation and medical management of a cat with perinephric abscessation and urosepsis following urethral obstruction and catheterization. CASE SUMMARY: A 2-year-old intact male domestic shorthaired cat presented to an emergency and referral center for lethargy, vomiting, and hematuria. Severe azotemia and hyperkalemia were observed on a serum biochemistry panel. The patient was diagnosed with urethral obstruction and was treated with urethral catheterization, calcium gluconate, IV fluid therapy, buprenorphine, and prazosin. The patient's azotemia improved, and the hyperkalemia resolved. Urinary catheterization was discontinued. The patient developed pyrexia, worsening azotemia, hypoalbuminemia, hyperbilirubinemia, and dysuria. Urethral catheterization was repeated. Abdominal radiographs showed left renomegaly, and abdominal ultrasound revealed left perinephric fluid. Ultrasound-guided centesis of the perinephric fluid revealed septic inflammation, and the sample was consistent with urine based upon sample creatinine. Fluid from the perinephric abscess and urine from the bladder both grew Pasturella spp. The patient was treated with perinephric catheterization, saline lavage, and a continuous infusion of cefotaxime for 72 h. The patient's azotemia quickly resolved, and the patient was discharged after 6 days of hospitalization. The patient was reported to have made a full recovery. NEW OR UNIQUE INFORMATION PROVIDED: This is the first described case of perinephric abscess and urosepsis following urethral obstruction in a cat and its successful medical management. Perinephric abscess not associated with intrarenal abscess has not previously been identified. Additionally, continuous antimicrobial infusion to treat overwhelming infection and the use of the RapidBac Vet immunoassay for point-of-care detection of urinary tract infection has not been described in cats.

Assuntos

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Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...

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RESUMO

A cistite idiopática felina é uma doença inflamatória estéril crônica que não esta limitada somente as anormalidades relacionadas à bexiga e uretra. Sua fisiopatogenia ainda não está totalmente esclarecida e é a causa de base mais comum em gatos com Doença do Trato Urinário Inferior dos Felinos (DTUIF). Pode ser desencadeada por situações estressantes, divididas em: comportamento social, como disputa territorial, estado físico, como imunossupressão e ambiental, como alterações na rotina e ambiente do gato. É necessária uma ótima comunicação ao tutor sobre a necessidade de medidas de manejo a longo prazo, para auxiliar no bem-estar do paciente, uso de analgésicos, enriquecimento ambiental e em alguns casos pode ser necessário o uso outros fármacos para amenizar os quadros agudos ou crônicos. A Modificação Ambiental Multimodal (MEMO) por ser uma abordagem multifatorial, é a mais indicada pois melhora a qualidade de vida e bem-estar do gato, e deve ser utilizada antes da administração de fármacos. Juntamente a esta terapia, indica-se a introdução de dieta úmida com o objetivo de aumentar a ingestão hídrica, e consequentemente aumentar a diluição da urina. Medicamentos devem ser administrados somente quando todas as outras terapias não obtiveram uma resposta positiva. Esta revisão bibliográfica tem como objetivo descrever as terapias que podem ser utilizados na cistite idiopática felina.

Feline idiopathic cystitis (FIC) is a chronic inflammatory disease that is not limited only to abnormalities related to the bladder and urethra. Its pathophysiology is still not fully understood and is the most common cause in cats with feline lower urinary tract disease (FLUTD). It can be triggered by stressful situations, divided into: social behavior, such as territorial dispute, physical state, such as immunosuppression and environmental, such as changes in the cat’s routine and environment. Adequate communication to the tutor is needed on the need for long-term management measures to assist patient well-being, use of analgesics, environmental enrichment, and in some cases it may be necessary to use other drugs to ameliorate acute or chronic diseases. The Multimodal Environmental Modification (MEMO), because it is a multifactorial approach, is the most indicated because it improves the quality of life and well-being of the cat, and should be used before the administration of drugs. Along with this therapy, the introduction of wet diet is indicated with the aim of increasing water intake, and consequently increasing the dilution of urine. Medications should be given only when all other therapies have not received a positive response. This literature review aims to describe the therapies that can be used in feline idiopathic cystitis.

Assuntos

RESUMO

A cistite idiopática felina é uma doença inflamatória estéril crônica que não esta limitada somente as anormalidades relacionadas à bexiga e uretra. Sua fisiopatogenia ainda não está totalmente esclarecida e é a causa de base mais comum em gatos com Doença do Trato Urinário Inferior dos Felinos (DTUIF). Pode ser desencadeada por situações estressantes, divididas em: comportamento social, como disputa territorial, estado físico, como imunossupressão e ambiental, como alterações na rotina e ambiente do gato. É necessária uma ótima comunicação ao tutor sobre a necessidade de medidas de manejo a longo prazo, para auxiliar no bem-estar do paciente, uso de analgésicos, enriquecimento ambiental e em alguns casos pode ser necessário o uso outros fármacos para amenizar os quadros agudos ou crônicos. A Modificação Ambiental Multimodal (MEMO) por ser uma abordagem multifatorial, é a mais indicada pois melhora a qualidade de vida e bem-estar do gato, e deve ser utilizada antes da administração de fármacos. Juntamente a esta terapia, indica-se a introdução de dieta úmida com o objetivo de aumentar a ingestão hídrica, e consequentemente aumentar a diluição da urina. Medicamentos devem ser administrados somente quando todas as outras terapias não obtiveram uma resposta positiva. Esta revisão bibliográfica tem como objetivo descrever as terapias que podem ser utilizados na cistite idiopática felina.(AU)

Feline idiopathic cystitis (FIC) is a chronic inflammatory disease that is not limited only to abnormalities related to the bladder and urethra. Its pathophysiology is still not fully understood and is the most common cause in cats with feline lower urinary tract disease (FLUTD). It can be triggered by stressful situations, divided into: social behavior, such as territorial dispute, physical state, such as immunosuppression and environmental, such as changes in the cats routine and environment. Adequate communication to the tutor is needed on the need for long-term management measures to assist patient well-being, use of analgesics, environmental enrichment, and in some cases it may be necessary to use other drugs to ameliorate acute or chronic diseases. The Multimodal Environmental Modification (MEMO), because it is a multifactorial approach, is the most indicated because it improves the quality of life and well-being of the cat, and should be used before the administration of drugs. Along with this therapy, the introduction of wet diet is indicated with the aim of increasing water intake, and consequently increasing the dilution of urine. Medications should be given only when all other therapies have not received a positive response. This literature review aims to describe the therapies that can be used in feline idiopathic cystitis.(AU)

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A obstrução uretral em felinos é uma etiologia comum e rotineira para clínicos e cirurgiões. A afecção pode ocorrer por vários motivos, mas de maneira geral, leva a sérios distúrbios renais e hidroeletrolí-ticos, que quando não revertidos rapidamente causarão o óbito do paciente. Este trabalho traz uma opção de abordagem de pacientes felinos com obstrução da uretra, bem como opções para tratamento emergencial e desobstrução.

Urethral obstruction in felines is a common and routine etiology for clinicians and surgeons. The condition can occur for several reasons, but in general leads to serious renal and hydroelectrolytic disorders, that when not quickly reversed caused the death of the patient. This article brings an option to approach these feline patients with urethral obstruction, as well as options for emergency treatment and urethral clearance.

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