News at AHSC

Welcome to the new AHSC website!

By: Geoff Heffner, DVM, DACVECC on Friday November 5, 2010

We've spent the past several months upgrading the format and content so as to better service the veterinary community. We hope you find this information useful to your family during times of health and illness. Stay tuned as we post additional updates, current events and educational articles. There will also be specific sections for our employees and referring veterinarians with access to commonly used forms, brochures and continuing education seminars.

Ureteral Stent Placement

By: Geoff Heffner, DVM, DACVECC on Monday November, 2010



PATIENT HISTORY

An 8-yr-old M/N Standard Poodle, presented to the Animal Hospital Specialty Center with a two week history of persistent positioning following urination. The urine stream was easily initiated and did not have any change in flow quality. He was minimally pollakiuric and did not have any hematuria but had periodic episodes of tenesmus.

PHYSICAL EXAM & INITIAL DIAGNOSTIC DATABASE

Physical exam findings noted a palpable, full urinary bladder and slight dorsal midabdominal discomfort thought to originate from the kidneys. His prostate was mildly enlarged, non-painful but slightly irregular along the cranial pole. There was no sublumbar lymphadenopathy appreciated. CBC was unremarkable but serum chemistry analysis showed mild azotemia (BUN 44 mg/dL, creatinine 2.9 mg/dL). Thoracic radiographs showed normal cardiovascular structures and pulmonary parenchyma. There was no evidence of metastatic disease present.

ABDOMINAL ULTRASOUND FINDINGS

A focal mass measuring 1.2 x 0.56 cm was identified within the apex of the bladder. The most severe bladder changes were located within the trigone region where the wall measured 1cm thick although there was diffuse infiltrative involvement. There was significant hydronephrosis noted bilaterally. The right kidney was more severely affected than the left (figure 1) causing diffuse thinning of the renal cortex (0.36cm). Each ureter was severely dilated (0.67cm) as they were visualized extending from the renal pelvises. Although extremely tortuous, the ureters could be easily traced as they passed caudally within the retroperitoneal space to the level of the bladder (figure 2). The left ureter contained a 0.2m, non-shadowing mass within its lumen (figure 4). The ureter was severely dilated before and after this mass providing supportive evidence that the obstruction was occurring at the level of the trigone instead of the ureteral mass. The prostate was enlarged (2 x 3 cm) with an irregular/nodular surface and areas of inhomogeneity. Shadowing mineralization was appreciated within the prostatic parenchyma...



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