Chick Weisse

Objectives: The prevalence of tracheal collapse syndrome (CTCS) and congenital portosystemic shunts (CPSS) in Yorkshire Terriers is poorly characterized. It is conceivable that CPSS could affect the likelihood of CTCS development if the observed prevalence rate of both conditions is lower than the expected prevalence rate based on multiplication of the individual prevalence rates of each condition. Animals: Yorkshire Terriers diagnosed with CTCS, CPSS, or both at the Animal Medical Center (AMC). Methods: In this cross-sectional, single-institution study, medical records of Yorkshire Terriers were reviewed for patient date of birth, sex, weight, date of last visit, and reported diagnoses of CTCS, CPSS, or both. Medical records were reviewed to confirm the diagnosis of CTCS or CPSS. Observed and expected age-specific prevalence rates were compared within defined age groups. Results: A total of 11 061 Yorkshire Terriers were identified, with 7263 having data for age at last visit available. The observed prevalence of CPSS was 0.8% (93 dogs), severe CTCS was 6.7% (739 dogs), and both conditions were 0.05% (6 dogs). The median age at diagnosis was 2.7 years (interquartile range [IQR], 1.0-5.7) for CPSS and 10.0 years (IQR, 8.0-13.0) for CTCS. The observed age-specific prevalence rate of both conditions (joint) in each age group was similar to the expected joint prevalence rates in each age group. Conclusions: Further investigation is needed to confirm whether there is a link between CPSS and the development of CTCS in Yorkshire Terriers. Investigation into genetic and physiologic interactions is warranted.

Objective: To assess clinical presentation, treatment, and outcomes of dogs with two or three congenital extrahepatic portosystemic shunts (M‐EHPSS). Study design: Multi‐institutional retrospective study. Sample population: A total of 15 dogs with M‐EHPSS. Methods: Medical records were reviewed, and data was collected on dogs with M‐EHPSS diagnosed via computed tomography (CT) between 2008 and 2024. Signalment, clinical signs, bloodwork values, postoperative complications, long‐term clinical outcome, survival, and owner reported quality of life were recorded. Results: Approximately half of the dogs (7/15; 47%) were Miniature Schnauzers. Clinical signs and hematologic indicators at presentation were comparable to EHPSS. The mean dog age at diagnosis via CT imaging was 1451 days, and all dogs underwent surgical attenuation (SA) except for one that was ultimately lost to follow up examination. A total of 12 dogs had two shunts, and three dogs had three shunts. Seven dogs did not undergo attenuation of one shunt; these other shunts were either not initially suspected (5/7), the attenuation device was misplaced (1/7) or surgeon preference to not place attenuation device (1/7). Left gastro‐phrenic EHPSS were the only EHPSS not suspected initially. At the time of last follow‐up (median: 1253 days), 10/15 dogs were alive. Clinical outcomes were good or excellent in most dogs (12/14; 86%). Conclusion: These findings suggest that M‐EHPSS dogs have a similar prognosis to dogs with standard EHPSS dogs when all EHPSS are identified and treated with appropriate attenuation placement. A potential breed predisposition towards Miniature Schnauzers was identified. Clinical significance: This information provides guidance for treatment and prognosis of dogs with M‐EHPSS.

Background: There are limited studies on cystoscopic-guided laser ablation for treating ectopic ureters in male dogs. Further investigation is needed to assess its safety and efficacy. Hypothesis/Objective: Retrospectively describe long-term outcomes in male dogs treated using cystoscopic-guided laser ablation of ectopic ureters (CLA-EU). Animals: Eighteen client-owned male dogs. Methods: Medical records of male dogs that had CLA-EU performed were retrospectively reviewed. Continence scores were assigned before and after the procedure. Data collected included signalment, neuter status, age of onset of urinary incontinence, pre- and post-operative continence scores, CBC, serum biochemistry, urinalysis, microbiological urine culture, pre- and post-operative abdominal imaging, EU laterality, concurrent anatomic anomalies, laser type and size used, procedure time, complications, and follow-up. Results: The procedure was performed successfully in all 28 ureters in the 18 dogs. Post-operative continence scores were significantly improved from pre-operative scores (p = 0.001). Four (22%) dogs were continent at the time of diagnosis. Of the 14 dogs initially incontinent, 11/14 (79%) became continent after CLA-EU without additional treatments, and an additional dog became continent with the addition of medications. Preoperatively, 14/28 kidneys and 17/28 ureters had evidence of hydronephrosis and hydroureter, respectively. Of the dogs, 10/14 with hydronephrosis and 12/17 with hydroureter showed improvement on post-operative ultrasonography. The median follow-up time was 1789 days (range, 98–3560). Conclusion and Clinical Importance: In male dogs, CLA-EU was a safe, effective, and minimally invasive procedure with good to excellent short- and long-term outcomes, achieving continence in most dogs and improvement or stabilization of associated hydronephrosis and hydroureter.

We describe the successful treatment of biliary duct obstruction (BDO) secondary to biliary carcinoma involving the bile duct, cystic duct, and intrahepatic ducts in two adult domestic shorthair cats using a novel technique. Both cats presented with marked hyperbilirubinemia, increased liver enzyme activities, and ultrasonographic evidence of BDO secondary to neoplasia. One cat previously had undergone cholecystoduodenostomy, with recurrence of BDO. Both cats were treated using a transhepatic biliary rendezvous procedure, in which a hybrid interventional radiological approach was used to place a self-expanding metallic stent into the left intrahepatic duct, into the common bile or cystic duct, and into the duodenum, relieving the obstruction. In both cases, BDO resolved at time of last follow-up. This technique offers an alternative to traditional surgical or interventional options for biliary decompression, particularly in cases of diffuse malignant biliary obstruction where access to the common bile duct (CBD) is challenging.

Introduction: Some massive or nodular liver tumors can make surgical resection dangerous. Transarterial embolization and chemoembolization recently have been evaluated in dogs and cats, but multinodular or diffuse tumors make selective embolization difficult, impractical, and may require multiple anesthetic events. Hepatic dearterialization in humans has been shown to be safe and sometimes successful in promoting temporary tumor regression. Materials and Methods: Retrospective review of patients with nodular, diffuse, or non-resectable massive liver tumors that underwent transarterial coil embolization of the hepatic artery from the origin of the gastroduodenal artery to the proximal hepatic artery was performed. Data recorded included patient signalment, clinical signs, serum biochemical changes, cross-sectional imaging results, complications, and response to treatment. Results: Seven patients (five dogs and two cats) underwent transarterial hepatic dearterialization and were included. All patients had increased pretreatment hepatocellular enzyme activities 24 h after surgery. All patients survived to discharge and five were discharged within 24 h after treatment. Two patients experienced mild short-term vomiting and anorexia, one of which required repeat hospitalization. Repeat laboratory testing approximately 6 weeks after treatment indicated decreased ALT and AST activities in 5/6 and 4/5 patients, respectively. Repeat imaging identified tumor regression in 3/4 patients evaluated by computed tomography (CT). Survival time ranged from 50 to 505 days. Conclusion: Hepatic dearterialization should be further investigated as a palliative management option for multinodular and diffuse liver tumors because it may provide a minimally invasive, safe, and palliative option based on the observation that all patients survived to discharge and tumor regression was noted in three animals.

Background: The use of subcutaneous ureteral bypass device(s) (SUB) for the treatment of benign ureteral obstructions (BUO) in cats has become more routine in veterinary practices. Device mineralization and chronic urinary tract infections (UTI) are the most reported long-term complications. Hypothesis/Objective: To evaluate the occurrence of mineralization, bacteriuria, and chronic infections in cats after SUB placement, where 2% tetrasodium ethylenediaminetetraacetic acid (tEDTA) was infused during standard SUB flushing when compared to a historical control group where sterile saline was used for flushing. The hypothesis is that tEDTA will decrease the rate of mineralization occlusions and infections of SUB devices without increasing other complications. Animals: Ninety-five SUBs (39 unilateral; 28 bilateral) in 66 cats. Methods: Retrospective study; Medical records from all cats that had > 180-day follow-up after undergoing SUB device placement were evaluated. Group 1 consisted of cats flushed routinely with saline only, Group 2 with saline and then switched to 2% tEDTA during their follow-up period, and Group 3 with 2% tEDTA only. Results: Device mineralization was documented in 9/28 (32%), 8/16 (50%), and 10/51 (19%) SUB devices in Groups 1, 2, and 3, respectively (p = 0.025). Exchange was needed from re-obstruction in 4/28 (14%), 5/16 (31%) and 3/51 (6%), respectively (p = 0.016). Chronic UTI occurred in 7/21 (33%), 4/12 (33%), and 1/33 (3%) of cats, respectively (p = 0.004). UTI at the time of surgery was associated with the development of a chronic UTI (p = 0.01). Conclusions/Clinical Importance: Prophylactic use of 2% tEDTA might be helpful in reducing frequency of long-term SUB device complications and could be considered as part of the long term management plan.

Background: Functional outflow tract obstruction (FOO) remains a challenging disease to manage in male dogs. Cystostomy tubes have been used to relieve urethral obstruction while allowing time to achieve effective medical management, avoiding the need for emergency visits and repeat urinary catheterizations. Objectives: To describe a series of dogs with FOO and categorize the most successful management strategies including medical management alone or with the support of cystostomy tubes for urinary diversion. Animals: Twelve client-owned dogs with FOO were included. Methods: Medical records of dogs presented from August 2012 to September 2021 with a presumptive diagnosis of FOO were retrospectively reviewed and findings recorded. Results: Seven dogs were managed with a cystostomy tube and 5/7 (71%) had a good-excellent outcome. Five dogs were managed without a tube and 1/5 (20%) had a good outcome. Eight dogs were refractory to medical management; 5 managed with a cystostomy tube and 3/5 (60%) had a good-excellent outcome; 3 managed without a cystostomy tube and 0/3 had a good or excellent outcome. Overall, dogs with cystostomy tubes had better outcomes but also had mild, moderate, and severe complications (100%, 71%, and 71%, respectively) reported. Conclusions and Clinical Importance: Most dogs that received a percutaneous cystostomy tube as part of their management plan had a good to excellent outcome, particularly when compared to those that did not, despite the high rate of tube-related complications. Percutaneous cystostomy tubes could be considered early during management for FOO to improve overall outcomes.

Background: Minimally invasive approaches are the standard for treatment of upper urinary tract uroliths in humans. Objective: To describe the medical dissolution of upper urinary tract uroliths in a series of dogs and report clinical outcomes. Animals: 6 female dogs (9 kidneys). Methods: Retrospective case series. A review of medical records in dogs that underwent medical dissolution of upper urinary tract uroliths utilizing diet, administration of antibiotics, and double-pigtail ureteral stent(s) placement, when indicated, was performed. Medical management was generally continued for 4 weeks beyond urolith dissolution. Information on biochemical, microbiological, imaging, and clinical outcomes before and after dissolution were recorded. Results: Six dogs (9 kidneys) were included with bilateral (3) or unilateral (3) nephrolithiasis, ureterolithiasis, or a combination. A ureteral stent(s) was placed endoscopically in 5/6 dogs (6/9 kidneys) for obstructive ureterolithiasis (n = 5) or a nonobstructive massive nephrolith (n = 1). All dogs had a positive urine culture of Staphylococcus pseudintermedius with a median urine pH of 7.25 (range, 6.5-8) and 4/5 had pyonephrosis. All dogs had initial evidence of urolith dissolution at a median of 1.1 months (range, 0.42-5.9), with complete dissolution of ureteroliths at a median of 3.9 months (range, 1.5-7.6), nephroliths at 5.3 months (range, 1.5-7.6), and lower urinary tract uroliths at 0.87 months (range, 0.42-5.9). Stents were removed in 3/6 once dissolution was documented. The median follow-up time was 519 days (range, 177-2492 days). Conclusion and Clinical Importance: Medical dissolution and decompression of upper urinary tract struvite uroliths should be considered a minimally invasive treatment for dogs before more invasive options.

Canine congenital extrahepatic portosystemic shunt (EHPSS) morphologies have not been fully elucidated. The goal of this retrospective, multi‐institutional study was to use CT angiography to create an anatomical‐based nomenclature system for canine congenital EHPSS. These shunt morphologies were then evaluated to identify any significant association with patient age, sex, breed, weight, or subjective portal perfusion score. Data collected respectively from the SVSTS and VIRIES list‐serves included patient DOB, sex, breed, weight, CT date, and reported diagnosis. A single author (C.W.) viewed all CT scans and classified shunts based on the shunt portal vessel(s) of origin, the shunt systemic vessel(s) of insertion, and any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between one (poor/none) and five (good/normal) based on the caliber of the intrahepatic portal veins. A total of 1182 CT scans were submitted from 13 different institutions. Due to exclusion criteria, 100 (8.5%) were removed, leaving 1082 CT scans to be included. Forty‐five different EHPSS anatomies were identified with five classifications accounting for 85% of all shunts (left gastric‐phrenic [27%], left gastric‐azygos [19%], left gastric‐caval [15%], aberrant left gastric‐caval with right gastric vein [12%], and aberrant left gastric‐caval with right gastric vein and short gastric vein [11%]). Shunt origin involved the left gastric vein in 95% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of the CT scan (P < .001), sex (P = .009), breed (P < .001), weight (P < .001), and subjective portal perfusion score (P < .001). An anatomical classification system for canine EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for these patients.

The prevalence of anatomical‐based subtypes of feline congenital extrahepatic portosystemic shunts (EHPSS) has not been completely elucidated. The goal of this study was to use CT angiography to create an anatomical‐based nomenclature system for feline congenital EHPSS. Additionally, subjective portal perfusion scores were generated to determine if intrinsic portal vein development was associated with different shunt conformations or patient age at the time of CT. The SVSTS and VIRIES list services were used to recruit cases. Data collected included patient DOB, gender, breed, weight, CT date, and reported diagnosis. Shunts were classified based upon (1) the shunt portal vessel(s) of origin, (2) the shunt systemic vessel(s) of insertion, and (3) any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between 1 (poor/none) and 5 (good/normal) based on the caliber of the intrahepatic PVs. A total of 264 CT scans were submitted from 29 institutions. Due to exclusion criteria, 33 (13%) were removed, leaving 231 CT scans to be included. Twenty‐five different EHPSS anatomies were identified with five classifications accounting for 78% of all shunts (LGP [53%], LGC‐post [11%], LCG [7%], LGC‐pre [4%], and PC [4%]). Shunt origin involved the left gastric vein in 75% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of CT scan (P = .002), breed (P < .001), and subjective portal perfusion score (P < .001). This refined anatomical classification system for feline EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for cats with these anomalies.