Browsing by Author "Bolton, Timothy"

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    A case of congenital ureteral atresia causing rare upper and lower urinary tract manifestations in a puppy: a case report
    Zalek, Megan; Shah, Rohan; Bolton, Timothy (2021-02-09)
    Background Ureteral atresia is the congenital absence of a ureteral opening, resulting in a blind-ended ureter that fails to terminate at the urinary bladder. Consequently, severe hydroureter and hydronephrosis occur ipsilateral to the atresic ureter. However, hydronephrosis contralateral to severe hydroureter, although reported in humans, is not documented in the dog. Additionally, ureteral atresia has not been reported as a cause for lower urinary tract signs directly related to extramural urinary bladder compression. This report aims to describe these unique manifestations of this congenital urinary tract disease, as well as follow-up findings after successful treatment. Case presentation A 4-month-old male Husky puppy was evaluated for pollakiuria, stranguria, and urine dribbling of 1-month duration. During the physical examination, a mass was palpated in the mid-abdomen. Diagnostic imaging and cystoscopy findings were diagnostic for right-sided ureteral atresia with secondary hydroureter and hydronephrosis. The severe right hydroureter caused lower urinary tract signs and contralateral hydronephrosis secondary to regional compression of the left distal ureter and urinary bladder. A right-sided ureteronephrectomy was performed, resolving the stranguria and pollakiuria. Significant reduction in the contralateral (left) hydronephrosis also occurred. Clinical Relevance Ureteral atresia should be considered as a differential diagnosis for lower urinary tract signs and/or bilateral hydronephrosis in a young dog. Reporting this case expands our knowledge of congenital lower urinary tract disease and the etiology of their manifestations in dogs. Surgical resolution of the congenital ureteral abnormality can result in preservation of renal function in the contralaterally obstructed kidney.
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    Effects of hyperlipidemia on gallbladder motility in dogs
    Villm, Jessica Ann (Virginia Tech, 2021-07-16)
    Background: The pathogenesis of gallbladder mucocele is unknown in the dog. It has been proposed that hyperlipidemia could impair gallbladder motility and contribute to gallbladder mucocele formation. Objectives: The objective of this study was to compare gallbladder motility in dogs with hyperlipidemia to healthy, control dogs using ultrasonography. We hypothesized that hyperlipidemic dogs have decreased gallbladder motility, defined by increased fasting gallbladder volume (GBV) and decreased gallbladder ejection fractions at 60 (EF60) and 120 minutes (EF120) compared to controls. Animals: 26 hyperlipidemic dogs, 28 healthy control dogs Methods: Twenty-six hyperlipidemic and 28 healthy, age-matched control dogs were prospectively enrolled. Hyperlipidemia was defined as hypercholesterolemia (>332 mg/dL) and/or hypertriglyceridemia (>143 mg/dL). Dogs with both primary and secondary causes of hyperlipidemia were included. All dogs were fasted for at least 12 hours prior to collection of plasma biochemistry and pre-prandial ultrasound. Ultrasound was performed on dogs in the fasted state as well as at 60 and 120 minutes after being fed 10g/kg of a high fat diet (Hill's a/d diet; Hill's Pet Nutrition, Topeka, Kansas, USA). GBVs and EFs were calculated using the following formulas: GBV = (0.52 x L x W x H)/kg and EF = ((GBV0- GBV60,120)/GBV0) x 100, respectively. GBV0, GBV60, GBV120, EF60 and EF120 were compared between dogs with hyperlipidemia and controls using the Wilcoxon rank sum test. Statistical significance was set to p<0.05. Results: Hypercholesterolemia and hypertriglyceridemia were present in 15/26 (58%) and 21/26 (81%) hyperlipidemic dogs, respectively and 10/26 (38%) had elevations in both parameters. The median age in both groups was 10 years. Median (range) cholesterol concentration was 346 mg/dL (181-1372 mg/dL) and 238 mg/dL (153-324) in hyperlipidemic and control dogs, respectively. Median triglyceride concentration was 330 mg/dL (52-2213) and 65.5 mg/dL (32-142) in hyperlipidemic and control dogs, respectively. Eleven (42%) hyperlipidemic dogs were considered severely hyperlipidemic based on the triglyceride and/or cholesterol concentrations above 500 mg/dL. There were significant differences in GBV0 and GBV60 between hyperlipidemic and control dogs. Dogs with severe hyperlipidemia had significantly larger GBVs at all time points. Dogs with hypercholesterolemia also had significantly greater GBVs at all times compared to dogs without hypercholesterolemia. Median EF60 and EF120 were not significantly different between hyperlipidemic and control dogs nor severely hyperlipidemic and mildly hyperlipidemic dogs. Conclusions: Hyperlipidemic dogs have significantly greater fasting and postprandial GBVs but similar ejection fractions when compared to control dogs. Gallbladder emptying is unaltered in hyperlipidemic dogs, but gallbladder volume is higher in hyperlipidemic dogs after feeding. This distention could contribute to bile retention of bile and potentially gallbladder disease.
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    Escherichia coli-associated granulomatous colitis in a cat
    Safian, Alexander M.; Bolton, Timothy (Wiley, 2021)
    A 6-year-old male castrated domestic shorthair cat was evaluated for a 6-month history of haematochezia, mucoid diarrhoea, tenesmus and rectal prolapse. Colonic histopathology revealed multifocal mucosal ulceration and lamina propria infiltration with large numbers of periodic acid-Schiff-positivemacrophages. Large clusters of intracellular Escherichia coli were confirmed with fluorescence in situ hybridization testing, similar to that seen in dogs with granulomatous colitis. An 8-week course of marbofloxacin resulted in resolution of clinical signs; however, recurrence occurred 4 weeks later. A 12-week course of marbofloxacin resulted in disease remission for which the cat still remains free of clinical signs (15 months). Escherichia coli-associated granulomatous colitis, although reported with rarity in this species, is an important infectious cause of chronic large intestinal disease in the cat.
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    Evaluation of a Feline-Optimized TSH Assay in Cats With Hyperthyroidism and With Non-Thyroidal Illness
    Brassard, Camille (Virginia Tech, 2024-08-13)
    About 10% of hyperthyroid cats have a normal total T4 (TT4), requiring further testing to make the diagnosis. Thyroid stimulating hormone (TSH) is measured using the "canine" assay (TSH-CLIA, Immulite 2000 by Siemens) as the only assay currently available. However, this assay cannot differentiate between subnormal and low-normal TSH concentrations in cats due to poor specificity (70-85%). A novel feline-optimized TSH assay (TSH-BAW, Truforma by Zomedica) was recently developed. It allows differentiation between euthyroid and hyperthyroid cats. However, the effect of non-thyroidal illness (NTI) on TSH-BAW has not been evaluated. Our objectives included the comparison of serum TSH concentration using both the TSH-CLIA and TSH-BAW assays among hyperthyroid cats, cats with NTI, and healthy cats, and the evaluation of the sensitivity and specificity of the TSH-BAW for diagnosis of FHT. This prospective cross-sectional study was performed on 102 client-owned cats, including 37 hyperthyroid, 33 healthy, and 32 NTI cats. The following thyroid hormones were measured in all cats: TT4, TSH with both assays (Immulite 2000 and Truforma). Hyperthyroidism was confirmed by thyroid scintigraphy. Euthyroidism was confirmed by repeating TT4 measurement at least three months after enrollment (if available) to rule out subclinical hyperthyroidism. Cats with NTI were further divided based on the severity of their illness. Serum TSH was compared among groups using Kruskal-Wallis followed by Dunn's procedure, and compared among NTI severity scores using the Fisher's Exact test. Significance was set at P <0.05. The sensitivity and specificity of TSH-BAW for detecting hyperthyroidism are 78% (62-90%) and 97% (84-100%), respectively. The median TSH is significantly different between hyperthyroid cats and healthy and NTI cats with both assays (P<0.01). The TSH was not different between the latter euthyroid groups (P=0.87 and P=0.29). Eight (21.6%) hyperthyroid cats have a normal TSH-BAW but undetectable TSH-CLIA. Twelve (4 healthy, 8 NTI) euthyroid cats (18.5%) have an undetectable TSH-CLIA with only two (1 healthy, 1 NTI) (3%) having an undetectable TSH-BAW. The proportion of cats with a suppressed TSH is higher with severe illnesses with the TSH-CLIA only. In conclusion, the TSH-BAW has a high specificity, identifies normal TSH in healthy cats more often, and appears to not be affected by NTI. It can be a useful tool for the diagnosis of feline hyperthyroidism. However, a low-normal TSH cannot be used to rule out hyperthyroidism.
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    Minimally Invasive, Integrated Endoscopic Hemilaminectomy for Hansen Type I Intervertebral Disc Extrusion in Chondrodystrophic Dogs
    Drury, Adam Gardner (Virginia Tech, 2021-05-24)
    The objective of this prospective pilot study is to assess the feasibility of a minimally invasive, integrated endoscopic hemilaminectomy in chondrodystrophic dogs with clinically relevant Hansen type 1 intervertebral disc extrusion (IVDE). Study subjects included five client-owned chondrodystrophic dogs under 15kg with an acute, single site IVDE between T10 and L5 of less than 90 days duration and no loss of deep pain perception. The extent of the extrusion could not exceed 2/3 the diameter of the cannula to be used as defined by magnetic resonance imaging (MRI). A postoperative MRI was performed to assess remaining spinal cord compression. If significant compression remained, patients returned to surgery for a standard, open hemilaminectomy. Only the first dog required conversion to an open approach which resulted in adequate decompression. The same dog had a significant surgical complication of iatrogenic damage to the spinal cord during the minimally invasive approach. The other 4 dogs had no complications and achieved adequate spinal cord decompression. Three dogs eventually returned to normal neurologic status and another was improved compared to presentation. One dog was euthanized for reasons unrelated to IVDE. The authors conclude that a minimally invasive, integrated endoscopic hemilaminectomy is a feasible approach and can allow for adequate decompression of the spinal cord secondary to acute, single-site extrusion. Endoscopic approaches have a steep learning curve and extra care is required in the learning phase to avoid complications. Further studies are warranted to compare the safety and efficacy of this technique to a standard approach.
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    Vasovagal reaction secondary to bladder overdistension in a dog undergoing a unique timeline of medical and surgical treatment for Corynebacterium urealyticum encrusting cystitis: a case report
    Peiffer, Ryan F.; Iulo, Carly; LeCuyer, Tessa; Bolton, Timothy (2021-09-28)
    Background Corynebacterium urealyticum urinary tract infections can result in a rarely reported condition called encrusting cystitis whereby plaque lesions form on and within the urinary bladder mucosa. Chronic lower urinary tract signs manifest subsequent to the infection-induced cystitis and plaque-induced decreased bladder wall distensibility. Because of the organism’s multidrug resistance and plaque forming capability, infection eradication can be difficult. While systemic antimicrobial therapy is the mainstay of treatment, adjunctive surgical debridement of plaques has been used with relative paucity in such cases, thereby limiting our understanding of this modality’s indications and success rate. Consequently, this report describes the successful eradication of Corynebacterium urealyticum encrusting cystitis utilizing a unique timeline of medical and surgical treatments. Additionally, this represents the first reported veterinary case of a vasovagal reaction due to bladder overdistension. Case presentation A 6-year-old female spayed Miniature Schnauzer was evaluated for lower urinary tract clinical signs and diagnosed with Corynebacterium urealyticum encrusting cystitis. The infection was persistent despite prolonged courses of numerous oral antimicrobials and urinary acidification. A unique treatment timeline of intravenous vancomycin, intravesical gentamicin, and mid-course surgical debridement ultimately resulted in infection resolution. During surgery, while the urinary bladder was copiously flushed and distended with saline, the dog experienced an acute vasovagal reaction from which it fully recovered. Conclusions Surgical debridement of bladder wall plaques should be considered a viable adjunctive therapy for Corynebacterium urealyticum encrusting cystitis cases failing to respond to systemic antibiotic therapy. The timing in which surgery was employed in this case, relative to concurrent treatment modalities, may be applicable in future cases of this disease as dictated on a case-by-case basis. If surgery is ultimately pursued, overdistension of the urinary bladder should be avoided, or at least minimized as much as possible, so as to prevent the possibility of a vasovagal reaction.