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使用球囊扩张金属支架缓解猫的恶性尿道梗阻。

Use of a balloon-expandable metallic stent to relieve malignant urethral obstruction in a cat.

作者信息

Newman Rebecca G, Mehler Stephen J, Kitchell Barbara E, Beal Matthew W

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.

出版信息

J Am Vet Med Assoc. 2009 Jan 15;234(2):236-9. doi: 10.2460/javma.234.2.236.

Abstract

CASE DESCRIPTION

A 19-year-old neutered male domestic shorthair cat was evaluated because of signs of urinary tract obstruction.

CLINICAL FINDINGS

Physical examination findings were consistent with urethral obstruction, and a mass could be palpated in the region of the bladder neck. Abdominal ultrasonography and thoracic radiography revealed a mass in the trigone of the urinary bladder and a solitary mass in the left caudal lung lobe. Cytologic examination of the urine sediment, samples obtained by means of traumatic urethral catheterization, and fine-needle aspirates of the bladder mass did not result in a diagnosis.

TREATMENT AND OUTCOME

A balloon-expandable metallic stent was placed in the proximal portion of the urethra to relieve the malignant obstruction. After stent placement, the cat had signs of urinary incontinence and detrusor atony, both of which resolved with medical treatment. The cat was euthanized 1 month after stent placement because of progressive azotemia. Histologic examination of necropsy samples revealed grade III urothelial carcinoma and papillary pulmonary adenocarcinoma.

CLINICAL RELEVANCE

Findings suggested that stent placement may be a viable palliative treatment in cats with malignant urinary obstruction.

摘要

病例描述

一只19岁已绝育的雄性家养短毛猫因出现尿路梗阻症状而接受评估。

临床发现

体格检查结果与尿道梗阻相符,在膀胱颈区域可触及一个肿块。腹部超声检查和胸部X线摄影显示膀胱三角区有一个肿块,左肺尾叶有一个孤立性肿块。对尿沉渣、通过创伤性尿道插管获取的样本以及膀胱肿块的细针穿刺抽吸物进行细胞学检查均未得出诊断结果。

治疗及结果

在尿道近端置入一个球囊可扩张金属支架以缓解恶性梗阻。置入支架后,这只猫出现尿失禁和逼尿肌无张力的症状,经药物治疗后均得到缓解。置入支架1个月后,这只猫因进行性氮质血症而实施安乐死。尸检样本的组织学检查显示为III级尿路上皮癌和乳头状肺腺癌。

临床意义

研究结果表明,对于患有恶性尿路梗阻的猫,置入支架可能是一种可行的姑息治疗方法。

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