Lam Nathaniel K, Berent Allyson C, Weisse Chick W, Bryan Christine, Mackin Andrew J, Bagley Demetrius H
Department of Surgery, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.
J Am Vet Med Assoc. 2012 Apr 15;240(8):983-90. doi: 10.2460/javma.240.8.983.
A 5-year-old 8.6-kg (18.9-lb) spayed female Pug was evaluated because of chronic hematuria and recurrent urinary tract infections.
Excretory urography, ultrasonography, and excretory CT urography were performed. Results indicated that the dog had bilateral hydronephrosis and hydroureter and suspected proximal ureteral stenosis. Retrograde ureteropyelography confirmed the presence of stenosis at the ureteropelvic junction of each ureter, along with a large amount of endoluminal ureteral debris. Clinical findings suggested that the dog had a congenital bilateral anomaly of the upper urinary tract.
The dog was anesthetized, and 2 double-pigtail ureteral stents were placed cystoscopically with fluoroscopic guidance for immediate relief of the ureteropelvic junction obstructions. Each stent extended from the left or right renal pelvis to the urinary bladder. The procedures and the patient's recovery from anesthesia were uncomplicated. Continuing improvements in severity of hydronephrosis, hydroureter, and dysuria were evident during routine follow-up examinations at 2, 4, 12, 16, and 45 weeks after stent placement. Over the subsequent 12 months, all clinical signs remained resolved other than a urinary tract infection that was successfully treated with antimicrobials.
Ureteral stenosis should be considered as a differential diagnosis for hydronephrosis in dogs, particularly when urinary tract calculi or neoplasia is not present. Chronic hematuria and recurrent urinary tract infections can be associated with this condition. Placement of ureteral stents may be a successful treatment option for ameliorization of congenital ureteral obstructions.
一只5岁、体重8.6千克（18.9磅）的已绝育雌性哈巴狗因慢性血尿和反复尿路感染接受评估。
进行了排泄性尿路造影、超声检查和排泄性CT尿路造影。结果显示该犬存在双侧肾盂积水和输尿管积水，并怀疑有近端输尿管狭窄。逆行输尿管肾盂造影证实每条输尿管的肾盂输尿管连接处存在狭窄，同时伴有大量输尿管腔内碎屑。临床检查结果提示该犬存在先天性双侧上尿路异常。
对该犬实施麻醉，在荧光透视引导下经膀胱镜置入2根双猪尾输尿管支架，以立即缓解肾盂输尿管连接处梗阻。每根支架从左或右肾盂延伸至膀胱。手术过程及犬从麻醉中恢复均顺利。在置入支架后第2、4、12、16和45周的常规随访检查中，肾盂积水、输尿管积水和排尿困难的严重程度持续改善。在随后的12个月里，除了一次用抗菌药物成功治疗的尿路感染外，所有临床症状均消失。
输尿管狭窄应被视为犬肾盂积水的鉴别诊断之一，尤其是在不存在尿路结石或肿瘤的情况下。慢性血尿和反复尿路感染可能与这种情况有关。置入输尿管支架可能是改善先天性输尿管梗阻的一种成功治疗选择。
