Berent Allyson C, Weisse Chick W, Branter Erinne, Adams Larry G, Aarhus Alissa, Smee Nicole, Berg Rebecca, Bagley Demetrius H
Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.
J Am Vet Med Assoc. 2013 Jun 1;242(11):1556-63. doi: 10.2460/javma.242.11.1556.
To describe the use of sclerotherapy for the renal-sparing treatment of idiopathic renal hematuria (IRH) in dogs and report clinical outcomes.
Retrospective case series.
6 dogs (8 renal pelvises) with IRH.
Medical records of dogs that underwent sclerotherapy were reviewed. Each ureterovesicular junction was identified cystoscopically to determine the side of bleeding, and a retrograde ureteropyelogram was performed with endoscopic and fluoroscopic guidance. A ureteropelvic junction balloon was used for ureteral occlusion, and pelvis filling volumes were recorded. A povidone iodine mixture, followed by a sterile silver nitrate solution, was infused into the renal pelvis. A double-pigtail ureteral stent was placed after the procedure. Information on preprocedure and postprocedure biochemical changes, imaging parameters, and clinical outcomes was obtained.
6 dogs (5 males and 1 female) had sclerotherapy for unilateral (4) or bilateral (2) bleeding. Five were right-sided and 3 were left-sided. The median age and weight of dogs were 3 years and 42.4 kg (93.28 lb), respectively. Median procedure time was 150 minutes. One dog that did not have a ureteral stent placed following the procedure developed short-term signs of renal pain and pyelectasis. Cessation of macroscopic hematuria occurred in 4 of 6 dogs (median, 6 hours). Two additional dogs improved moderately. Median follow-up time was 8 months (range, 3.5 to 20.5 months).
Topical sclerotherapy for IRH was safe and effective. Local sclerotherapy for IRH in dogs could be considered a valuable and minimally invasive renal-sparing treatment over ureteronephrectomy.
描述硬化疗法在犬特发性肾血尿（IRH）保肾治疗中的应用并报告临床结果。
回顾性病例系列。
6只患有IRH的犬（8个肾盂）。
回顾接受硬化疗法的犬的病历。通过膀胱镜检查确定每个输尿管膀胱连接部以确定出血侧，并在内镜和荧光镜引导下进行逆行输尿管肾盂造影。使用输尿管肾盂连接部球囊进行输尿管闭塞，并记录肾盂充盈量。将聚维酮碘混合物，随后是无菌硝酸银溶液注入肾盂。术后放置双猪尾输尿管支架。获取术前和术后生化变化、影像参数及临床结果的信息。
6只犬（5只雄性和1只雌性）因单侧（4只）或双侧（2只）出血接受硬化疗法。5只为右侧，3只为左侧。犬的中位年龄和体重分别为3岁和42.4千克（93.28磅）。中位手术时间为150分钟。1只术后未放置输尿管支架的犬出现了短期肾痛和肾盂积水的体征。6只犬中有4只（中位时间，6小时）肉眼血尿停止。另外2只犬有中度改善。中位随访时间为8个月（范围，3.5至20.5个月）。
IRH的局部硬化疗法安全有效。犬IRH的局部硬化疗法可被认为是一种比输尿管肾切除术更有价值且微创的保肾治疗方法。
