Culler Christine A, Fick Meghan, Vigani Alessio
College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
J Vet Emerg Crit Care (San Antonio). 2019 May;29(3):331-336. doi: 10.1111/vec.12832. Epub 2019 Apr 17.
Circumstances such as the inability to pass a retrograde urinary catheter or a lack of surgeon availability may prevent immediate relief of urethral obstruction in dogs. In such situations, a cystostomy tube may be placed with ultrasound guidance to allow urinary diversion until further treatment is possible.
A case of a 5-year-old male neutered Swiss Mountain dog with an obstructive urolith at the level of the os penis is used to describe the technique. Multiple attempts to pass a urinary catheter under sedation were unsuccessful. A pigtail cystostomy tube was placed with ultrasound guidance to allow urinary diversion. The dog was discharged from the hospital within 2 days after scrotal urethrostomy and the dog made a full recovery. Ultrasound-guided placement of a pigtail cystostomy tube was straightforward and without complications.
Ultrasound-guided placement of a pigtail cystostomy tube may be beneficial as it is not technically challenging, can be performed rapidly, and may avoid the need for general anesthesia. Additionally, ultrasound is readily available and an inexperienced ultrasonographer can easily locate the urinary bladder. This report serves to provide a detailed technique of ultrasound-guided placement of a pigtail cystostomy tube in dogs for emergency urinary diversion.
诸如无法插入逆行导尿管或外科医生无法到场等情况,可能会阻碍犬只尿道梗阻的立即缓解。在这种情况下,可在超声引导下放置膀胱造瘘管以实现尿液改道,直至能够进行进一步治疗。
以一例5岁去势雄性瑞士山地犬为例,该犬阴茎骨水平处存在阻塞性尿路结石,以此描述该技术。在镇静状态下多次尝试插入导尿管均未成功。在超声引导下放置了猪尾状膀胱造瘘管以实现尿液改道。该犬在阴囊尿道造口术后2天内出院,且完全康复。超声引导下放置猪尾状膀胱造瘘管操作简单,无并发症。
超声引导下放置猪尾状膀胱造瘘管可能有益,因为它在技术上没有挑战性,操作迅速,且可能避免全身麻醉的需要。此外,超声设备容易获得, inexperienced ultrasonographer(此处原文有误,推测可能是“inexperienced ultrasonographer”,意为“经验不足的超声检查人员”)也能轻松找到膀胱。本报告旨在提供犬只超声引导下放置猪尾状膀胱造瘘管以进行紧急尿液改道的详细技术。