Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
BMC Vet Res. 2024 Nov 6;20(1):507. doi: 10.1186/s12917-024-04363-7.
Urethral obstruction is a common and life-threatening condition in male small ruminants.
This case report describes a 3-year old 103 kg Zwartbles breeding ram, presented with the complaint of straining, suspected to have an urethral obstruction. The work-up included clinical examination, laboratory analyses, ultrasound imaging, (contrast) radiography and urine examination. At presentation, blood analysis revealed a respiratory alkalosis, hyperkalaemia and mild azotaemia. On transabdominal ultrasound an enlarged bladder (diameter 11 cm) and free fluid surrounding the right kidney were observed. Treatment of the animal included tube cystostomy, intravenous perfusion, antimicrobial treatment, ammonium chloride and NSAIDs. No indications for urolithiasis were found on ultrasound, radiography, or urine examination. As no improvement was seen despite 16 days of therapy, a contrast radiograph of the urinary tract, as well as reproductive exam were conducted. Positive anterograde urethrogram showed a contrast filled cavitary lesion at the caudal aspect of the pelvic urethra. The reproductive ultrasonography revealed the same large urethral distention or abscess compressing the pelvic urethra, as well as severe testicular degeneration in both testis. The results of the contrast radiograph and the reproductive exam lead to the decision to euthanize the animal, as the animal would not be capable of breeding. Computed tomography was performed post-mortem, which showed close relation between the cavitary lesion and the left bulbourethral gland. Pathology revealed a lymphoplasmacytic to suppurative infection at the level of the urogenital tract, chronic interstitial nephritis and a perirenal to cortical abscess of the right kidney as well as a periurethral abscess. As for the reproductive system, multifocal interstitial inflammatory infiltrates were seen on the entire system. Marked fibrosis and atrophy was seen at the level of the testes and both epididymides.
A periurethral abscess should be included in the differential diagnosis for an urethral obstruction in small ruminants. The extensive medical imaging, together with the ante-mortem and post-mortem findings, makes this a good reference case for diagnosticians confronted with urethral problems in a ram.
尿道阻塞是雄性小反刍动物的一种常见且危及生命的疾病。
本病例报告描述了一只 3 岁、103 公斤重的 Zwartbles 种公羊，因出现努责症状而被怀疑患有尿道阻塞。检查包括临床检查、实验室分析、超声成像、（对比）射线照相和尿液检查。在就诊时，血液分析显示呼吸性碱中毒、高钾血症和轻度氮血症。经腹部超声检查发现膀胱增大（直径 11 厘米），右肾周围有游离液体。对该动物的治疗包括导尿管膀胱造口术、静脉灌注、抗菌治疗、氯化铵和 NSAIDs。超声、射线照相或尿液检查均未发现尿路结石的迹象。尽管经过 16 天的治疗后仍未见改善，因此进行了尿道造影和生殖器官检查。阳性逆行尿道造影显示骨盆尿道尾部有一个充满对比剂的腔隙性病变。生殖超声显示相同的尿道扩张或脓肿压迫骨盆尿道，同时双侧睾丸严重退化。对比射线照相和生殖器官检查的结果导致决定对该动物实施安乐死，因为它将无法繁殖。死后进行了计算机断层扫描，结果显示该腔隙性病变与左侧球海绵体腺密切相关。病理学显示泌尿生殖道的淋巴浆细胞至化脓性感染、慢性间质性肾炎以及右肾的肾周至皮质脓肿和尿道周围脓肿。就生殖系统而言，整个系统都可见多发性间质炎症浸润。睾丸和两个附睾均可见明显的纤维化和萎缩。
尿道阻塞的鉴别诊断中应包括尿道周围脓肿。广泛的医学影像学检查，加上生前和死后的发现，为诊断师处理公羊尿道问题提供了一个很好的参考案例。
