Category Archives: Case Study

Bladder stones

SAMSUNG CAMERA PICTURESJasper is a 7 year old, neutered male, orange and white cat that has been urinating bloody urine frequently for a couple months.

 

 

 

 

He had a urinalysis and x-rays taken and calcium oxalate crystals were found, along with 2 stones in his bladder.  Here is the initial x-ray taken of his bladder.
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At the time of his bladder stone diagnosis, he was found to have a heart murmur.  An echocardiogram was performed and Jasper was diagnosed with an elongated mitral valve, causing some outflow obstruction (which makes the blood flow turbulent, leading to the murmur).  He was started on 2 heart medications and cleared for surgery.

His surgery (a cystotomy) went very well.  SAMSUNG CAMERA PICTURESThere was concerned for a very inflamed bladder, due to the expected spikiness of the stones and how long they had been in his bladder, but everything looked very healthy.SAMSUNG CAMERA PICTURES

 

 

 

SAMSUNG CAMERA PICTURESThis is the bladder, exteriorized through the incision.

 

 

A small, sterile “spoon” is inserted into the bladder through an incision, and the stones removed.

 

 

 

The bladder is sutured closed and tested to make sure it doesn’t leak.

 

 

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These were the two, spiky stones found in the bladder.

 

 

An x-ray was taken post-op to make sure no stones were missed.  He then had his teeth cleaned and he woke up well.  A few hours after surgery he had already urinated in his litter box!

 

Hip dysplasia

Jack is a 6 month old Boston Terrier belonging to Natasha, our practice manager/receptionist/tech assistant at the time.  Natasha adopted him at 10 weeks of age and by about 4 months of age noticed that he “runs like a bunny” and that his left hip would “pop out.”  Jack didn’t seem to be in any pain or discomfort from his hip problem and is a very active puppy.
He came in to be neutered and have x-rays taken of his hip to find out what was going on.  Small dogs can develop a condition called Legg-Perthes where the head of the femur (the “ball” in the ball and socket hip joint) basically disintegrates.  Large breed dogs are prone to hip dysplasia, where the head of the femur isn’t held into the acetabulum (socket) very well.

On the day of his neuter surgery, Jack vomited up a cotton-tipped swab and some foam from a stuffed toy, but was otherwise acting fine.  Natasha wanted x-rays of his stomach, in addition to his hips, to make sure he hadn’t eaten anything else of concern.

JacksFBThe neuter went smoothly with no complications.  The abdominal x-rays provided us with a puzzle for the rest of the day until Jack pooped!

 

 

 

 

 

Here is the x-ray of his hips:jackships

 

There were lots of interesting guesses on Facebook as to what that white object might be.  Natasha’s daughter has a Barbie salon and she thought it might be Barbie’s face mask.  A small bedpan was suggested, and it certainly looked like that!  After he woke up from surgery he finally pooped it out.  After a quick wash:

The rubber ear piece from a stethoscope!!

Now, let’s look at the x-ray again:

JacksFBVD w description

 

So Jack definitely has hip dysplasia and not Legg Perthes disease.  The other hip (which is seen best on the second x-ray above) shows a rather shallow acetabulum.  It is that hip that may end up causing him the most pain.  The hip that is mostly out may not bother him too much, if there isn’t bone rubbing on bone.  But the one that is currently in place may develop arthritic changes over time and be painful.  If surgery is ever needed, a femoral head ostectomy will likely be done to remove the ball and keep it from rubbing on the bone of the hip socket.  But that surgery won’t be considered until Jack is showing signs of pain.

Here is a picture of normal hips (from a Labrador retriever) for comparison–you can see how nicely the head of the femur fits in the actebulum:
pennyhips

 

Cryptorchidism

Pixel is a Papillon-mixed dog.  He had his first puppy exam when he was 8 weeks old and at
that time only had one testicle descended into his scrotum.  We continued to monitor for both
testicles at each visit, but only the left testicle was present.  The condition where one testicle
fails to descend into the scrotum is call Cryptorchidism.
cryptorchid

In the fetus (dogs, cats, humans, etc), a structure called the gubernaculum connects the testicle (located next to the kidney during development) to the scrotum. If this structure fails to develop properly, the testicle will not end up in the scrotum, but will remain in the abdomen or the inguinal canal (which lies next to the prepuce in the dog).  About 4% of mixed breed dogs and 9% of purebred dogs (particularly toy and miniature breeds) will be cryptorchid.  Cats have a lower incidence–about 1% of male cats will be cryptorchid.  It’s considered to be an X-linked, autosomal-recessive trait.

Cryptorchidism can be one-sided (unilateral) or bilateral. In unilateral cryptorchidism the right testicle is retained twice as often as the left. Bilaterally cryptorchid animals are usually sterile because the higher body temperature inside the abdomen is enough to prevent sperm production. (The animals will, however, still exhibit male behaviors.)

If an animal is cryptorchid, he should not be used for breeding. Dogs with cryptorchid testicles are prone to testicular torsion and testicular cancer, so these dogs should be neutered to prevent problems later.  So when Pixel was 8 months old, had all his permanent teeth, and still only the left testicle in his scrotum, he came in to be neutered.

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This is Pixel (anesthestized) and on his back; his head is to the left.  Sometimes, if the dog is relaxed and the testicle is at the inguinal ring, you can see or feel it under the skin in the groin area.  It is easy to be fooled into thinking you can feel the retained testicle by fat or a lymph node in that same area.SAMSUNG CAMERA PICTURES

The descended testicle is generally removed first.  An incision is made just above the scrotum and the testicle, spermatic cord, etc is exteriorized, tied off with suture material, and removed.  Then the skin is closed.

 

 

The retained tesSAMSUNG CAMERA PICTURESticle was not found in the inguinal canal area, so an abdominal exploratory was done.  This is similar to spaying a female dog–you need to find the retained testicle, which is often around the area of the uterus in a female.  Once the testicle is found, it is tied off and removed like the other one.

 

It is a little hard to see on this picture, but the retained testicle is always smaller than the one SAMSUNG CAMERA PICTURESthat dropped into the scrotum.

 

 

 

 

 

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Because I thought I could feel the retained testicle in the inguinal ring, I made an incision there.  No luck, so then I had to make the incision into the abdomen to find it.

 

 

This is Pixel recovering after his surgery.

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