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Tierarztl Prax Ausg K Kleintiere Heimtiere 2019; 47(06): 394-401
DOI: 10.1055/a-1020-3359
Originalartikel

Urethrolithiasis beim Hund – eine retrospektive Untersuchung an 83 Rüden

Urethrolithiasis in the dog – a retrospective evaluation of 83 male dogs
Cetina Thiel
Klinikum Veterinärmedizin, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen
,
Thomas Christian Häußler
Klinikum Veterinärmedizin, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen
,
Martin Kramer
Klinikum Veterinärmedizin, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen
,
Sabine Tacke
Klinikum Veterinärmedizin, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen
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Zusammenfassung

Gegenstand und Ziel Die Urethrolithiasis ist eine häufige Ursache für Harnabsatzstörungen. Ziel der retrospektiven Studie war, Fälle von Rüden zu evaluieren, bei denen Harnröhrensteine unter standardisierter Epiduralanästhesie in die Harnblase zurückverlagert wurden.

Material und Methode Die Daten von 83 männlichen Hunden mit Urethrolithiasis wurden hinsichtlich klinischer Symptome, Lokalisation der Harnsteine, Anzahl der Urethrolithen, Art der bildgebenden Diagnostik und des operativen Eingriffs sowie der Ergebnisse der postoperativen Röntgenkontrollen ausgewertet. Zusätzlich erfolgte eine Auswertung der bakteriologischen Urinuntersuchungen und Steinanalysen. Alle Patienten erhielten zusätzlich zu einer Allgemeinanästhesie eine standardisierte Epiduralanästhesie.

Ergebnisse Mit einer Ausnahme wurden alle der 83 Rüden wegen Harnabsatzbeschwerden vorgestellt, die bei 33 Patienten chronisch waren. In 66 Fällen ließen sich röntgendichte Konkremente in der Harnröhre nachweisen, 11-mal wurde die Diagnose Urethrolithiasis mittels sonografischer Untersuchung gestellt und bei 6 Patienten führte eine Katheterisierung mit nachfolgendem Nachweis der Harnsteine in der Harnblase zur Diagnose Urethrolithiasis. Mehr als ein Drittel der Hunde wiesen zum Vorstellungszeitpunkt ausschließlich Konkremente in der Urethra auf. Bei 44 Rüden wurden 3 oder mehr Urethrasteine diagnostiziert. Bei 77 von 83 Hunden (92,7 %) gelang es, alle Harnsteine unter Epiduralanästhesie in die Harnblase zurückzuverlagern. Neun Patienten mit röntgendichten Harnsteinen wiesen bei der postoperativen radiologischen Kontrolle residuale Konkremente auf.

Schlussfolgerung Für die zuverlässige radiologische Diagnostik von Harnsteinen beim Rüden muss bedacht werden, dass sich ein nicht unerheblicher Anteil ausschließlich in der Harnröhre befindet. Das Vorliegen röntgendurchlässiger Urethrasteine kann durch sonografische Untersuchung der Harnröhre evaluiert werden, die alleinige Ultraschalluntersuchung der Harnblase reicht hier nicht aus. Eine Epiduralanästhesie sollte spätestens dann in Erwägung gezogen werden, wenn Spülversuche zur Behebung der urethralen Obstruktion erfolglos bleiben. Die postoperative radiologische Kontrolle nach Laparozystotomie hinsichtlich einer vollständigen Steinentfernung ist bei röntgendichten Urolithen auf jeden Fall anzuraten.

Abstract

Objective Urethral calculi are a frequent cause of urinary disorders in male dogs. The aim of this study was to evaluate male dogs with urethral stones, which were relocated into the urinary bladder with the support of standardized epidural anesthesia in addition to general anesthesia.

Materials and methods Data of 83 male dogs with urethral calculi were evaluated regarding clinical signs, localization and number of urethral calculi, diagnostic imaging, surgical procedure and postoperative radiographs. Additionally, bacterial culture and stone type analysis were evaluated. Besides general anesthesia all dogs received an epidural anesthesia.

Results With one exception all dogs showed signs of urinary disorders, in 33 cases, these were chronic. In 66 cases, urethral stones were diagnosed radiographically and in 11 cases, radiolucent urethral concrements were detected via ultrasonography. In 6 dogs, diagnosis was reached by catheterization and subsequent evidence of stones in the urinary bladder. At the time of presentation, more than one third of the dogs showed urethral calculi only. In 53 % of the dogs (n = 44), 3 or more urethral stones were present. In 77 of 83 dogs (92.7 %), relocation of all urethral stones into the urinary bladder was achieved. During postoperative radiography 9 dogs were diagnosed with residual urethral calculi.

Conclusion and clinical relevance Due to a significant proportion of dogs with sole urethral stones reliable radiological diagnosis of urethral calculi requires precise patient positioning. In cases of radiolucent calculi, ultrasonography of the urethra may lead to a diagnosis, sonographic evaluation of the urinary bladder alone is not sufficient. The use of epidural anesthesia should in the least be considered in cases in which relocation of the urethral stones is not possible by flushing. Postoperative radiographs is advisable in patients with radiodense calculi.

Schlüsselwörter

Harnsteine - Zystotomie - Urinbsatzstörungen - Lokalanästhesie - Regionalanästhesie

Key words

Uroliths - cystotomy - urinary disorder - local anesthesia - regional anesthesia


Publication History

Received: 08 April 2019

Accepted: 16 September 2019

Article published online:
06 December 2019

© Georg Thieme Verlag KG
Stuttgart · New York

 

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