Immune-mediated diseases represent some of the most frustrating types of disorders that are diagnosed and treated in veterinary medicine. Drug-induced immunosuppression is an attempt to control the aberrant immune response against self antigens but the immunosuppression can result in sepsis or other unacceptable adverse effects. If the pathophysiology of immune-mediated and autoimmune disease is considered, the immune response can be divided into several components and attempts can be made to selectively deal with each component separately. The components of the immune response that can be manipulated by therapy include antibodies, effector cells, the mononuclear phagocytic system, and the peripheral manifestations of disease. This article reviews the therapy of immune-mediated and autoimmune diseases based on a pathophysiologic approach and discusses conventional as well as current therapies in the treatment of these devastating diseases. (Journal of Veterinary Internal Medicine 1992; 6~206-213)
Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed.
Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed.
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