Unilateral Hydronephrosis and Partial Ureteral Obstruction by Entrapment in a Granuloma in a Spayed Dog

Abstract

A 6-year-old, spayed female dog had hydronephrosis and incomplete ureteral occlusion on the left side. An end-to-side ureteral anastomosis was performed. The incomplete ureteral occlusion was determined to be related to an ovarian pedicle granuloma formation and was presumably related to a reaction to the suture material used for ovariohysterectomy (OVH) performed 5 years prior to presentation. Azotemia and hydronephrosis were dramatically improved after surgery, and renal function has been well maintained for 3 years. To the authors' knowledge, a chronic partial ureteral occlusion associated with an ovarian pedicle granuloma from an OVH has not been reported.

Bilateral hydronephrosis and hydroureter after ovariohysterectomy using nylon cable tie: a case report

“…Reports of urinary incontinence after ovariohysterectomy have been attributed to stump granulomas in female dogs (Okkens et al1981;Werner et al 1992;Goethem et al 2006). Extramural ureteral compression due to uterine scar tissue located in the bladder trigone or ovarian pedicle granuloma may contribute to postoperative development of hydronephrosis (Werner et al 1992;de Gopegui et al 1999;Kanazono et al 2009), as observed in the present case. The potential of nylon cable tie to induce inflammation and complications is controversial (Werner et al 1992;Murphy et al 1998;Hammond et al 1998;Barros et al 2009;Lima et al 2010;Macedo et al 2012).…”

“…However, inadequate aseptic technique or excessive residual devitalised tissue or excessive tissue trauma are other causes that may contribute to excessive inflammation and granuloma development (Werner et al 1992;Murphy et al 1998;Goethem et al 2006;DeTora and McCarthy 2011). Only a few reports have described chronic ureteral obstruction secondary to spaying (Werner et al 1992;de Gopegui et al 1999;Kanazono et al 2009). The dog in the present study probably developed a chronic renal disease, which, after the use of an anti-inflammatory drug became clinically apparent.…”

“…A bilateral lesion may require ureteral surgery if preservation of renal function is critical to survival (Hardie and Kyles 2004). Renal descensus and ureteroureterostomy were successfully performed in a case of incomplete unilateral ureteral occlusion because of the formation of an ovarian pedicle granuloma (Kanazono et al 2009). In the present case both ureters were released from the surrounding tissue at the same time that the nylon cable ties were removed.…”

Endoscopic placement of ureteral stents for treatment of congenital bilateral ureteral stenosis in a dog

“…24 Because the clinical signs in the dog of this report were first detected following ovariohysterectomy, it is also important to differentiate congenital ureteral stenosis from strictures attributable to complications of ovariohysterectomy, such as ovarian stump granulation or, much less likely, proximal ureteral ligation. 25,26 The lack of any clear extraluminal masses or compressive lesions, the lack of foreign material detected via CT, the partial patency of the ureteral lumen, and the symmetry of the lesions indicate that complications of ovariohysterectomy were unlikely to be the cause of the clinical signs in this dog; however, without a definitive histopathologic diagnosis, this is difficult to determine. Because the dog was spayed and adopted at approximately the time that clinical signs were first noted, a history of clinical signs prior to adoption could not be ascertained.…”

End-to-end ureteral anastomosis and double-pigtail ureteral stent placement for treatment of iatrogenic ureteral trauma in two dogs

“…Interestingly, temporary placement of red rubber catheters within the ureteral lumen, in a manner similar to that used for stent placement in the present report, resulted in comparably good outcomes in the dogs of those reports. 5,11,38 We believe that the technique of concurrent ureteral stent placement and ureteral anastomosis has several advantages in the treatment of dogs with ureteral trauma. 5,11,38 In the SCWT of the present report, stent placement appeared to have reduced the amount of tension on the anastomosis site caused by the considerable gap between the proximal and distal portions of the ureter.…”