Urethral obstruction in a ram with a periurethral abscess: clinical findings, diagnostic imaging and pathology.

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES BMC Veterinary Research Pub Date : 2024-11-06 DOI:10.1186/s12917-024-04363-7
Mathilde Laetitia Pas, Laurens Chantillon, Justine Clinquart, Raphaela Hiltrop, Louis Vandekerckhove, Bart Pardon, Jan Govaere, Maya Meesters
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Abstract

Background: Urethral obstruction is a common and life-threatening condition in male small ruminants.

Case presentation: 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.

Conclusions: 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.

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患有尿道周围脓肿的公羊尿道梗阻:临床发现、影像诊断和病理学。
背景:尿道阻塞是雄性小型反刍动物常见的一种危及生命的疾病:本病例报告描述的是一只 3 岁、体重 103 千克的 Zwartbles 种公羊,主诉拉稀,疑似尿道阻塞。检查包括临床检查、实验室分析、超声波成像、(对比)射线照相和尿液检查。就诊时,血液分析显示呼吸性碱中毒、高钾血症和轻度氮质血症。经腹超声波检查发现膀胱肿大(直径 11 厘米),右肾周围有游离液体。对该动物的治疗包括膀胱插管术、静脉灌注、抗菌治疗、氯化铵和非甾体抗炎药。超声波检查、放射线检查和尿液检查均未发现尿路结石的迹象。由于治疗了 16 天仍不见好转,于是进行了尿路造影和生殖系统检查。前行尿道造影呈阳性,显示骨盆尿道尾部有一个充满造影剂的腔隙性病变。生殖超声波检查显示,同样的巨大尿道膨胀或脓肿压迫骨盆尿道,以及双侧睾丸严重退化。造影和生殖检查的结果导致决定对该动物实施安乐术,因为该动物无法繁殖。尸体解剖后进行了计算机断层扫描,结果显示腔隙性病变与左侧球部尿道腺体关系密切。病理结果显示,泌尿生殖道有淋巴浆细胞性化脓感染、慢性间质性肾炎、右肾肾周至皮质脓肿以及尿道周围脓肿。至于生殖系统,整个系统都出现了多灶性间质性炎症浸润。睾丸和两个附睾都出现了明显的纤维化和萎缩:结论:小反刍动物尿道梗阻的鉴别诊断应包括尿道周围脓肿。广泛的医学影像检查,加上死前和死后的检查结果,使本病例成为诊断人员在面对公羊尿道问题时的一个很好的参考病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Veterinary Research
BMC Veterinary Research VETERINARY SCIENCES-
CiteScore
4.80
自引率
3.80%
发文量
420
审稿时长
3-6 weeks
期刊介绍: BMC Veterinary Research is an open access, peer-reviewed journal that considers articles on all aspects of veterinary science and medicine, including the epidemiology, diagnosis, prevention and treatment of medical conditions of domestic, companion, farm and wild animals, as well as the biomedical processes that underlie their health.
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