Small Animal Internal Medicine

Research Report

NU04 - Complications of Transurethral Ectopic Ureter Correction

Friday, June 15
11:00 AM - 11:15 AM
Location: WSCC 307/308

The purpose of this presentation is to report a complication in three cases of transurethral ectopic ureter correction(TUCLCUE).     Transurethral cystoscopy (TUC) is the procedure of choice for correction of ectopic ureters in female dogs.     Since the first correction was performed in 2004 this procedure has been performed at multiple institutions with reports on technique and success rates.    Significant complications other than failure to completely correct incontinence have not been reported.A 2 year old spayed female Golden Retriever was presented for lethargy and abdominal pain 18 months after bilateral TUCLCUE.   Ultrasound revealed a large hydronephrotic right kidney with perirenal fluid and right hydroureter.    TUC revealed complete occlusion of the right neostoma.    Right nephrectomy and ureterectomy were performed at the owners insistence.      Communication was received from a remote client that their 2 year old female Australian Shepherd was diagnosed with right side hydronephrosis and hydroureter 18 months after bilateral TUCLCUE.    Communication was received from a remote client 2 years after TUCLCUE was performed on a 4 month old female Newfoundland with ultrasound showing early hydronephrosis and hydroureter that was monitored with ultrasound.    Transurethral cystoscopy revision of the neostoma has been recommended in all cases.  The last case was reexamined with TUC after an inadequate response to TUCLCUE and a portion of the left vaginal ectopic ureter had not been completely corrected.   Revision of the neostoma and residual vaginal ectopic ureter was performed. Spontaneous closure of the neostoma after TUCLCUE surgery is a significant complication of the procedure.    Postoperative monitoring TUCLCUE cases with ultrasound is recommended to diagnose hydronephrosis and hydroureter early and allow early stoma revision to preserve the involved kidneys.    
    

Timothy C. McCarthy, DVM, PhD, DEACVS, ACVS FOUNDING FELLOW SMALL ANIMAL SOFT TISSUE MIS

Surgeon
VetMIST(Veterinary Minimally Invasive Surgery Training)

Dr Timothy C. McCarthy was born in Seattle on an old farm on the Mercer Island waterfront when the island was still totally wild. He grew up on a farm in Roseburg with cats, dogs, horses, goats, cows, snakes, turtles and an endless variety of other critters. Raising and training his own horse "Lucky" and riding her all over the wilds of the Cascades. During this period he developed his interest in Veterinary Medicine stimulated and encouraged by Dr Don and Betty Bailey. His pre veterinary training was at Oregon State University and he attended Colorado State University for Veterinary School where he graduated in 1969. After two years in practice he returned to Colorado State University for six years of advanced training in Veterinary Surgery leading to board certification by the American College of Veterinary Surgeons in 1978 and a PhD in Veterinary surgery in 1981. Dr McCarthy then spent three years practicing as a small animal surgeon in California before moving to Portland in 1981 where he was the first board certified surgeon in private practice in Oregon. The Surgical Specialty Clinic for Animal was started in 1985 flourishing as a free standing referral only practice that was listed twice in the Business Journals 100 fastest growing privately held Oregon companies.

Endoscopy became a part of the practice in 1982 expanding and developing into the main focus of the practice and primary expertise of Dr McCarthy. Endoscopes and techniques were added and developed until the practice had a full range of rigid and flexible endoscopes, 40 in all, and performed all the diagnostic endoscopy, interventional endoscopy, minimally invasive soft tissue surgery, and arthroscopy procedures utilized in small animal practice. Dr McCarthy pioneered the application of many minimally invasive diagnostic and therapeutic techniques that have changed the way small animal veterinary medicine is practiced and are now or are now becoming the standard of care. These span from simple techniques such as transurethral cystoscopy, rhinoscopy, and otoscopy to more difficult and challenging techniques including arthroscopy and transabdominal nephroscopy. A recent paradigm changing technique devised by Dr McCarthy is the transurethral correction of ectopic ureters utilizing cystoscopy and a diode laser.
Dr McCarthy has lectured extensively both nationally and internationally, has published numerous articles, and is editor of a definitive work on endoscopy in small animal practice, "Veterinary Endoscopy for the Small Animal Practitioner". He received the 2010 AVMA practitioner research award presented to a veterinarian who performed original research and published that research while in private practice. Dr McCarthy recently was designated as an ACVS Founding Fellow for Small Animal Minimally Invasive Surgery in both soft tissue and orthopedics. He is the only veterinarian to achieve this designation in both categories. Not bad for a kid who graduated from Veterinary School last in his class!

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