Page 2 - Clinical Connections - Summer 2024
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RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK


           which has been caring for senior cats with
           CKD  since  the  early  1990s.  Recent  work
           in the group has focused on risk factors for
           development  and  progression  of  disease,
           with publications contributing to international
           guidelines.
             At  RVC  Small  Animal  Referrals,  the
           team offers general advice in relation to the
           management of urinary tract conditions as
           well as advanced diagnostic investigations.
           These  include  renal  biopsy  for  dogs  and
           cats  with  proteinuric  kidney  disease  and
           cystoscopic  evaluation,  where  there  are
           concerns for lower urinary tract disease or
           urinary incontinence.                Hattie Syme, Rebecca Geddes, Jack Lawson and Rosanne Jepson
             Advanced  management  options  for   RVC Small Animal Referrals remains the   interest for Jack Lawson who, in conjunction
           urinary incontinence provided include laser   only UK-based centre to offer laser lithotripsy   with  Rebecca  Geddes,  has  started  a
           ablation  of  ectopic  ureters  (congenital   –  a  completely  non-invasive  method  for   clinically important biobank to facilitate the
           abnormality of the urinary tract) and urethral   stone fragmentation, permitting cystoscopic   investigation of factors that predispose cats
           bulking for older dogs, where medical and   retrieval. Key advantages of this procedure   to  the  development  of  upper  urinary  tract
           surgical options are not viable.    include  shorter  hospitalisation  and  faster   stones.
             The team also has a particular interest in   recovery times than conventional surgery.   The  nephrology  and  urology  team  is
           the care of patients with urinary tract stones   For  cats  where  stones  affect  the  upper   excited  to  be  able  to  offer  their  expertise
           and provides minimally invasive options for   urinary  tract,  and  cause  obstructions,  the   and  guidance  in  the  management  of  all
           stone management. For some stone types,   team  works  closely  with  the  Soft  Tissue   conditions  affecting  the  urinary  tract  both
           dissolution with careful medical therapy and   Surgery  Service  to  offer  placement  of   to  cases  referred  for  advanced  care  and
           close monitoring is possible, but for others   subcutaneous  ureteral  bypass  (SUB)   to  primary  care  practitioners  seeking  the
           a minimally invasive surgical approach can   devices  with  long-term  care  provided  via   opportunity to discuss cases further.
           be offered.                         our unique SUB Clinic. This is a particular

             Advanced techniques and technologies used in nephrology and urology

             The RVC team has a particular interest in the management of stone disease affecting both the upper and lower urinary tract. We have
             expertise in the evaluation of cats and dogs with nephroliths (stones in the kidney) and ureteroliths (stones in the ureter) as well as
             those in the bladder (cystoliths).

             Laser lithotripsy
             RVC Small Animal Referrals is the only veterinary service in the UK offering laser lithotripsy treatment for urolithiasis. Laser energy
             is provided within treatments via a fine silica quartz fibre. This can be advanced through the working channel of an endoscope to
             provide targeted application of energy directly onto stones, causing fragmentation. It is particularly useful for managing stones causing
             obstruction of the urethra in male dogs and cystoliths that cannot be dissolved in female dogs.

             Fluoroscopy
             Fluoroscopy is a specialist diagnostic imaging modality, enabling capture of real-time moving pictures of inside the body. It takes a
             continuous series of low dose radiographs, which creates a live movie of the patient’s internal structures. Fluoroscopy is valuable for
             many different sorts of cases by teams at RVC Small Animal Referrals, including checking for stones in the urinary tract. Such stones
             may not be evaluated by ultrasound due to the pelvic bones and when fluoroscopy is used in conjunction with radiographic contrast
             solutions it can help detect stones or structures that might not be visible with plain radiographs. Fluoroscopy and laser lithotripsy
             equipment was funded by the Animal Care Trust, the RVC's registered charity.

             Percutaneous cystolithotomy (minimally invasive cystotomy)
             Percutaneous cystotomy enables uroliths to be removed from the bladder using a much smaller incision than a routine cystotomy
             procedure. This minimally invasive technique minimises contamination of the abdominal cavity with urine, permits better visualisation
             and, because the incision is smaller, there is less risk of future stone formation around suture material. When combined with cystoscopy,
             a more thorough evaluation of the bladder and urethra is possible, to avoid leaving any stone material behind.

                                                                                      For small animal referrals, please call:
                                                                                     01707 666399
                                                                                      Email:
                                                                                     qmhreception@rvc.ac.uk


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