Page 2 - Clinical Connections - Summer 2024

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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2 Summer 2024