Endoscopy-guided, renal-sparing sclerotherapy in 2 dogs with idiopathic renal hematuria

Abstract

A 10-month-old male Australian Shepherd and a 3.5-year-old female Staffordshire Bull Terrier were presented due to chronic gross hematuria. Further diagnostics, including ultrasonography and cystoscopy of the urinary tract, revealed no cause for the bleeding. Accordingly, a diagnosis of unilateral idiopathic renal hematuria (IRH) was made.

Treatment with Yunnan Baiyao was unsuccessful. Both patients underwent retrograde ureteropyelography and unilateral sclerotherapy. A 5% povidone iodine mixture and a 0.5% silver nitrate solution were administered sequentially into the renal pelvis multiple times and left there for 20 minutes. The second dog showed a tortuous course of the ureter caused by bilateral ectopic ureters, already treated with a laser ablation. This made treatment considerably more challenging. Giving the persistence of hematuria, the procedure was repeated 3 weeks later. Neither dog exhibited any complications associated with the treatment and they remain free of microscopic hematuria 15 and 11 months later, respectively.

The reported cases demonstrate that sclerotherapy should be considered as a renal-sparing therapy, even in dogs with more complicated conditions.

Zusammenfassung

Ein 10 Monate alter Australian Shepherd Rüde und eine 3,5 Jahre alte Staffordshire Bullterrier Hündin wurden aufgrund von chronischer makroskopischer Hämaturie vorgestellt. Weitere Untersuchungen, einschließlich einer Sonografie und Zystoskopie der Harnwege, zeigten keine Ursache für die Blutung. Infolgedessen wurde die Diagnose einer unilateralen idiopathischen renalen Hämaturie (IRH) gestellt.

Eine Behandlung mit Yunnan Baiyao blieb erfolglos. Bei beiden Patienten wurde eine retrograde Ureteropyelografie sowie eine unilaterale Sklerotherapie durchgeführt. Eine 5-prozentige Povidon-Jod-Mischung und eine 0,5-prozentige Silbernitrat-Lösung wurden nacheinander mehrmals ins Nierenbecken instilliert und für 20 Minuten dort belassen. Die Hündin wies aufgrund bilateraler ektopischer Ureteren, die bereits durch eine Laserablation behandelt wurden, einen schlängelnden Verlauf des Ureters auf. Dies erschwerte die Behandlung deutlich. Da die Hämaturie weiterhin bestand, wurde diese 3 Wochen später wiederholt. Bei beiden Hunden traten keinerlei Komplikationen der Behandlung auf. Sie zeigen 15 bzw. 11 Monate danach keine mikroskopische Hämaturie mehr.

Der Fallbericht zeigt, dass die Sklerotherapie auch bei Hunden mit komplizierteren Voraussetzungen als nierenerhaltende Therapie in Betracht gezogen werden sollte.

Keywords

Minimally invasive - fluoroscopic - ureteropyelogram - silver nitrate - povidone iodine - urethrocystoscopy

Schlüsselwörter

Minimalinvasiv - fluoroskopisch - Ureteropyelogramm - Silbernitrat - Povidon-Jod - Urethrozystoskopie

Publication History

Received: 22 December 2024

Accepted: 23 April 2025

Article published online:
13 June 2025

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