William R. Pritchard Veterinary Medical Teaching Hospital

Internal Medicine

Internal Medicine - Procedures for Respiratory Disorders

Rhinoscopy: This procedure is used when dogs or cats have a foreign body into the nasal cavity, have discharge from the nose, or have difficulty passing air through the nasal cavity. Anesthesia is required to perform this procedure, and in virtually all situations, x-rays or CT (computed tomography) is performed immediately before rhinoscopy in order to locate the abnormal region. For the initial portion of the rhinoscopy, a flexible endoscope is passed into the mouth and around the soft palate to look at the back of the nasal cavity. This is a common site for foreign bodies or masses to be located. Biopsy samples may be collected from this region, and then a rigid scope is used to evaluate both sides of the front of the nasal cavity. Most diseases of the nose require collection of biopsy samples to determine the diagnosis. Pain medication is given before and after the procedure. Because the nose is very vascular, some bleeding is expected during and after a biopsy sample is taken. Animals are hospitalized overnight to provide additional pain medication as needed and to keep them calm to prevent further bleeding.

Bronchoscopy : This procedure is commonly performed in animals with cough to determine whether they suffer from asthma/bronchitis, pneumonia, airway foreign bodies, or other conditions of the lung or airways. Animals must be fully anesthetized to have this procedure performed, and dogs larger than ~15 pounds have an endotracheal tube placed down the trachea (windpipe) to provide general anesthesia. In small dogs and cats, intravenous agents are used to maintain anesthesia and oxygen is administered through a catheter placed in the trachea. A small endoscope (2.8mm - 5.3mm in diameter) is passed down the airways and all airway openings are evaluated. After this procedure, fluid is instilled into the airways and then withdrawn to collect a sample of the fluid that lines the airways. This fluid is evaluated for evidence of pneumonia, bronchitis, or cancer. After bronchoscopy, dogs or cats may cough slightly more than previously or the cough may sound different because small amounts of fluid remain in the airways after the fluid lavage procedure.

Laryngoscopy ; Laryngoscopy is performed in dogs and cats that have signs of loud breathing, a change in voice, exercise intolerance, or difficulty breathing. Normally, the walls of the larynx should open when your pet breathes in to allow rapid flow of air into the lungs. Laryngoscopy evaluates how well the larynx is working. This procedure is also used to look for masses or foreign bodies in the oral cavity, and to investigate snoring noises in animals. Complete evaluation of the larynx requires anesthesia to assess all regions of the upper airway.

Procedures for Urinary Disorders

Holmium: YAG laser lithotripsy now available at UC Davis - VMTH
We are now offering laser lithotripsy for cystic and urethral calculi in male and female dogs and female cats. This procedure involves using a holmium:YAG laser (introduced through the cystoscope) to non-invasively 'break up' stones and remove them from the bladder without surgery. Holmium:YAG lithotripsy can fragment stones by means of a photothermal process and the laser energy is absorbed in <0.5mm of fluid, making it safe for urologic procedures. Once the stones are fragmented, a basket can be inserted through the cystoscope and the largest fragment is grasped to ensure that it will pass easily through the urethra. The larger pieces should be included for stone analysis to properly identify all the layers of the stone. This is important in order to subsequently initiate proper management strategies for stone prevention. All other fragments can be removed by voiding urohydropropulsion. Dogs and cats with extreme stone burdens can be more difficult, but each case can be evaluated individually and recommendations made. This is an ideal tool for urethral obstructions in male dogs.

Prior to referral, a urinalysis and urine culture should be performed if possible. If a urinary tract infection is suspected, appropriate antibiotics should be started at least 3-4 days prior to referral. The cost for the procedure itself is approximately $675.00 (not including anesthesia, or other diagnostics which may be warranted).

Other applications for this laser include the removal of bladder polyps and minor biopsies or masses from the bladder or urethral mucosa. We cannot perform this procedure for ureteral stones at this time. Ureteral calculi warrant the use of extracorporal shock wave laser lithotripsy for removal which we currently do not have available at this time.

If you have any questions about the procedure do not hesitate to call Dr. Westropp at: 530-752-1393 or contact the Gerald V. Ling Urinary Stone Analysis Laboratory at: 530-752-3228 or by email at: jlwestropp@ucdavis.edu.

What is Cystoscopy?
Cystoscopy is a diagnostic procedure that is used to evaluate the lower urinary and genital tract in male and female dogs and cats. The procedure uses a rigid scope for females and a flexible scope for males to obtain good visualization of the bladder, urethra and ureteral insertions. Both dogs and cats need to be under general anesthesia for this procedure. We have cystoscopes available for all sizes of small animals - from male cats to large female dogs. We have even scoped several other species such as goats and tortoises.

When is Cystoscopy Indicated?
Cystoscopy can be used to help identify ectopic ureters in dogs, a common reason many young dogs present with urinary incontinence. We can also use cystoscopy to less invasively obtain biopsies of the lower urinary tract if mass lesions such as polyps or tumors are suspected. Oftentimes, we use this technique to evaluate dogs and cats that present with recurrent urinary tract infections; if no underlying cause is found, biopsy forceps can be inserted through the scope and small samples of the bladder wall can be obtained and submitted for histopathology and culture analysis. Finally, the cystoscope can be used as a treatment option for stones (see laser lithotripsy section), ectopic ureters, as well as submucosal urethral collagen injections for treatment of
urinary incontinence.

If you have any questions about the use of cystoscopy in small animal medicine, please contact Dr. Jodi Westropp or our service coordinator, Mari Anne Green at 530-752-1393

UC Davis School of Veterinary Medicine