動物臨床医学 Journal of Animal Clinical Medicine 128 - 症例報告 - 尿管結石摘出術を ₂ 度行ったウサギの ₁ 例 大成 衷子,白石 加南,八村 寿恵,山岡 佳代,和田 慎太郎,網本 昭輝 ☆ アミカペットクリニック(〒 ₇₅₅-₀₀₂₃ 山口県宇部市恩田町 ₃-₂-₃) ☆連絡責任者:網本 昭輝(アミカペットクリニック) 〒 ₇₅₅-₀₀₂₃ 山口県宇部市恩田町 ₃-₂-₃ Tel:₀₈₃₆-₃₄-₂₈₆₁ A Rabbit Which Received Ureterotomy Two Times Atsuko ONARI, Kana SHIRAISHI, Hisae HACHIMURA, Kayo YAMAOKA, Shintaro WADA, Akiteru AMIMOTO ☆ Amica Pet Clinic, 3-2-3 Ondacho, Ube-shi, Yamaguchi 755-0023, Japan ( Received 1 December 2014 / Accepted 7 July 2015) SUMMARY : A 7-year-old male rabbit showed a hunched posture and abdominal pain with the main complaint of loss of appetite and vigor. In radiographic examinations, stones were detected in the right and left renal pelvises. Medical treatment was initiated with analgesics and subcutaneous infusion. On day 8, stones in the right renal pelvis were found to have migrated into the ureter, causing ureteral obstruction. As abdominal ultrasound examination revealed distention of the right renal pelvis and ureter, right ureterotomy was performed to remove the stones, which were found to be mainly calcium oxalate. The postoperative course was uneventful; however, the patient returned to our hospital on day 21 because of increased squatting posture and urinary frequency. Distention of the left renal pelvis and ureter was noted with migration of stones from the left renal pelvis into the ureter. Left ureterotomy was performed for stone removal, and postoperative recovery was uneventful. Seven weeks after the second surgery, the rabbit exhibited loss of vigor and pollakiurea, and newly formed stones were detected on radiographs. The rabbit was treated with infusion and analgesics if needed, and its daily activity was almost the same as before. One year and 10 months after the second surgery, growth of stones in the right and left renal pelvises and elevation of the values of BUN and creatinine were seen, and the patient died of aggravated renal dysfunction 2 years and 4 months after the second surgery. KEY WORDS : calcium oxalate stone, rabbit, ureteral lithotomy (J Anim Clin Med. 24(3)128-131, 2015) 要約:₇ 才齢雄のウサギが食欲低下と元気消失を主訴に来院した。 背弯姿勢,腹部の疼痛がみられたため X 線検査を 行ったところ,左右腎臓の腎盂内に結石が認められた。鎮痛剤や皮下輸液などによる内科的な治療を行っていたが, 第 ₈ 病日に右腎盂内にあった結石が尿管に移動し尿管閉塞を起こした。腹部超音波検査で右腎盂と尿管の拡張が認め られたため,右尿管切開を行い結石の摘出を行った。結石の主成分はシュウ酸カルシウムであった。術後の経過は良 好であったが,第 ₂₁ 病日に腰をうかす姿勢をとり排尿回数が多いとのことで来院した。左腎盂内にあった結石が尿 管に移動し,左腎盂と尿管の拡張を起こしていたため,左尿管切開を行い,結石の摘出を行った。経過は順調であっ たが,第 ₆₄ 病日(₂ 回目の手術から ₄₃ 日目)に元気消失,頻尿を訴え X 線検査にて右腎盂内に新たな結石が形成さ れたことを確認した。以降必要に応じ皮下輸液や鎮痛剤の投与を行い維持し,日常生活に支障はなかった。しかし第 ₆₉₁ 病日(₂ 回目の手術から ₆₇₀ 日目)に左右腎盂内の結石の増大と, BUN および Cre の上昇がみられ,第₈₈₇ 病日(₂ 回目の手術から ₈₆₆ 日目)に腎不全の悪化により死亡した。 キーワード:シュウ酸カルシウム結石,ウサギ,尿管結石摘出術 (動物臨床医学₂₄(₃)₁₂₈-₁₃₁, ₂₀₁₅)
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動物臨床医学 J o u r n a l o f A n i m a l C l i n i c a l M e d i c i n e 動物臨床医学 J o u r n a l o f A n i m a l C l i n i c a l M e d i c i n e 128
Amica Pet Clinic, 3-2-3 Ondacho, Ube-shi, Yamaguchi 755-0023, Japan
( Received 1 December 2014 / Accepted 7 July 2015)
SUMMARY : A 7-year-old male rabbit showed a hunched posture and abdominal pain with the main complaint of loss of appetite and vigor. In radiographic examinations, stones were detected in the right and left renal pelvises. Medical treatment was initiated with analgesics and subcutaneous infusion. On day 8, stones in the right renal pelvis were found to have migrated into the ureter, causing ureteral obstruction. As abdominal ultrasound examination revealed distention of the right renal pelvis and ureter, right ureterotomy was performed to remove the stones, which were found to be mainly calcium oxalate. The postoperative course was uneventful; however, the patient returned to our hospital on day 21 because of increased squatting posture and urinary frequency. Distention of the left renal pelvis and ureter was noted with migration of stones from the left renal pelvis into the ureter. Left ureterotomy was performed for stone removal, and postoperative recovery was uneventful. Seven weeks after the second surgery, the rabbit exhibited loss of vigor and pollakiurea, and newly formed stones were detected on radiographs. The rabbit was treated with infusion and analgesics if needed, and its daily activity was almost the same as before. One year and 10 months after the second surgery, growth of stones in the right and left renal pelvises and elevation of the values of BUN and creatinine were seen, and the patient died of aggravated renal dysfunction 2 years and 4 months after the second surgery.KEY WORDS : calcium oxalate stone, rabbit, ureteral lithotomy