Page 238 - Clinical Manual of Small Animal Endosurgery

226 Clinical Manual of Small Animal Endosurgery

Fig. 7.19 Urethra following laser ablation of TCC with 8 French catheter in
place.

Clinical signs usually resolve immediately and tumour regrowth is
controlled using chemotherapy (piroxicam and mitoxantrone). In this
author’s experience a single laser treatment usually gives remission of
signs for around 6 months if used alone or 8–12 months if combined
with chemotherapy. However, repeat laser debulking at 3–5 month inter-
vals can keep the dog free of clinical signs for considerably longer. Cur-
rently the author has three dogs undergoing laser debulking that have
been free of clinical signs for over 2 years. Eventually distant metastasis
to lungs or lymph nodes is likely to occur.
An alternative to laser debulking is the use of urethral stents placed
under fluoroscopic guidance to try and maintain patency. This is also a
palliative procedure and does not remove any tumour tissue, which will
eventually grow through the stent.

Foreign bodies
Foreign bodies can occasionally be found in the vestibule or vagina.
Grass seeds can find their way into the reproductive tract via the vulva
and result in a persistent vaginal discharge. These can usually be visual-
ised easily at vaginoscopy and retrieved using grasping forceps. More
uncommon foreign bodies are occasionally seen as a result of malicious
intent or inquisitive children. The stick in Fig. 7.20 was the result of a
penetrating stick injury in the left flank of the dog. The bulk of the stick
had been removed following exploratory surgery and laparotomy but
the tip of the stick which had penetrated the cranial vagina was missed
and resulted in a vaginal discharge a few weeks later. This was retrieved
using large grasping forceps alongside the cystoscope.