Interventional Endoscopy (IE) and Interventional Radiology (IR) in Zoo Animal Patients: A New Way of “Looking” at Things
Interventional techniques such as interventional endoscopy (IE) and interventional radiology (IR) utilize fluoroscopy with endoscopy to gain access into any part of the body minimally invasively. This novel approach provides the clinician with an option where traditional surgery is either not ideal or potentially contraindicated. These techniques could potentially benefit zoo and wildlife patients as exemplified in two cases with on the urinary tract problems.
An adult female African lion (Panthera leo) was presented with persistent frank hematuria for at least 1.5 years. Bloodwork, urine culture, ultrasound and CT imaging were normal. The patient was anesthetized and a urethrocystoscopy was performed. Frank hematuria was noted jetting from the left ureteral orifice, suggesting renal hematuria as a cause of her condition. The right ureter had normal yellow colored urine. The lion subsequently had a uretero-nephroscopy performed and her renal pelvis was evaluated in a retrograde fashion through her ureterovesicular orifice. A lesion was found in her renal pelvis and was cauterized using Bugbee (Valley Lab) cautery through the ureteroscope. Post-procedure recovery was uneventful, and the hematuria resolved.
A 15-year-old male neutered spectacled langur monkey (Presbytis obscura) presented with stranguria. On radiographs the patient had bladder and urethral stones. An emergency cystotomy was performed, but a stone remained in the urethra and therefore the animal continued with dysuria. A flexible urethroscope was used to identify the urethrolith, a Hol:YAG laser was used to perform lithotripsy, and a stone basket was used to remove the fragments. A cystourethrogram was performed to confirm patency of the urethra. The monkey recovered uneventfully.