-
Recent Posts
Archives
- October 2022
- August 2022
- May 2022
- March 2022
- January 2022
- December 2021
- September 2021
- July 2021
- June 2021
- May 2021
- April 2021
- February 2021
- January 2021
- November 2020
- October 2020
- September 2020
- June 2020
- April 2020
- March 2020
- February 2020
- January 2020
- December 2019
- November 2019
- October 2019
- September 2019
- June 2019
- March 2019
- February 2019
- January 2019
- December 2018
- November 2018
- October 2018
- August 2018
- July 2018
- June 2018
- May 2018
- April 2018
- March 2018
- February 2018
- January 2018
- December 2017
- November 2017
- October 2017
- September 2017
- August 2017
- July 2017
- June 2017
- May 2017
- April 2017
- March 2017
- February 2017
- January 2017
- December 2016
- November 2016
- August 2016
- July 2016
- June 2016
- May 2016
- April 2016
- March 2016
- February 2016
- January 2016
- December 2015
- November 2015
- October 2015
- September 2015
- August 2015
- July 2015
- June 2015
- May 2015
- April 2015
- March 2015
- December 2014
- June 2014
- May 2014
- April 2014
- November 2013
- September 2013
- August 2013
- July 2013
- June 2013
- May 2013
- March 2013
- January 2013
- November 2012
- October 2012
- July 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- December 2010
- November 2010
Categories
NorthStar VETS Cool Case Parker
The team at NorthStar VETS is doing innovative and amazing things every day as they work to advance the level of care available to your pet. This is the first in a new series of posts to be shared highlighting cool cases at NorthStar VETS and the types of things done to save pets and improve their quality of life. These are cases using innovative and cutting-edge medical techniques, and/or stories of pets beating the odds. Read the story below and watch the doctor tell you the story in their own words via the video at the end. We begin with the story of Parker, a patient of Veterinary Surgeon, Dr. Heather Knapp-Hoch, and how new technology helped this dog in a minimally-invasive way.
About Parker
Parker is a miniature poodle that presented to NorthStar VETS at 18 weeks of age for urinary incontinence. Her owners noted that she had been incontinent since they rescued her. She would constantly dribble urine and had been diagnosed with multiple urinary tract infections. A contrast study was performed by her referring veterinarian which was suspicious for a left ectopic ureter. She presented to the surgery service for evaluation and treatment options.
Ectopic Ureters
Ectopic ureters are a congenital abnormality where the distal aspect of the ureter does not enter the bladder in the normal location of the trigone of the bladder. They most commonly bypass this location and enter the urinary tract system distal to the urethral sphincter which results in urinary incontinence. Surgical correction of the abnormal ureter is recommended to improve urinary incontinence. Traditionally this was accomplished with an open abdominal surgery which involved a cystotomy and the creation of a new ureteral opening in the trigone of the bladder via various surgical techniques. Recently the surgical treatment of this disease has shifted to a minimally invasive procedure which allows for diagnosis and treatment of this disease in the same anesthesia episode with no need for an open abdominal surgery.
About the new procedure
Cystoscopic laser ablation of intramural ectopic ureters is accomplished via a minimally invasive scoping procedure and ablation of the ureteral wall with a cystoscopically-guided laser fiber. Advantages of this technique over an open surgical approach are diminished surgical time, postoperative pain and hospitalization time as well as the diagnosis and treatment of this disease within the same anesthesia episode. The rate of continence post laser ablation or open abdominal surgery is similar with 50-75% of dogs improving or becoming fully continent post-procedure.
How things went for Parker
Parker was the first patient at NorthStar VETS to undergo this new minimally-invasive treatment for ectopic ureters. During the scoping procedure, she was diagnosed with a definitive left ectopic ureter which entered the urinary tract in the urethra. A holmium – yag laser was used to ablate the ureteral wall and take the opening of the ureter to the level of the trigone in the bladder. She stayed in our hospital overnight and went home on antibiotics and nonsteroidal anti-inflammatory medication to help with pain and inflammation. She was discharged from our hospital less than 24 hours after surgery and the best news of all is that she was fully continent when she was discharged.
Prognosis
It has been 3 months since Parker’s procedure and her owners were happy to report she was doing great at home. She is a normal puppy with no evidence of dribbling urine or incontinence. Her long-term prognosis is expected to be excellent with a decreased risk of urinary tract infections in the future.
Learn more about the Surgery service at NorthStar VETS
Heather Knapp-Hoch, DVM, MS, DACVS
Originally from New Jersey, Dr. Knapp-Hoch is excited to return home and join the NorthStar VETS surgical team. Dr. Knapp-Hoch earned her Bachelor of Science in biology from Long Island University in 2001. She then traveled across the US to obtain a Masters degree in genetics and cell and molecular biology from Washington State University where she also obtained her Doctorate of Veterinary Medicine in 2007. Dr. Knapp-Hoch then completed a small animal rotating internship at Cornell University in 2008. Following her internship she completed a three-year surgical residency at Cornell University in 2011. She obtained board certification in 2012 and practiced as a small animal clinical instructor at Cornell University from 2011-2014.
Dr. Knapp-Hoch’s special areas of interest include surgical oncology and minimally invasive surgery including laser ablation of ectopic ureters. She is proficient in advanced wound management and has a special interest in the use of negative pressure wound therapy (NPWT) to treat difficult surgical and traumatic wounds. She is trained in both the tibial plateau leveling osteotomy (TPLO) and the tibial tuberosity advancement (TTA) surgical procedures for cranial cruciate ligament disease.
The information presented on this web site is not intended to take the place of your family veterinarian’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your own veterinarian to determine what is right for your pet. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give you medical advice via this blog. The information contained in this online site and emails is presented in summary form only and intended to provide broad understanding and knowledge. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your veterinarian. We do not recommend the self-management of your pet’s health problems.
This entry was posted in Pets, Veterinary Medicine and tagged Ectopic Ureter, Heather Knapp-Hoch, Holmium-Yag Laser, NorthStar VETS, veterinary surgery. Bookmark the permalink.
Leave a Reply