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Endoscopic-guided sclerotherapy for renal-sparing treatment of idiopathic renal hematuria in dogs: 6 cases (2010-2012).

OBJECTIVE
To describe the use of sclerotherapy for the renal-sparing treatment of idiopathic renal hematuria (IRH) in dogs and report clinical outcomes.


DESIGN
Retrospective case series.


ANIMALS
6 dogs (8 renal pelvises) with IRH.


PROCEDURES
Medical records of dogs that underwent sclerotherapy were reviewed. Each ureterovesicular junction was identified cystoscopically to determine the side of bleeding, and a retrograde ureteropyelogram was performed with endoscopic and fluoroscopic guidance. A ureteropelvic junction balloon was used for ureteral occlusion, and pelvis filling volumes were recorded. A povidone iodine mixture, followed by a sterile silver nitrate solution, was infused into the renal pelvis. A double-pigtail ureteral stent was placed after the procedure. Information on preprocedure and postprocedure biochemical changes, imaging parameters, and clinical outcomes was obtained.


RESULTS
6 dogs (5 males and 1 female) had sclerotherapy for unilateral (4) or bilateral (2) bleeding. Five were right-sided and 3 were left-sided. The median age and weight of dogs were 3 years and 42.4 kg (93.28 lb), respectively. Median procedure time was 150 minutes. One dog that did not have a ureteral stent placed following the procedure developed short-term signs of renal pain and pyelectasis. Cessation of macroscopic hematuria occurred in 4 of 6 dogs (median, 6 hours). Two additional dogs improved moderately. Median follow-up time was 8 months (range, 3.5 to 20.5 months).


CONCLUSIONS AND CLINICAL RELEVANCE
Topical sclerotherapy for IRH was safe and effective. Local sclerotherapy for IRH in dogs could be considered a valuable and minimally invasive renal-sparing treatment over ureteronephrectomy.