12/09/2025
來自Elise Robertson醫生的案例分享👩⚕️
一名4歲的雄性博美犬——Peanut，自幼犬時期已被診斷患有膀胱結石。Peanut的主人是一位香港的獸醫，特別關注Peanut的病情，並最終選擇由Elise Robertson醫生提供專業治療。
通過全面的診斷影像檢查，包括增強對比CT和超聲波，已排除門靜脈分流（Portosystemic Shunt, PSS），一種可能導致結石形成的先天性血管異常。然而，進一步檢查發現Peanut患有一種先天性肝臟血管異常，這影響了身體正常的代謝功能，並導致膀胱結石反覆形成。
針對此案例，Elise醫生為Peanut進行了微創經皮膀胱取石術（PCCL）以移除膀胱結石，同時進行肝臟活檢以確認具體的肝臟狀況。
PCCL是一種革命性的微創手術技術，相較於傳統膀胱切開術具有顯著優勢。傳統手術的結石殘留率約為20%，而PCCL在持續鹽水沖洗和放大視野下進行，結石殘留率僅約3.7%。這種技術特別適合小型犬，能精確移除膀胱結石，包括可能落入尿道的小結石，顯著降低術後併發症的風險。
手術進展非常順利，Peanut在術後僅20分鐘便成功甦醒，充分展示了微創手術的優勢。此案例不僅成功解決了Peanut的膀胱結石問題，更重要的是通過肝臟活檢確定了根本原因，為後續治療提供了關鍵信息。
Case sharing from Dr. Elise Robertson, Specialist Veterinarian at Concordia Pet Care👩⚕️
A 4-year-old male Pomeranian - Peanut, had been diagnosed with bladder stones since puppyhood. Peanut's owner, who is a veterinarian in Hong Kong, was particularly concerned about Peanut's condition and ultimately chose to seek professional treatment from Dr. Elise Robertson.
Comprehensive diagnostic imaging, including contrast-enhanced CT and ultrasound, had excluded portosystemic shunts - a congenital vascular anomaly that can also lead to stone formation. However, further investigation revealed that Peanut had a congenital hepatic vascular anomaly, which affected the body's normal metabolic function and led to recurrent bladder stone formation.
For this case, Dr. Elise performed minimally invasive percutaneous cystolithotomy (PCCL) to remove the bladder stones, while simultaneously conducting a liver biopsy to confirm the specific hepatic condition.
PCCL is a revolutionary minimally invasive surgical technique with significant advantages over traditional cystotomy. Traditional surgery has approximately 20% stone retention rate, while PCCL, performed under continuous saline irrigation and magnified visualization, has only about 3.7% retention rate. This technique is particularly suitable for small dogs, allowing precise removal of bladder stones, including tiny stones that may fall into the urethra, significantly reducing the risk of postoperative complications.
The surgery proceeded very smoothly, with Peanut successfully awakening just 20 minutes post-operatively, demonstrating the advantages of minimally invasive surgery. This case not only successfully resolved Peanut's bladder stone problem, but more importantly, identified the underlying cause through liver biopsy, providing crucial information for subsequent treatment.
#香港獸醫 #香港專科獸醫 #內窺鏡
