• 1. Henneke DR, Potter GD, Kreider JL, et al. Relationship between condition score, physical measurements and body fat percentage in mares. Equine Vet J 1983; 15:371372.

    • Search Google Scholar
    • Export Citation
  • 2. Lillich JD, DeBowes RM. Urethra. In: Auer JA, Stick JA, eds. Equine surgery. 3rd ed. St Louis: Elsevier, 2006;887893.

  • 3. Röcken M, Mosel G, Stehle C, et al. Left- and right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. Vet Surg 2007; 36:568572.

    • Search Google Scholar
    • Export Citation
  • 4. Schott HC. Obstructive disease of the urinary tract. In: Reed SM, Bayly WM, Sellon DC, eds. Equine internal medicine. 3rd ed. St Louis: Saunders Elsevier, 2010;12011243.

    • Search Google Scholar
    • Export Citation
  • 5. Squire KRE, Adams SB. Bilateral ureterocystostomy in a 450-kg horse with ectopic ureters. J Am Vet Med Assoc 1992; 201:12131215.

  • 6. Byars TD, Simpson JS, Divers TJ, et al. Percutaneous nephrostomy in short-term management of ureterolithiasis and renal dysfunction in a filly. J Am Vet Med Assoc 1989; 195:499501.

    • Search Google Scholar
    • Export Citation
  • 7. Macharg MA, Foerner JJ, Phillips TN, et al. Two methods for the treatment of ureterolithiasis in a mare. Vet Surg 1984; 13:9598.

  • 8. MacHarg MA, Foerner JJ, Phillips TN, et al. Electrohydraulic lithotripsy for treatment of cystic calculus in a mare. Vet Surg 1985; 14:325327.

    • Search Google Scholar
    • Export Citation
  • 9. Eustace RA, Hunt JM. Electrohydraulic lithotripsy for the treatment of cystic calculus in two geldings. Equine Vet J 1988; 20:221223.

    • Search Google Scholar
    • Export Citation
  • 10. Koenig J, Hurtig M, Pearce S, et al. Ballistic shock wave lithotripsy in an 18-year-old Thoroughbred gelding. Can Vet J 1999; 40:185186.

    • Search Google Scholar
    • Export Citation
  • 11. Verwilghen D, Ponthier J, Van Galen G, et al. The use of radial extracorporeal shockwave therapy in the treatment of urethral urolithiasis in the horse: a preliminary study. J Vet Intern Med 2008; 22:14491451.

    • Search Google Scholar
    • Export Citation
  • 12. Howard RD, Pleasant RS, May KA. Pulsed dye laser lithotripsy for treatment of urolithiasis in two geldings. J Am Vet Med Assoc 1998; 212:16001603.

    • Search Google Scholar
    • Export Citation
  • 13. May KA, Pleasant RS, Howard RD, et al. Failure of holmium:yttrium-aluminum-garnet laser lithotripsy in two horses with calculi in the urinary bladder. J Am Vet Med Assoc 2001; 219:957961.

    • Search Google Scholar
    • Export Citation
  • 14. Judy CE, Galuppo LD. Endoscopic-assisted disruption of urinary calculi using a holmium: YAG laser in standing horses. Vet Surg 2002; 31:245250.

    • Search Google Scholar
    • Export Citation
  • 15. Rodger LD, Carlson GP, Moran ME, et al. Resolution of a left ureteral stone using electrohydraulic lithotripsy in a Thoroughbred colt. J Vet Intern Med 1995; 9:280282.

    • Search Google Scholar
    • Export Citation
  • 16. Sisson S. Equine urogenital system. In: Getty R, ed. Sisson and Grossman's the anatomy of the domestic animals. 5th ed. Philadelphia: WB Saunders Co, 1975;528.

    • Search Google Scholar
    • Export Citation
  • 17. Rapp HJ, Sernetz M. Urethroskopie und Ureterenkatheterisierung bei der Stute. Pferedeheilkunde 1985; 1:197200.

  • 18. Laverty S, Pascoe JR, Ling GV, et al. Urolithiasis in 68 horses. Vet Surg 1992; 21:5662.

  • 19. Ehnen SJ, Divers TJ, Gillette D, et al. Obstructive nephrolithiasis and ureterolithiasis associated with chronic renal failure in horses: eight cases (1981–1987). J Am Vet Med Assoc 1990; 197:249253.

    • Search Google Scholar
    • Export Citation
  • 20. Voss ED, Taylor DS, Slovis NM. Use of a temporary indwelling ureteral stent catheter in a mare with a traumatic ureteral tear. J Am Vet Med Assoc 1999; 214:15231526.

    • Search Google Scholar
    • Export Citation
  • 21. Robertson SA, Sanchez LC, Merritt AM, et al. Effect of systemic lidocaine on visceral and somatic nociception in conscious horses. Equine Vet J 2005; 37:122127.

    • Search Google Scholar
    • Export Citation
  • 22. Wood T, Weckman TJ, Henry PA, et al. Equine urine pH: normal population distributions and methods of acidification. Equine Vet J 1990; 22:118121.

    • Search Google Scholar
    • Export Citation
  • 23. Reimillard RL, Modransky PD, Welker FH, et al. Dietary management of cystic calculi in a horse. J Equine Vet Sci 1992; 12:359363.

  • 24. Mavangira V, Cornish JM, Angelos JA. Effect of ammonium chloride supplementation on urine pH and urinary fractional excretion of electrolytes in goats. J Am Vet Med Assoc 2010; 237:12991304.

    • Search Google Scholar
    • Export Citation
  • 25. McKenzie EC, Valberg SJ, Godden SM, et al. Plasma and urine electrolyte and mineral concentrations in Thoroughbred horses with recurrent exertional rhabdomyolysis after consumption of diets varying in cation-anion balance. Am J Vet Res 2002; 63:10531060.

    • Search Google Scholar
    • Export Citation

Advertisement

Removal of ureteral calculi in two geldings via a standing flank approach

Jeremy Frederick DVM, DACVIM1, David E. Freeman MVB, PhD, DACVS2, Robert J. MacKay BVSc, PhD, DACVIM3, Sarah Matyjaszek DVM, DACVS4, Jordan Lewis DVM5, L. Chris Sanchez DVM, PhD, DACVIM6, and Stephanie Meyer DVM7
View More View Less
  • 1 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 2 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 3 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 4 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 5 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 6 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 7 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Abstract

Case Description—Two geldings, aged 11 and 17 years, were examined for treatment of ureteroliths located approximately 10 cm proximal to the bladder.

Clinical Findings—Ureteral obstruction was an incidental finding in 1 horse that was referred because of urinary tract obstruction and a cystic calculus. This horse did not have clinical or laboratory evidence of renal failure, although severe hydronephrosis was evident on transabdominal ultrasonography. The second patient had a serum creatinine concentration of 6.3 mg/dL (reference range, 0.8 to 2.2 mg/dL) and mild hydronephrosis of the affected left kidney.

Treatment and Outcome—In both patients, the obstructed ureter was exteriorized through a flank incision as a standing procedure, and the calculus was crushed and removed with a uterine biopsy forceps introduced through a ureterotomy approximately 25 cm proximal to the calculus. The cystic calculus was removed through a perineal urethrostomy by lithotripsy, piecemeal extraction, and lavage. The horse without azotemia developed pyelonephritis in the affected kidney and was euthanatized because of complications of a nephrectomy 13 months later. In the horse with azotemia, the serum creatinine concentration decreased after surgery, and the horse returned to its intended use. However, it was euthanatized approximately 2 years after surgery because of progressive renal failure, and a large nephrolith was found in the previously unobstructed right kidney.

Clinical Relevance—The technique used for ureterolith removal was successful in both horses in this report, did not require sophisticated equipment, and could be effective in the early stages of ureteral obstruction as a means of restoring urine flow and renal function. The outcome in the horse with advanced unilateral renal disease without azotemia would suggest that nephrectomy should be considered as a treatment in such patients.

Abstract

Case Description—Two geldings, aged 11 and 17 years, were examined for treatment of ureteroliths located approximately 10 cm proximal to the bladder.

Clinical Findings—Ureteral obstruction was an incidental finding in 1 horse that was referred because of urinary tract obstruction and a cystic calculus. This horse did not have clinical or laboratory evidence of renal failure, although severe hydronephrosis was evident on transabdominal ultrasonography. The second patient had a serum creatinine concentration of 6.3 mg/dL (reference range, 0.8 to 2.2 mg/dL) and mild hydronephrosis of the affected left kidney.

Treatment and Outcome—In both patients, the obstructed ureter was exteriorized through a flank incision as a standing procedure, and the calculus was crushed and removed with a uterine biopsy forceps introduced through a ureterotomy approximately 25 cm proximal to the calculus. The cystic calculus was removed through a perineal urethrostomy by lithotripsy, piecemeal extraction, and lavage. The horse without azotemia developed pyelonephritis in the affected kidney and was euthanatized because of complications of a nephrectomy 13 months later. In the horse with azotemia, the serum creatinine concentration decreased after surgery, and the horse returned to its intended use. However, it was euthanatized approximately 2 years after surgery because of progressive renal failure, and a large nephrolith was found in the previously unobstructed right kidney.

Clinical Relevance—The technique used for ureterolith removal was successful in both horses in this report, did not require sophisticated equipment, and could be effective in the early stages of ureteral obstruction as a means of restoring urine flow and renal function. The outcome in the horse with advanced unilateral renal disease without azotemia would suggest that nephrectomy should be considered as a treatment in such patients.

Contributor Notes

Dr. Frederick's present address is Center for Veterinary Care, 680 State Rd 343, Millbrook, NY 12545.

Dr. Matyjaszek's present address is Chaparral Veterinary Medical Center, 32100 N Cave Creek Rd, Cave Creek, AZ 85331.

Dr. Lewis' present address is Palm Beach Equine Clinic, 13125 Southfields Rd, Wellington, FL 33414.

Dr. Meyer's present address is Pilchuck Veterinary Hospital, 11308 92nd St SE, Snohomish, WA 98290.

Address correspondence to Dr. Freeman (freemand@ufl.edu).