Urethral Calculi in Five Horses

Abstract

Urinary cafculi are not uncommon in many domestic animals and man. Urethral calculi, however, occur infrequently in horses relative to other domestic species. Of 14 cases of urinary calculi in horses admitted to the Colorado State University Veterinary Teaching Hospital during the past eight years, nine had cystic calculi, one had a ureteral calculus, and five had urethral calculi. One case had a cystic and a urethral calculus. The clinical findings, medical and surgical management, and postoperative results in five cases of urethral calculi are reviewed in this article.RINARY CALCULI in horses occur infrequently. Of U 25,250 equine patients treated over 25 years at one veterinary hospital, 17 horses had cystic calculi.' Another report documented five cases of equine urolithiasis in 1, OOO patients treated over a 15-year period. Two of these cases were geldings reported to have urethral calculi.2 The clinical signs in horses having urethral calculi have been mentioned, and the routine surgical approach to perineal urethrostomy has been recommended for retrieval of c a l c~l i .~-~ Five cases of urethral calculi in three geldings and two stallions are reviewed in this report. Four cases were managed by surgical removal of calculi via perineal urethrostomy. Clinical signs were frequently nonspecific, and there was a high incidence of bladder rupture and peritonitis. Case ReportsCase I An 8-year-old quarter horse gelding was referred because of urethral blockage. The horse would assume a urination stance and exhibit tenesmus. A small amount of blood was passed from the urethral orifice. A urinary catheter could not be passed beyond 30 cm from the orifice. The penis was prolapsed continually from the prepuce.Upon presentation, the horse was bright and alert but had a heart rate of 64. A firm mass was palpated in the penis approximately 30 cm from the urethral orifice. Rectal palpation revealed a taut and distended

Use of an Absorbable Urethral Stent for the Management of a Urethral Stricture in a Stallion

“…The rough spiculated surface of the urolith in this stallion made removal challenging and urethral trauma likely lead to postoperative bleeding, delayed healing and stricture formation. Stricture at the perineal urethrotomy site is uncommon but is previously reported . In this stallion, urethral stricture occurred at the level of the urethrolith, not the urethotomy which was more proximal to the site of stricture.…”

“…In this stallion, clinical signs of obstructive urethrolithiasis were noted before referral, including straining and posturing to urinate, persistent dropping of the penis, and colic because of severe urinary bladder distension . The stallion appeared uncomfortable at presentation, had reduced feed intake and had not voided urine despite multiple attempts.…”

“…Previous studies report complications with perineal urethrotomy in 19–52% of cases, half of which would be considered major . Complications include excessive postoperative bleeding from the urethrotomy, urethral fistula, urethral diverticulum, septic peritonitis, orchitis, postoperative tenesmus, dysuria, ascending infection and urethral stricture . The rough spiculated surface of the urolith in this stallion made removal challenging and urethral trauma likely lead to postoperative bleeding, delayed healing and stricture formation.…”

“…Urethral stricture can develop after blunt or sharp trauma, and after circumferential ulceration of the urethra by urethroliths . Urethral stricture is more common in male horses as they have a narrower urethra than females, and the urethra at the level of the ischial arch is particularly susceptible .…”

“…Urethral catheterization of the stallion at initial presentation was unsuccessful and a perineal urethrotomy was performed to remove the urolith, performed as previously described . Previous studies report complications with perineal urethrotomy in 19–52% of cases, half of which would be considered major .…”