Topic:Urinary Health
Urinary health in horses encompasses the study of the equine urinary system, which includes the kidneys, ureters, bladder, and urethra. This system is responsible for filtering blood, removing waste products, and regulating fluid and electrolyte balance. Conditions affecting urinary health can range from infections and obstructions to renal dysfunction and urolithiasis. Monitoring urinary health involves assessing clinical signs, conducting urinalysis, and utilizing imaging techniques. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, pathophysiology, and clinical management of urinary health issues in horses.
Removal of ureteral calculi in two geldings via a standing flank approach. Two geldings, aged 11 and 17 years, were examined for treatment of ureteroliths located approximately 10 cm proximal to the bladder. Results: 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. Results: In ...
Pyogranulomatous lesion causing neurological signs localised to the sacral region in a horse. This case report describes neurological signs associated with a pyogranulomatous lesion within the sacral vertebral canal of a horse. The clinical findings included urinary overflow incontinence and reduced anal, perianal and tail tone. The horse failed to respond to medical management and a guarded prognosis for return to athletic performance initiated the decision for euthanasia.
Nephrogenic diabetes insipidus in a 14-year-old gelding. A 14-year-old Cleveland Bay cross gelding was presented with severe urinary incontinence that had been present for 1 year, and chronic polydipsia and polyuria over 4 years. Water intake had been recorded as 240 L over a 24-hour period. Results: The horse had marked urinary incontinence and polyuria and polydipsia. The urine was markedly hyposthenuric, but no abnormalities on urinalysis were detected. There were no other abnormal clinical or neurological signs. Haematological and serum biochemical examinations showed no abnormalities and ultrasonographic and endoscopic examination of the urinar...
Local anesthesia and hydro-distension to facilitate cystic calculus removal in horses. To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. Methods: Retrospective case series. Methods: Geldings (8) with cystic calculi. Methods: After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was instilled. After 10 minutes, the bladder was distended with sterile, warmed Hartmann's solution to a pressure of ≈ 40 cm H(2) O, using gravity feed. This was left in place until abdominal access was gained at surgery, then the fluid siphoned off via the catheter. Results: Calculi were 3-11 cm ...
Endoscopic-assisted electrohydraulic shockwave lithotripsy in standing sedated horses. To report use of transendoscopic electrohydraulic shockwave lithotripsy for fragmentation of urinary calculi in horses. Methods: Case series. Methods: Male horses (n = 21). Methods: Fragmentation of cystic calculi (median, 6 cm diameter; range, 4-11 cm diameter) was achieved by transurethral endoscopy in standing sedated horses using an electrohydraulic shockwave fiber introduced through the biopsy channel of an endoscope. The fiber was advanced until it contacted the calculus. Repeated activation of the fiber was used to disrupt the calculus into fragments <1 cm diameter. Visibility within...
Modified parainguinal approach for cystic calculus removal in five equids. This report describes a modification of the parainguinal approach for removal of cystic calculi: a ventral midline laparotomy-guided parainguinal laparocystotomy. The ventral midline approach to the abdomen is rapid and routinely used by equine surgeons. With an arm introduced to the abdomen via the ventral midline, the surgeon is able to select the ideal parainguinal laparotomy incision location that allows bladder exteriorisation with the minimum amount of tension. Because the surgeon's hand is introduced via the ventral midline incision, the parainguinal incision can be sized to just allow ...
Laparoscopic-assisted cystotomy and cystostomy for treatment of cystic calculus in a gelding. To report laparoscopic-assisted cystotomy and inguinal cystostomy for treating bladder urolithiasis in a gelding. Methods: Clinical report. Methods: Twelve-year-old Appaloosa gelding. Methods: A laparoscopic approach was used to locate and grasp the bladder, which was exteriorized through an enlarged instrument portal for cystotomy to remove the calculus. During withdrawal, the calculus fragmented into multiple pieces. To avoid urethral occlusion and facilitate elimination of these fragments, an inguinal cystostomy was created. The seromuscular layer of the bladder was circumferentially secure...
Septic peritonitis and uroperitoneum secondary to subclinical omphalitis and concurrent necrotizing cystitis in a colt. A 15-day-old American Quarter horse colt was presented for depression and pyrexia. Peritonitis was diagnosed following peritoneal fluid analysis. Exploratory laparotomy revealed an area of focal necrosis over the dorsal wall of the urinary bladder leading to peritonitis and uroperitoneum. The affected area of the urinary bladder was resected and the peritonitis resolved with medical treatment. Péritonite et uropéritoine septiques secondaires à une omphalite subclinique et à une cystite nécrosante concomitante chez un poulain. Un poulain American Quarter Horse âgé de 15 jours a été prÃ...
Case report: squamous cell carcinoma of the urinary bladder in a horse. A 14-year-old Hanoverian gelding was evaluated after a 10-week history of occasional straining during urination and dark red urine production after exercise. Physical examination findings were within normal limits. After 2 weeks of clinical signs, ultrasonography had found no abnormalities in the kidneys or bladder. A freely voided urine sample revealed an elevated protein concentration (500 mg/dL; reference range: <100 mg/dL) and few red blood cells. Vitamin C supplementation was suggested to acidify the urine, as was provision of a salt block to encourage water intake.
[Regenerative therapy for tendon and ligament disorders in horses. Terminology, production, biologic potential and in vitro effects]. Conventional treatments of equine tendon injuries lead to an unsatisfactory healing process that usually results in a relatively high recurrence rate. Therefore, in recent years so-called regenerative therapeutics were studied scientifically in vitro and in laboratory animals. These include substances that ideally lead to the formation of replacement tissue, which in contrast to the low quality scar, has similar functional properties as the original intact tendon. Currently, a plethora of different substrates is either commercially available or can be produced in practice with the help of kits...
Urinary glycosaminoglycans in horse osteoarthritis. Effects of chondroitin sulfate and glucosamine. Our objectives were to characterize the urinary excretion of glycosaminoglycans (GAGs) in horse osteoarthritis, and to investigate the effects of chondroitin sulfate (CS) and glucosamine (GlcN) upon the disease. Urinary GAGs were measured in 47 athletic horses, 20 healthy and 27 with osteoarthritis. The effects of CS and GlcN were investigated in mild osteoarthritis. In comparison to normal, urinary GAGs were increased in osteoarthritis, including mild osteoarthritis affecting only one joint. Treatment with CS+GlcN led to a long lasting increase in the urinary CS and keratan sulfate (KS), and ...
Ulcerative cystitis associated with phenylbutazone administration in two horses. A 15-year-old Quarter Horse gelding and a 26-year-old Thoroughbred gelding were evaluated because of hematuria of 4 to 6 days' duration following prolonged oral administration of phenylbutazone. Results: The horses had received either treatment with phenylbutazone for 3 months or intermittent long-term phenylbutazone treatment prior to development of hematuria. Each horse was systemically stable but had orthopedic or neurologic problems. Clinicopathologic findings included normochromic normocytic anemia in both horses and hypoalbuminemia and high BUN concentration in 1 horse. In both horses, u...
Use of pressor therapy in 34 hypotensive critically ill neonatal foals. Arginine vasopressin (AVP) is used in human medicine in the management of vasodilatory shock and cardiac arrest, but it is not widely used in equine neonatal intensive care because of concerns about potential side effects and suboptimal efficacy. This retrospective study reports the clinical use of AVP and norepinephrine (NE) in foals with refractory hypotension. Objective: To report the cardiovascular responses and fluid balance in critically ill, hypotensive foals receiving either NE or AVP. Methods: The medical records of neonatal foals (<7 days of age) from 2000 to 2007 admitted to the ...
Hypospadias in a Friesian gelding. To report clinical signs and management of hypospadias in a horse. Methods: Clinical report. Methods: A 6-year-old, Friesian gelding. Methods: Partial phallectomy was performed to resolve contact dermatitis of the pelvic limbs and abnormal behavior during urination. Subsequent urethral meatal stenosis was treated by revision. Results: Hypospadias and chordee caused altered direction of urine flow, contact dermatitis of the pelvic limbs, and abnormal behavior. Partial phallectomy and subsequent revision after meatal stenosis resolved urine direction, flow and abnormal behavior. Conclusions: Abn...
Repair of an incompetent urethral sphincter in a mare. To describe successful surgical treatment of urinary incontinence caused by a ruptured and/or transected urethral sphincter in a mare. Methods: Clinical report. Methods: A 7-year-old, Swedish Warmblood mare with urinary incontinence. Methods: The urethral sphincter, which had been damaged during removal of a cystic urolith, was repaired by apposing the ends of the disrupted urethralis muscle and tunica muscularis. Results: The mare was no longer incontinent after repair of the defect by apposition of the ends of the urethralis muscle and tunica muscularis. Conclusions: Transection and/or ruptu...
Clinical application of Patlak plot CT-GFR in animals with upper urinary tract disease. Glomerular filtration rate (GFR), an important parameter of renal function, is difficult to assess clinically. Serum creatinine and blood urea nitrogen measurements lack sensitivity, whereas radionuclide determination of GFR is not always available and requires postinjection patient isolation. GFR can be determined using computed tomography (CT), most commonly via Patlak plot analysis. Four adult cats, two adult dogs, and a foal underwent abdominal CT under general anesthesia for various diseases of the upper urinary tract. CT-GFR was measured with a single-slice dynamic acquisition and Patlak...
Optimisation of the frequently sampled intravenous glucose tolerance test to reduce urinary glucose spilling in horses. The frequently sampled i.v. glucose tolerance test (FSIGTT) is used to evaluate glucose and insulin dynamics in horses, but it has not been determined whether urinary glucose spilling (UGS) affects results. Objective: UGS occurs in horses during the FSIGTT and this problem can be minimised by adjusting the dextrose and insulin dosages used. Methods: Six mature mares were included in this study. In the first phase, 6 FSIGTT procedures were performed in each horse to evaluate 6 different dextrose dosages. Six different insulin dosages were evaluated during the second phase of the study after adm...
Determination of and correlation between urine protein excretion and urine protein-to-creatinine ratio values during a 24-hour period in healthy horses and ponies. OBJECTIVE-To determine whether urine protein-to-creatinine (UP:C) ratio assessment provides an estimate of urine protein excretion (UPE) over a 24-hour period in horses and ponies, establish a preliminary UP:C ratio reference range, and determine UP:C ratio variation over time in healthy equids. ANIMALS-11 female horses and 6 female ponies. PROCEDURES-Urine was collected from all equids at 4-hour intervals for 24 hours. Total 24-hour UPE (mg of protein/kg of body weight) and UP:C ratio were determined; these variables were also assessed in aliquots of urine collected at 4-hour intervals. On 2 ...
A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report. An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand int...
Ultrasonography of bovine urinary tract disorders. Ultrasonography is a helpful diagnostic tool in cattle with urinary tract disorders. It can be used to diagnose pyelonephritis, urolithiasis, hydronephrosis, renal cysts, renal tumors, amyloidosis, cystitis, bladder paralysis, bladder rupture, bladder neoplasms, and, occasionally, nephrosis, glomerulonephritis, and embolic nephritis. This article describes the anatomy, scanning technique, indications, limitations, normal and pathologic sonographic appearance of the bovine urinary tract. References from horses and humans are included, especially when the sonographic findings in these species ma...
Holmium:YAG laser lithotripsy for urolithiasis in horses. Laser lithotripsy has been used as an alternative to surgical removal of uroliths. Objective: To describe the procedure and efficacy of laser lithotripsy for removal of lower urinary tract uroliths in horses. Additionally, the ultrastructure and the differences in mineralogy and microstructure from 1 successful and 1 unsuccessful laser lithotripsy case are described. Methods: Six client-owned horses with 7 episodes of naturally occurring urocystoliths, urethroliths, or both. Methods: Retrospective study of all horses treated between 2006 and 2008 by laser lithotripsy. All horses were sedated f...
Urinary clinical pathologic findings and glomerular filtration rate in the horse. Urinary specific gravity (USG) measurements are underused by equine ambulatory veterinarians. Urinary dipstick and USG findings can assist in the diagnosis and prognosis of many disease processes in the horse. Simple methods for measurement of the glomerular filtration rate and urinary biochemical markers can improve equine urinary diagnostic abilities in critical care patients. Fractional excretion of electrolytes and minerals assists in fluid care and in management of nutrition of horses.
Seroprevalence of anti-Borrelia burgdorferi antibodies in dogs and horses in Turkey. The aim of the study was to determine the seroprevalence of anti-Borrelia burgdorferi antibodies in a population of Turkish dogs and horses, as well as to compare the sensitivity of novel flow-cytometry-based borreliacidal antibody test (BAT) with ELISA assay. Serum samples collected from 400 dogs and 300 horses were tested with enzyme-linked protein A/G assay (ELPAGA), using Borrelia whole cell antigens. ELPAGA test showed 93 dogs (23.2%) and 18 horses (6%) serologically positive for anti-Borrelia antibodies. In parallel testing of sera with BAT, we found 27.75% positive dogs and 6.33% positi...
Long-term management of sabulous cystitis in five horses. Five horses with sabulous cystitis were managed for up to three years. They were treated by emptying the bladder through a urinary catheter and saline lavage with cytoscopic guidance to remove residual sabulous material. The cystitis was treated with antimicrobial and anti-inflammatory medications, and bethanechol chloride was also administered. Frequent catheterisation and emptying of the bladder was an alternative to regular cystoscopic examination with saline lavage but it resulted in the development of a urethral stricture in one case. Four of the horses returned to work and one was retire...
Medical and surgical management of uroperitoneum in a foal. A 4-day-old, male, American paint foal was presented for abdominal distention, respiratory distress, and diarrhea. Bladder rupture and uroperitoneum were diagnosed following abdominal ultrasonography and abdominocentesis. The defect in the dorsocranial part of the bladder wall was surgically repaired. Un poulain American Paint mâle âgé de quatre jours est présenté pour ballonnement abdominal, détresse respiratoire et diarrhée. Une rupture de la vessie et un uropéritoine sont diagnostiqués après une échographie et une paracentèse abdominale. Le défaut dans la partie dorso-crânial...
Congenital anomalies of the equine urinary tract. Congenital anomalies of the urinary tract in horses may be difficult to diagnose and treat. Presenting complaints are variable and include weight loss, depression, dysuria, hematuria, and mild colic. Although the most severe abnormalities are diagnosed in the neonate, some diseases, such as ectopic ureter(s), may be identified in older horses. In human medicine, the fetus is examined in the prenatal period for evidence of urinary tract dysfunction, but this is not yet common practice in equine medicine. As a result, urinary tract anomalies are diagnosed after birth using a wide variety of diag...
Examination of the urinary tract in the horse. Pathologic conditions of the urinary tract may produce specific clinical signs, but they are more than likely to be nonspecific clinical signs, which often occur with chronic renal disease in addition to countless other diseases. Further, clinical signs that may seem to be directly related to the urinary tract may be the result of other systemic diseases. Thus, before embarking on diagnostics, it is important to obtain a thorough history and physical examination.
Toxins affecting the urinary system. Many different substances can induce toxic damage to various structural components of the equine kidney, and most lack pathognomonic signs. Some of these agents have specific treatments, although many do not. Supportive and symptomatic therapy is an important aspect of treatment of most cases of equine nephrotoxicosis. Regardless of cause, if the toxic substance is removed or neutralized before significant renal damage, full recovery of renal function may occur. Many horses already have significant renal damage before a definitive diagnosis is made, and the prognosis for full recovery thus rem...
Essentials of equine renal and urinary tract physiology. Knowledge of urinary tract anatomy and the numerous functions of the kidney in regulating fluids, electrolytes, acid-base balance, and waste products improves the ability of the clinician to diagnose, treat, and make appropriate recommendations for the management of the horse with renal disease. Several conditions can directly or indirectly affect renal function on a temporary or permanent basis. Endogenous and exogenous compounds (eg, drugs, toxins, hemoglobin) alone or in combination with inappropriate renal blood flow can promote or exacerbate renal disease.