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.
Simhofer H, Riedelberger K.A 6 year old Haflinger gelding was presented to the reporting clinics with a history of chronic dysuria. A large cystic calculus (12 x 9 x 9 cm) was diagnosed cystoscopically. Lithotripsy was carried out endoscopically in the standing, sedated patient with a Holmium:YAG surgical laser (2100 nm, 0.5-3.5 J/pulse, 3-60 pulses/sec.). The endoscope was inserted into the bladder via perineal urethrostomy. Fragmentation of the urolith was carried out with a laser fiber (core diameter 600 microns) in contact mode. Healing proceeded uneventfully. On follow up examination 8 weeks post surgery, no signs ...
Chandler KJ, Dixon RM.Urinary cortisol and creatinine concentrations, and the cortisol:creatinine ratio were compared between 12 healthy horses (group 1), 13 horses with Cushing's disease (group 2), and eight horses with dysautonomia syndrome (equine grass sickness) (group 3). The mean (sd) urinary cortisol concentrations were 112 (55.7), 250 (357) and 864 (526) nmol/litre in groups 1, 2 and 3, respectively; the mean (sd) urinary creatinine concentrations were 18.9 (7.3), 12.0 (6.7) and 45.2 (26.4) nmol/litre in groups 1, 2 and 3, respectively, and the mean (sd) ratios were 6.1 (2.6), 19.8 (23.8) and 21.3 (14.5) (x...
Higuchi T, Nanao Y, Senba H.To report the clinical findings, surgical technique, and outcome after repair of urinary bladder rupture through a urethral incision in postpartum mares. Methods: Retrospective study. Methods: Four Thoroughbred broodmares. Methods: Medical records were reviewed for clinical signs, surgical technique, medical therapy, and outcome. The bladder was everted into the vagina through a urethral incision that included a sphincterotomy. The bladder defect was repaired with absorbable suture material in a single-layer, full thickness, simple, continuous pattern. The urethral incision was closed similarl...
Judy CE, Galuppo LD.To describe a technique for endoscope-assisted disruption and removal of urinary calculi using a holmium:YAG laser in sedated, standing horses. Methods: Retrospective study. Methods: Six horses with urinary calculi. Methods: A holmium:YAG laser was used to disrupt naturally occurring urinary calculi in horses (4 geldings, 1 stallion, 1 mare). Ischial urethrotomy was performed in male horses to provide a portal for the endoscope and laser fiber. Calculus fragments were removed by a combination of lavage, transendoscopic basket snare removal, forceps, and digital manipulation. Ischial urethrotom...
Morisset S, Hawkins JF, Frank N, Sojka JE, Berg D, Blevins WE.A 2-day-old male foal developed uroperitoneum. Initial exploration of the abdomen via ventral midline celiotomy failed to localize the source of uroperitoneum. Bilateral nephropyelocentesis and antegrade urography were performed, and a defect in the right ureter and stenosis of the left ureter were identified. With the foal in dorsal recumbency in the Trendelenburg position, ureterorrhaphy was performed on the right ureter. After ureterorrhaphy, a ureteral catheter was maintained as a stent. The stenotic left ureter was transected, and ureteroneocystostomy was performed using a drop-in mucosal...
Saam D.A 9-year-old, quarter horse gelding with obstructive urethrolithiasis was treated with a perineal urethrostomy. The horse's condition deteriorated and abdominocentesis confirmed septic uroperitonitis. The horse was euthanized and postmortem examination revealed peritonitis, a tear in the lateral wall of the bladder, and a nephrolith within the left renal pelvis.
May KA, Pleasant RS, Howard RD, Moll HD, Duesterdieck KF, MacAllister CG, Bartels KE.Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy was attempted in a mare and a gelding with calculi in the urinary bladder. The procedure was unsuccessful in producing adequate fragmentation of the calculi. In the gelding, pulsed dye laser lithotripsy was subsequently used to fragment the urolith. Manual removal of the urolith via the urethra was performed in the mare.
Textor JA, Goodrich L, Wion L.An 8-hour-old Standardbred filly was evaluated because of an enlarging umbilical mass and stranguria. It was suspected that the mass was the urinary bladder; this was confirmed on surgical exploration of the abdomen. Despite a normal umbilical ring, the bladder had descended and partially everted through its urachal communication with the umbilical stalk. Partial cystectomy and umbilical resection were performed and resulted in an excellent clinical outcome. Evagination of the urinary bladder via the umbilicus has rarely been described in human infants, and, to our knowledge, it has not been r...
Tomlinson JE, Farnsworth K, Sage AM, Turner TA, Wilson JH.Ultrasound-guided percutaneous pyelography has previously been used in dogs to diagnose ectopic ureter. To the authors' knowledge its use has never been reported in the horse. This paper reports the technique used in a three-week-old filly with a suspected ectopic ureter. Pyelography can be performed under sedation and is a relatively simple, safe procedure. The technique enables assessment of individual renal function through collection and analysis of urine from each renal pelvis.
Blikslager AT, Tate LP, Jones SL.An 8-year-old Hanoverian gelding was examined because of urine dribbling and urethral obstruction. Mild proprioceptive deficits of the left hind limb were evident during neurologic examination. Ultrasonography per rectum revealed dilatation of the pelvic portion of the urethra. Endoscopy of the urethra revealed 2 webs of tissue: 1 was located 10 cm proximal to the external urethral opening; the other was located 65 cm proximal to the external urethral opening and prevented passage of the endoscope into the urinary bladder. The mass was ablated with a neodymium:yttrium-aluminum-garnet laser, us...
Toribio RE, Kohn CW, Chew DJ, Sams RA, Rosol TJ.To evaluate calcium balance and parathyroid gland function in healthy horses and horses with enterocolitis and compare results of an immunochemiluminometric assay (ICMA) with those of an immunoradiometric assay (IRMA) for determination of serum intact parathyroid hormone (PTH) concentrations in horses. Methods: 64 horses with enterocolitis and 62 healthy horses. Methods: Blood and urine samples were collected for determination of serum total calcium, ionized calcium (Ca2+) and magnesium (Mg2+), phosphorus, BUN, total protein, creatinine, albumin, and PTH concentrations, venous blood gases, and...
Harkins JD, Woods WE, Lehner AF, Fisher M, Tobin T.Clenbuterol is a beta2 agonist/antagonist bronchodilator marketed as Ventipulmin and is the only member of this group of drugs approved by the US Food and Drug Administration (FDA) for use in horses. Clenbuterol is a class 3 drug in the Association of Racing Commissioners International (ARCI) classification system; therefore, its identification in postrace samples may lead to sanctions. Recently, the sensitivity of postrace testing for clenbuterol has been substantially increased. The objective of this study was to determine the 'detection times' for clenbuterol after administration of an oral...
Hassel DM, Schiffman PS, Snyder JR.To characterize the texture, mineralogic features, and chemical features of enteroliths obtained from horses. Methods: Enteroliths from 13 horses with colic. Methods: Enteroliths were harvested from 13 horses that underwent ventral midline celiotomy for treatment of colic or necropsy because of colonic obstruction and rupture caused by enteroliths. Dietary and environmental history were determined via questionnaires or evaluation of medical records. In 7 horses that underwent surgical treatment for enterolithiasis, samples of colonic contents were obtained via an enterotomy in the pelvic flexu...
Wasfi IA, Abdel Hadi AA, Elghazali M, Boni NS, Alkatheeri NA, Barezaig IM, Al Muharami AM, Hamid AM.The pharmacokinetics of tripelennamine (T) was compared in horses (n = 6) and camels (n = 5) following intravenous (i.v.) administration of a dose of 0.5 mg/kg body weight. Furthermore, the metabolism and urinary detection time was studied in camels. The data obtained (median and range in brackets) in camels and horses, respectively, were as follows: the terminal elimination half-lives were 2.39 (1.91-6.54) and 2.08 (1.31-5.65) h, total body clearances were 0.97 (0.82-1.42) and 0.84 (0.64-1.17)L/h/kg. The volumes of distribution at steady state were 2.87 (1.59-6.67) and 1.69 (1.18-3.50) L/kg, ...
Dirikolu L, Lehner AF, Karpiesiuk W, Harkins JD, Woods WE, Carter WG, Boyles J, Fisher M, Tobin T.Lidocaine is a local anesthetic drug that is widely used in equine medicine. It has the advantage of giving good local anesthesia and a longer duration of action than procaine. Although approved for use in horses in training by the American Association of Equine Practitioners (AAEP), lidocaine is also an Association of Racing Commissioners International (ARCI) Class 2 drug and its detection in forensic samples can result in significant penalties. Lidocaine was observed as a monoprotonated ion at m/z 235 by ESI+ MS/MS (electrospray ionization-positive ion mode) analysis. The base peak ion at m/...
Patterson-Kane JC, Tramontin RR, Giles RC, Harrison LR.A 14-year-old Thoroughbred gelding with a history of acute onset of hematuria was presented for necropsy. Transitional cell carcinoma of the urinary bladder with intra-abdominal dissemination was diagnosed. Tumor masses were observed on the splenic capsule and surrounding the distal abdominal aorta. Tumor cells showed diffuse cytoplasmic reactivity for cytokeratin but were negative for epithelial membrane antigen, carcinoembryonic antigen, tumor-associated glycoprotein 72, and vimentin.
Steffey EP, Pascoe PJ, Woliner MJ, Berryman ER.To quantitate dose- and time-related anesthetic-sparing effects of xylazine hydrochloride (XYL) during isoflurane-induced anesthesia in horses and to characterize selected physiologic responses of anesthetized horses to administration of XYL. Methods: 6 healthy adult horses. Methods: Horses were anesthetized 2 times to determine the minimum alveolar concentration (MAC) of isoflurane in O2 and to characterize the anesthetic-sparing effect (MAC reduction) after IV administration of XYL (0.5 and 1 mg/kg of body weight, random order). Selected measures of cardiopulmonary function, blood glucose co...
Ros A.A case of a cystic calculus in a pony mare is described. In this case an urethro-sphincterostomy accomplished removal of a 362 g calculus with dimensions of 9 x 7 cm without any complications after surgery.
Jansson A, Lindholm A, Lindberg JE, Dahlborn K.The aim of this study was to investigate the adaptation to an increased potassium (K+) intake in horses and to study whether the regulation of the post exercise K+, sodium (Na+) and fluid balances were altered by an increased K+ intake. Four Standardbred horses were fed 2 levels (4.1 and 5.4 mmol/kg bwt/day) of K+ for 17 days in a crossover design. The effects on K+, Na+ and fluid balance were studied both at rest and in response to 29 km exercise. K+, Na+ and fluid intakes and outputs were balanced within 24 h after a new diet had been introduced. Adaptation consisted primarily of an increase...
Jose-Cunilleras E, Hinchcliff KW.Pharmacologic treatment of diseases of the urinary tract of horses is limited to administration of antibiotics for treatment of urinary tract infections (UTIs), administration of drugs that alter urine pH, administration of drugs that alter bladder smooth muscle function or urethral sphincter tone, and treatment of acute renal failure. The indications, mechanisms of action, pharmacokinetic characteristics, and adverse effects of these agents in each of these groups are discussed in this article. The use of the agents is discussed within the context of the pathophysiology of the disease being t...
Wooldridge AA, Seahorn TL, Williams J, Taylor HW, Oliver JL, Kim DY, Vicek TJ.A 2-year-old quarter horse gelding presented for evaluation of polyuria and polydipsia. Azotemia was detected on serum chemistry profile. Small, misshapen, hyperechoic kidneys with decreased corticomedullary demarcation, hydronephrosis, and a right nephrolith were noted ultrasonographically. The diagnosis of end-stage kidney disease and dysplasia was made histopathologically using ultrasound-guided biopsy. Two ureteroliths were found in the right ureter via cystoscopy, and a nephrolith was seen in the right kidney at necropsy. Clinical, ultrasonographic, and pathologic features of equine uroli...
Dyke TM, Hinchcliff KW, Sams RA.The objectives of this study were to determine the effect of phenylbutazone premedication on the pharmacokinetics and urinary excretion of frusemide in horses; and on frusemide-induced changes in urinary electrolyte excretion. Six Standardbred mares were used in a 3-way crossover design. The pharmacokinetics and renal effects of frusemide (1 mg/kg bwt i.v.) were studied with and without phenylbutazone premedication (8.8 mg/kg bwt per os 24 h before, followed by 4.4 mg/kg bwt i.v. 30 min before frusemide administration). A control (saline) treatment was also studied. Administration of frusemide...
Popot MA, Garcia P, Fournier F, Bonnaire Y, Tabet JC.A threshold concentration for cortisol in equine urine was fixed at 1.0 microgram ml-1 by the racing authorities in 1994. In some circumstances, interlaboratory discrepancies were observed and structural cortisol modification was revealed. In order to elucidate the degradation process and to prevent it, an identification study of the produced compound was carried out. The modified substrate was characterised by the same molecular weight as cortisol and a shorter retention time under the conditions used for the cortisol quantification (M.A. Popot, PhD Thesis, King's College, London, 1996). To i...
Koenig J, Hurtig M, Pearce S, Henderson J, Morris T.Prolonged postoperative recuperation time and restricted exercise were circumvented by using ballistic shock wave lithotripsy to break up an 8-cm diameter vesical calculus and by flushing out the sand-like residue under epidural anesthesia with the horse standing. Recovery was uneventful.
Adams LG, Senior DF.The literal meaning of lithotripsy is the "act of breaking stones." There are two forms of lithotripsy available for use in veterinary medicine: electrohydraulic shock-wave lithotripsy (EHL) and extracorporeal shock-wave lithotripsy (ESWL). With EHL, a shock-wave is generated immediately adjacent to a urolith within the urinary bladder. In dogs, nephroliths or ureteroliths can be successfully treated with ESWL. With ESWL, the shock-waves are generated outside the body and directed toward the urolith.
Traub-Dargatz JL.This article is a review of reports on neoplasia of the equine urinary tract. Clinical signs associated with equine patients with urinary tract neoplasia are summarized along with a description of diagnostic methods used in such patients. The prognosis for treatment of urinary tract neoplasia is guarded. A review of the limited treatments that have been reported to date are also provided in this article.
Sertich PL, Pozor MA, Meyers SA, Brown JS.A 9-year-old Thoroughbred stallion was examined because of breeding dysfunction and possible urethritis. The stallion had good libido and readily obtained an erection, mounted, and intromitted but did not thrust and ejaculate. After mounting the mare, the stallion would squeal and dismount. Endoscopic examination of the urethra and bladder revealed irregular, spiculate yellow crystals (< 1 cm in size) and sabulous deposits; numerous calculi were embedded in the mucosa of the bladder. Because the horse was at the start of a breeding season, the owner would not give permission for general anesth...
Maldonado PA, Montoya TI, Acevedo JF, Keller PW, Word RA.Although the positive effects of vaginal estrogens and the selective estrogen receptor modulator, ospemifene (OS), on the vaginal epithelium are well recognized, less is known regarding the effects of these therapies on the lower urinary tract or vaginal muscularis. Clinical evidence suggests that vaginally administered estrogen may improve overactive bladder-related symptoms. The objective of this study was to compare the effects of OS, vaginal conjugated equine estrogens (CEE), or both on the vaginal wall and lower urinary tract in a rat model of menopause. Contractile force of the bladder n...
Genetzky RM, Hagemoser WA.Two mature horses were examined for changes in laboratory and physical findings after experimentally induced bladder rupture. The postrupture laboratory diagnostic changes, which provide valuable information for a correct diagnosis are described. Hematology, serum and peritoneal fluid sodium, potassium, calcium, phosphorous, creatinine, urea nitrogen, albumin and peritoneal fluid components were measured and evaluated versus time. Hyponatremia and hyperkalemia occurred, as well as increased concentrations of peritoneal fluid potassium and inorganic phosphorus. In addition, peritoneal fluid cre...
Ramsay L, Eberhardt C, Schoster A.Reports of leptospirosis in horses are limited. Objective: To describe the clinical and diagnostic findings of acute systemic leptospirosis in horses. Methods: Eleven client-owned horses presented to an equine hospital because of acute onset of disease between 2015 and 2023. Methods: Retrospective case series. Horses diagnosed with leptospirosis by 1 or more of urine PCR, serologic microscopic agglutination test (MAT), and histopathology. Results: Common clinical signs included lethargy (10), anorexia (10), fever (9), tachypnea (9), abnormal lung sounds (9), and epistaxis (6). Acute kidney inj...
Tharwat M, Al-Sobayil F.Colic or acute abdominal pain is the most prevalent cause of emergency intervention in veterinary medicine, and it has been considered the principal reason for collapse and/or euthanasia in a wide range of studies. The condition may be initiated by a number of different disorders affecting the abdominal viscera, but acute gut disease is the most common etiology in equines showing colic symptoms. of the main goals of colic management is to distinguish between surgical and medical causes, as prompt surgical intervention can significantly improve outcomes for those requiring surgery. Despite the ...
Chaney KP.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...
Knych HK, Arthur RM, Kanarr KL, McKemie DS, Kass PH.Methamphetamine is a central and peripheral nervous system stimulant. There is only a single study that describes exposure to and disposition of this compound in horses. The potential for abuse and inadvertent exposure in equine athletes along with the limited data available necessitates further study. The objectives of the current study were to describe drug and metabolite concentrations, develop an analytical method that could be used to regulate its use, and describe selected pharmacodynamic effects. In phase 1, six horses were randomized into three transmucosal dose groups (n = 2/group; ...
Choi TLS, Wong JKY, Ho ENM, Kwok WH, Leung GNW, Curl P, Wan TSM.Lithium salts are commonly prescribed to treat bipolar disorder in humans. They are effective for the treatment of acute mania and the prophylaxis of manic relapses through long-term use. Although there is no reported legitimate therapeutic use of lithium in horses, its potential mood-stabilizing effect, low cost, and ready availability make lithium salt a potential agent of abuse in equine sports, especially for equestrian competition horses. Lithium can be found in soil, plants, and water, as such it is naturally present in the equine body, thus a threshold is necessary to control its misuse...
Wilson ME.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.
Popot MA, Garcia P, Fournier F, Bonnaire Y, Tabet JC.A threshold concentration for cortisol in equine urine was fixed at 1.0 microgram ml-1 by the racing authorities in 1994. In some circumstances, interlaboratory discrepancies were observed and structural cortisol modification was revealed. In order to elucidate the degradation process and to prevent it, an identification study of the produced compound was carried out. The modified substrate was characterised by the same molecular weight as cortisol and a shorter retention time under the conditions used for the cortisol quantification (M.A. Popot, PhD Thesis, King's College, London, 1996). To i...
Brink P, Schumacher J.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...
Harkins JD, Woods WE, Lehner AF, Fisher M, Tobin T.Clenbuterol is a beta2 agonist/antagonist bronchodilator marketed as Ventipulmin and is the only member of this group of drugs approved by the US Food and Drug Administration (FDA) for use in horses. Clenbuterol is a class 3 drug in the Association of Racing Commissioners International (ARCI) classification system; therefore, its identification in postrace samples may lead to sanctions. Recently, the sensitivity of postrace testing for clenbuterol has been substantially increased. The objective of this study was to determine the 'detection times' for clenbuterol after administration of an oral...
Rivas LJ, Hinchcliff KW.To investigate the effect of i.v. administration of fluids on the furosemide-induced reduction in right atrial pressure (RAP) and relative change in blood volume (BV) of splenectomized mares. Methods: 5 splenectomized mares. Methods: RAP was measured by use of a micromanometer placed in the right atrium. Jugular venous blood was collected for measurement of hematocrit, plasma total protein concentration, and hemoglobin concentration. Right atrial pressure was recorded and blood samples were collected immediately before furosemide (1 mg/kg of body weight, i.v.) administration, then every 15 min...