Bilateral ureterocystostomy in a 450-kg horse with ectopic ureters.

This research article outlines the surgical treatment of a young Clydesdale horse diagnosed with bilateral ectopic ureters, a condition leading to urinary incontinence. The successful procedure resolved the significant issues with bladder control and eventually led to the healing of the related skin condition.

Issue Presentation and Initial Diagnosis

In the study, a yearling Clydesdale filly weighing 450kg suffered from severe malodorous perineal dermatitis. The issue was:

• Largely attributed to urinary incontinence caused by bilateral ectopic ureters – a condition where the ureters do not correctly connect to the bladder.
• The affected horse was only seen urinating 2 or 3 times a week, a frequency well below the norm.
• The urethral sphincter lacked tone, which also plays a role in incontinence.
• The bladder capacity was considerably low, recorded at 800 ml only.

Surgical Intervention

The veterinary doctors opted for a surgical solution, using a midline celiotomy, to correct the ectopic ureters issue. The steps involved in the surgery were as follows:

• The first step was identifying the ureters, which was achieved by cannulation from the ectopic openings.
• They then ligated the ureters and anastomosed the cut ends to the dorsal bladder surface. This was carried out using an extravesicular end-to-side technique.
• A partial thickness seromuscular layer of the bladder was sutured over the ureters, which protected the anastomosis site from tension and securely fixed the ureters to the bladder’s dorsal surface.

Post-Surgical Results and Follow-up Care

The post-surgical recovery period was marked by significant improvement in the horse’s urinary problems:

• The urinary incontinence continued to some extent but gradually improved with time.
• The horse’s bladder capacity incrementally increased over 13 months to 4.3 L.
• Normal urination frequency was restored, with the horse urinating several times a day post-surgery.
• Medical treatments with phenylpropanolamine and estrogen, and surgical treatments for urethral extension were applied to increase the tone of the urethral sphincter.”
• After 11 months from the surgery, the incontinence issue was almost negligible, and the horse’s perineal dermatitis had completely healed.

This case study demonstrates the possibility of a positive outcome by surgical intervention for equines suffering from similar urinary disorders.