Sonographic diagnosis of a presumed ureteral tear in a horse.

The study focuses on the use of diagnostic ultrasound in identifying a suspected ureteral tear in a 14-year-old racehorse that was presenting with acute abdominal pain.

Case Presentation and Initial Findings

• The study discusses a case where a 14-year-old thoroughbred racehorse was examined due to complaints of acute abdominal pain.
• Upon physical examination, the medical team discovered that the horse had a tender swollen area located above the bladder and on the right side of the horse’s midline.
• Checking the peritoneal fluid, they learned that it had a creatinine concentration of 15 mg/dl, which was excessively high.

Use of Transrectal Ultrasonograph

• The team conducted a transrectal ultrasonographic examination of the horse’s urinary tract.
• The ultrasound data exhibited a vast collection of fluid seeping from the pelvic area of the right ureter, which extends to the right side of the bladder wall and into the retroperitoneal space.
• There was also a noted thickening of the right ureter and bladder wall near the trigone, an area located at the base of the bladder.

Additional Discoveries and Confirming the Diagnosis

• Cystoscopy, a procedure that examines the lining of the bladder and the tube that carries urine out of the body, revealed moderate hemorrhage within the bladder wall.
• Moreover, the ultrasound revealed air within the retroperitoneal fluid collection after placing a catheter in the ureter, thus confirming the suspected diagnosis of a right ureter’s tear.

Treatment and Observation

• The horse underwent medical treatment and was closely observed in the hospital for 48 hours.
• Using nuclear scintigraphy, a diagnostic procedure which evaluates the kidneys’ function and patient’s blood flow, they observed normal clearance from both kidneys, and there was no apparent leakage from the right ureter.
• The tear in the ureter and the urinary tract were consistently monitored through the use of transrectal ultrasound until they noticed an improvement.

Conclusion

• The horse was able to return to racing successfully as a result of the medical intervention.
• The case demonstrates the effective use of diagnostic ultrasound in identifying and managing a traumatic ureteral tear in a horse.