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Journal of veterinary internal medicine2024; 38(5); 2795-2800; doi: 10.1111/jvim.17181

Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse.

Abstract: A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent placed in the urethra after which the horse was able to void normally and fully empty his bladder. Repeat urethroscopy and ultrasonography 6 months after the procedure showed the stent to have completely reabsorbed with urethra remaining patent. Nineten months after the procedure, the owner reports the horse remaining at his intended level of athletic performance with no dysuria.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-09-12 PubMed ID: 39262299PubMed Central: PMC11423433DOI: 10.1111/jvim.17181Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This is a case study about a 10-year-old horse who suffered complications due to general anesthesia, which resulted in urinary problems and urethral stricture. This was resolved through the image-guided placement of a custom-made stent that was reabsorbed, allowing the horse to return to its normal level of athletic performance.

Background

  • The subject of the case study is a 10-year-old Irish Sport Horse gelding that experienced complications following general anesthesia, specifically needing sling support and recurrent urinary catheterization.
  • Clinical implications of these complications included dysuria (painful urination) and pollakiuria (frequent urination), signs of a urinary tract disorder. The horse was ultimately diagnosed with sabulous cystitis, a bladder inflammation related to the formation of gritty, sandy residue.
  • The recurrent catheterization resulted in another complication – a urethral stricture or narrowing of the urethra. This was confirmed through urethroscopy, an endoscopic examination of the urethra.
  • Attempts at conservative management, such as topical corticosteroids and urethral bougienage with balloon dilators to widen the urethra, didn’t yield the desired results and the clinical signs persisted.

Treatment Approach

  • The medical team opted for a minimally invasive image-guided approach in treating the stricture. This involved using an echogram or ultrasound to guide the placement of a stent inside the urethra.
  • The stent used was custom-made from polydioxanone, a biodegradable material known for its tensile strength and flexibility, which makes it suitable for mechanically challenged applications such as stents.
  • The procedure, which was conducted while the horse was standing and under sedation, allowed the horse to resume regular urination and fully empty his bladder, indicating the restoration of normal urinary function.

Outcome and Follow-up

  • Repeat examinations of the urethra through urethroscopy and ultrasonography six months after the procedure revealed the stent to have completely reabsorbed leaving the urethra fully patent or open.
  • Nineteen months post-procedure, the horse maintained its previously intended level of athletic performance without any recurrence of dysuria, as reported by the owner. This suggested the long-term success of the treatment in this case.

Cite This Article

APA
Baltrimaite M, Kearney C, O'Brien A, Duggan M, Cuq B. (2024). Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse. J Vet Intern Med, 38(5), 2795-2800. https://doi.org/10.1111/jvim.17181

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 38
Issue: 5
Pages: 2795-2800

Researcher Affiliations

Baltrimaite, Milda
  • Section of Equine Clinical Studies, Anaesthesia and Diagnostic Imaging, University College Dublin School of Veterinary Medicine, Dublin, Ireland.
Kearney, Clodagh
  • Section of Equine Clinical Studies, Anaesthesia and Diagnostic Imaging, University College Dublin School of Veterinary Medicine, Dublin, Ireland.
O'Brien, Anne
  • Section of Equine Clinical Studies, Anaesthesia and Diagnostic Imaging, University College Dublin School of Veterinary Medicine, Dublin, Ireland.
Duggan, Michael
  • Section of Equine Clinical Studies, Anaesthesia and Diagnostic Imaging, University College Dublin School of Veterinary Medicine, Dublin, Ireland.
Cuq, Benoît
  • Section of Small Animal Clinical Studies, University College Dublin School of Veterinary Medicine, Dublin, Ireland.

MeSH Terms

  • Horses
  • Animals
  • Male
  • Urethral Stricture / veterinary
  • Urethral Stricture / surgery
  • Urethral Stricture / therapy
  • Horse Diseases / therapy
  • Stents / veterinary
  • Urinary Catheterization / veterinary
  • Urinary Catheterization / instrumentation
  • Absorbable Implants / veterinary

Conflict of Interest Statement

Authors declare no conflict of interest.

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