The Use of Pneumatic Impact Lithotripsy in a Laparoscopic Retrieval Pouch for Removal of Large Cystoliths in Two Female Horses |
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| Institution: | 1. Department of Clinical Sciences, Ross University, School of Veterinary Medicine, St Kitts;2. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA;3. San Luis Rey Equine Hospital, Bonsall, CA;1. Department of Veterinary Medicine, Animal Reproduction, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, Brazil;2. Department of Veterinary Medicine, Surgery and Anaesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, Brazil;3. Department of Veterinary Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil;4. Department of Veterinary Medicine, Clinic of Large Animals, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, Brazil;1. Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL;2. Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL;3. Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL;1. Department Large Animal Clinical Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada;2. Department of Animal and Poultry Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada;3. Department of Veterinary Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada;1. Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki, Japan;2. Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan;3. Center for Animal Diseases Control, University of Miyazaki, Miyazaki, Japan;4. Miho Training Center, Racehorse Clinic, Japan Racing Association, Ibaraki, Japan;5. Ritto Training Center, Racehorse Clinic, Japan Racing Association, Shiga, Japan;1. Racehorse Hospital, Miho Training Center, Japan Racing Association, Ibaraki, Japan;2. Laboratory of Racing Chemistry, Utsunomiya, Tochigi, Japan;3. Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga, Japan;4. Equine Department, Japan Racing Association, Tokyo, Japan |
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| Abstract: | Two mares, aged 15 and 21 years, were examined because of urinary incontinence, intermittent hematuria, and urine scalding. On admission of both horses, physical parameters were within normal limits and urine scalding of the skin at the ventral perineum was noted. Transrectal palpation and cystoscopy revealed a large type I cystolith (>10 cm) with associated hyperemia and focal ulceration of the bladder mucosa. In horse 1, hemogram, serum biochemical analysis, and renal ultrasound were not performed because of owner finances. In horse 2, results from hematological and serum biochemical analysis were unremarkable and renal ultrasonography did not reveal any abnormalities. Pneumatic impact lithotripsy in a laparoscopic retrieval pouch was performed under cystoscopic guidance after caudal epidural anesthesia, with the horses standing and under sedation. A laparoscopic retrieval device was passed alongside a flexible endoscope into the urinary bladder and the cystolith was manipulated into the pouch. A customized single stainless-steel rod scaler attached to an air compressor was used for fragmentation of the cystolith contained within the retrieval pouch. Lithotripsy time was 42 minutes for horse 1 and 31 minutes for horse 2. Both horses were released from hospital the day of surgery. Both horses were continent and voided normal streams of urine for the duration of the follow-up periods of 27 and 19 months for horse 1 and horse 2, respectively. Pneumatic impact lithotripsy in a laparoscopic retrieval pouch provided a time-efficient and minimally invasive surgical treatment option for removal of large cystoliths in mares. |
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| Keywords: | Horse Bladder Bladder stone Cystolithiasis Lithotripsy Minimally invasive |
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