Peer-reviewed veterinary case report
Minimally invasive removal of obstructive ureteral stones by intracorporeal lithotripsy in horses: 3 patients.
- Journal:
- The Canadian veterinary journal = La revue veterinaire canadienne
- Year:
- 2023
- Authors:
- Ternisien, Thomas et al.
- Affiliation:
- CHUV (Ternisien · Canada
- Species:
- horse
Plain-English summary
Three horses with blocked ureters due to stones were treated using a minimally invasive technique that involved looking inside the ureters and breaking up the stones with special tools. Tests showed that all three horses had some kidney issues and were experiencing blockage. The procedures were done while the horses were awake but sedated, and in two cases, a small incision was made to help with the treatment. All three horses had successful surgeries, with no pain or complications afterward, and they were able to go home from the hospital.
Abstract
Three client-owned horses diagnosed with obstructive ureteral stones were referred and treated in a minimally invasive manner by retrograde ureteroscopy in conjunction with electrohydraulic lithotripsy (EHL) or laser Holmium:YAG lithotripsy (HYL). For all 3 horses, additional tests revealed variable degrees of azotemia and ureteral obstruction. Ultrasound examination (2 horses) revealed a loss of cortico-medullary distinction consistent with a chronic nephropathy. Ultrasound-guided biopsy of the right kidney in 1 horse revealed moderate glomerulosclerosis and lymphoplasmacytic nephritis. A standing anesthesia with a coccygeal epidural was done for each horse. A perineal urethrotomy was performed in 2 horses before the urethrocystoscopy. One horse was treated with Holmium:YAG laser lithotripsy and 2 others were treated using a electrohydraulic lithotripsy probe. Each procedure was successful. The ureteroscopy was successfully performed and visualization was excellent. Fragmentation of stones seemed easier with the electrohydraulic lithotripsy probe. No complications, pain, or signs of discomfort after the procedure were noticed. All 3 horses were discharged from the hospital. Key clinical message: Obstructive ureteral stones in horses can be successfully treated in a minimally invasive manner by retrograde ureteroscopy accompanied by lithotripsy. This technique is safe, not painful and did not require general anesthesia. Electrohydraulic lithotripsy appeared superior for stone fragmentation.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/36593938/