Ureteropyeloscopic anatomy of the renal pelvis of the horse

Ureteropyeloscopic removal of a nephrolith from a 19 year old Hanoverian gelding

OBJECTIVE

To describe the ureteropyeloscopic removal of a nephrolith in a horse.

ANIMALS

A 19 year old Hanoverian gelding with history of urolithiasis requiring surgical intervention.

STUDY DESIGN

Case report METHODS: The horse presented with signs of abdominal straining and stranguria. A proximal urethral calculus was palpable externally within the perineal urethra. Perineal urethrostomy (PU) at the location of the urethral calculi was performed to remove the urethral obstruction. Left nephrolithiasis was then treated by endoscopic retrieval, inserting the endoscope through the PU. The procedures were performed over 2 consecutive days, with the horse standing and sedated. Medical therapy included antimicrobial and anti-inflammatory treatment.

RESULTS

The ureteropyeloscopic removal of a nephrolith from the left renal pelvis was completed. No complications were appreciated following the procedure, and the horse was able to return to athletic activity within 2 weeks. The horse had no further clinical signs referable to urinary dysfunction 7 months later.

CONCLUSION

Ureteropyeloscopic removal of a nephrolith from the renal pelvis is technically feasible in the equine patient and preserves function of the affected kidney. The availability of a treatment that maintains renal function is a distinct benefit over unilateral nephrectomy, particularly when treating a condition that frequently involves both kidneys.

Relevant Equine Renal Anatomy, Physiology, and Mechanisms of Acute Kidney Injury: A Review

Regulation of renal blood flow is by both extrinsic and intrinsic systems. Intrinsic regulation occurs via the afferent and efferent arterioles and tubuloglomerular feedback mechanisms with activation of the juxtaglomerular apparatus. Mechanisms of acute kidney injury are frequently associated with changes in renal blood flow. Acute tubular necrosis and apoptosis are common in horses following ischemic or toxic insults and in sepsis-associated acute kidney injury. Sepsis-associated renal injury often has a complex mechanism of disease involving both functional and obstructive changes in intrarenal circulation. Acute interstitial nephritis may occur following Leptospira sp infection or can be secondary to tubular necrosis.

Imaging of the Urinary Tract

This article provides a comprehensive review of imaging techniques used to evaluate the equine urinary tract. This overview includes officially recognized modalities and new applications reported in the most current literature. Technical aspects and indications for use of endoscopy and ultrasonography are highlighted. Normal endoscopic and ultrasonographic appearance of the upper and lower urinary tract is described, with characterization of common abnormalities found in patients with hematuria, stranguria, and renal failure. Visual examples of several pathologic conditions from clinical cases are provided. An outline of the main features, potentials, and limitations of radiography, nuclear scintigraphy, and computed tomography is provided.

Corrosion casting in anatomy: Visualizing the architecture of hollow structures and surface details

Corrosion casting is the technique by which a solid, negative replica is created from a hollow anatomical structure and liberated from its surrounding tissues. For centuries, different types of hardening substances have been developed to create such casts, but nowadays, thermosetting polymers are mostly used as casting medium. Although the principle and initial set-up are relatively easy, producing high-quality casts that serve their intended purpose can be quite challenging. This paper evaluates some of the more popular casting resins that are currently available and provides a step-by-step overview of the corrosion casting procedure, including surface casts of anatomical structures. Hurdles and pitfalls are discussed, along with possible solutions to circumvent them, based on personal experience by the authors.

Filho I, Guedes R, Dornbusch P. Sondagem da pelve renal guiada por cistoscopia em éguas

RESUMO O objetivo deste trabalho foi padronizar a técnica de acesso à pelve renal por meio de sondagem ureteral guiada por cistoscopia em éguas. Foram utilizados oito animais, de raças variadas, com peso médio de 439kg. As éguas foram sedadas e mantidas em tronco de contenção para a realização da cistoscopia com endoscópio flexível. Após identificação do óstio ureteral esquerdo, uma sonda de polietileno foi introduzida em seu lume, até a pelve renal. A localização da sonda no rim foi confirmada por meio de ultrassonografia transcutânea. Foram coletados 3mL de urina, de forma asséptica, para citologia e cultura bacteriana. Todas as amostras obtiveram resultados negativos na cultura e análise do sedimento urinário. Nenhum dos animais apresentou quaisquer complicações após a sondagem. Este estudo demonstrou que a coleta de urina diretamente da pelve renal em éguas, com auxílio da cistoscopia na realização da sondagem ureteral, consiste em um procedimento viável e seguro.