Tube cystostomy for management of obstructive urolithiasis in ruminants

Obstructive urolithiasis in buffalo calves (Bubalus bubalis): Serum changes of Vitamins A and D and efficacy of surgical management using tube cystostomy

Background and Aim:

Obstructive urolithiasis is one of the major health problems in livestock animals, mainly in young calves. The present study was designed first to investigate the changes in the serum levels of Vitamins A and D in buffalo calves (Bubalus bubalis) with obstructive urolithiasis and second to investigate the efficacy of tube cystostomy technique in management of such condition.

Materials and Methods:

One hundred and forty-nine buffalo calves of variable ages ranged from 3 to 7 months with a history of retained urine were examined clinically and ultrasonographically. Then, they were subjected to surgical treatment using the tube cystostomy technique. The serum levels of Vitamins A and D were investigated in retained urine calves in addition to 10 clinically healthy calves of the same age used as a control group.

Results:

Based on clinical and ultrasonographic findings, the calves were diagnosed as obstructive urolithiasis with intact bladder (n=64 calves) or with bladder rupture (n=85 calves) with the peak incidence in winter months. Tube cystostomy was an efficient and quick surgical technique for the management of such condition and 95.3% of calves returned their normal urination within 7–14 days after surgery. Significant hypovitaminoses A and D were found between retained urine calves and control ones (p= 0.01 and 0.002, respectively).

Conclusion:

Hypovitaminoses A and D suggested predisposing obstructive urolithiasis in buffalo calves, but further clinical studies are recommended for more confirmation. Surgical treatment using tube cystostomy technique is recommended for the management of obstructive urolithiasis in buffalo calves.

Management of Urologic Conditions in Small Ruminants

Small ruminants frequently experience urologic conditions, such as obstructive urolithiasis, posthitis, vulvitis, and urinary tract infections. Urologic conditions are more common in male small ruminants, especially castrated males, primarily due to their anatomy. Traditionally, urologic conditions warranted culling from the herd without significant efforts in treatment. However, more goats and sheep are now being kept as pets. Small ruminant owners have strong emotional attachments to their animals and are more likely to seek treatment of medical disorders, including urologic conditions. Surgical or medical treatments are available. Conditions also may be avoided through hydration, diet, hygiene, and other means.

Risk factors for, frequency, and type of complications after temporary tube cystostomy in goats, sheep, and pigs

OBJECTIVE

To describe risk factors for as well as type and frequency of complications, time to occurrence of complications, and mortality after temporary tube cystostomy alone or in combination with other surgical procedures, in goats, sheep, and pigs.

STUDY DESIGN

Retrospective case series.

ANIMALS

One hundred thirteen goats, eight sheep, and six pigs.

METHODS

Medical records of goats, sheep, and pigs that underwent temporary tube cystostomy alone or in combination with urethrotomy at the Veterinary Medicine Teaching Hospital, University of California-Davis from January 1, 2007 to December 31, 2018 were reviewed. Signalment, presurgical and surgical procedures, urolith type and location, and postoperative complications and mortality were analyzed. In goats, logistic regression analysis was performed to determine association between the presence of complications or mortality as well as candidate predictor variables.

RESULTS

Postoperative complications were reported in 54.9% (62/113) of goats, 37.5% (3/8) of sheep, and 50% (3/6) of pigs. The most frequent type of complication was reobstruction. Median (range) time to first complication was 171 days (1-2247) for goats. In sheep and pigs, the range for time to re-presentation for complications was 11 to 37 and 17 to 1182 days, respectively. Proportions of nonsurvivors after tube cystostomy were 48.4% (30/62) goats, 1/8 sheep and 2/6 pigs. No association between examined predictor variables and the occurrence of complications or mortality was detected.

CONCLUSION

The risk of complications and mortality after temporary tube cystostomy was high, especially in goats.

CLINICAL SIGNIFICANCE

Owners should be made aware of the high complication rate after temporary tube cystostomy alone or in combination with other procedures. Investigation of alternative approaches to manage obstructive urolithiasis in goats, sheep, and pigs should be considered.

Variables of initial examination and clinical management associated with survival in small ruminants with obstructive urolithiasis

BACKGROUND

Obstructive urolithiasis is a common disease associated with a guarded prognosis in small ruminants.

HYPOTHESIS/OBJECTIVE

The results of physical examination, laboratory analyses, and clinical management of male small ruminants presented to 2 referral clinics were investigated to identify variables significantly associated with disease outcome, so as to provide better recommendations to animal owners regarding the management of these patients.

ANIMALS

Two-hundred ten small ruminants (130 sheep and 80 goats) with confirmed diagnosis of obstructive urolithiasis.

METHODS

Clinical findings (including diagnostic imaging) and laboratory results of the 210 animals were reviewed, and relevant information regarding clinical and laboratory variables recorded upon admission and clinical management was retrieved. The association of the different variables with nonsurvival was investigated by univariable and multivariable logistic regression models.

RESULTS

Only 39% of all patients considered for treatment and 52% of those undergoing tube cystostomy survived to be released from the clinic. Nonsurvival was strongly associated with a very poor clinical condition upon presentation, obesity, castration, and evidence of uroperitoneum. Among blood variables, abnormal PCV, severely increased serum creatinine concentrations, and increased activity of the creatine kinase were associated with increased risk of nonsurvival. Presence of signs of colic or macroscopic appearance of urine was not significantly associated with outcome.

CONCLUSIONS AND CLINICAL IMPORTANCE

The prognosis of obstructive urolithiasis was guarded with survival rates of 39% (overall) to 52% (after tube cystostomy). Intact young males with normal body condition presented early in the course of disease had the best chances of survival.

Clinical findings and diagnostic procedures in 270 small ruminants with obstructive urolithiasis

Background

Details of the clinical signs of obstructive urolithiasis in male small ruminants have not been documented in a large population.

Objective

To describe the clinical presentation and diagnostic procedures in a large group of small ruminants with urolithiasis.

Animals

Two hundred and seventy small ruminants (158 sheep and 112 goats).

Methods

Retrospective study of 270 cases identified based on clinical records.

Results

81.2% affected goats were castrated and 91.7% sheep were intact males; 65.5% of the animals had been sick ≤2 days before referral. Common abnormalities included dysuria (93.6%), indigestion (84.4%), reduced general state of health (79.5%), signs of pain (73%), increased heart and respiratory rates (53.6% and 39.1%), and azotemia (89.4%). Blood urea nitrogen (BUN) and creatinine concentrations were strongly correlated (r² = 0.81). Hypochloremia (52.2%), hyponatremia (43.3%), hypophosphatemia (52.4%), and abnormal potassium concentrations (26.2% hypokalemia and 24.5% hyperkalemia) were the most common serum electrolyte imbalances. Packed cell volume (PCV), plasma proteins, potassium, BUN, and creatinine concentrations were significantly increased in animals with uroperitoneum. Ultrasonography allowed for confirmation of diagnosis in 83.9% of the cases (135/161 with sufficient available information), uroliths were visible on 34 of 56 plain radiographs.

Conclusions and Clinical Importance

Our study confirmed that clinical and ultrasonographic examinations are sufficient to diagnose urolithiasis. Clinical signs can be divided into an early stage with discrete unspecific clinical signs, a painful stage with frequent straining, expression of pain and moderately reduced general condition, and an advanced stage with a markedly reduced general condition and eventually recumbency.

Perineal urethrostomy to treat obstructive urolithiasis in a captive hand-raised steenbok (<i>Raphicerus campestris</i>)

The steenbok (Raphicerus campestris) is a small antelope of the family Bovidae native to the African continent. Urolithiasis, the formation of urinary calculi in the urinary tract, can be caused by a variety of factors such as diet, dehydration, infection and anatomical predisposition. Urolithiasis, with uroliths identified as magnesium calcium phosphate carbonate in composition, was diagnosed in a hand-reared 5-month-old steenbok. Perineal urethrostomy was performed as a component of the broad treatment regime that included fluid therapy, antibiotic and anti-inflammatory treatment. However, the animal died 4 days later as a result of systemic hypoxia and energy depletion because of stress and cachexia. The challenges of post-surgical treatment, the importance of positive energy balance in small ruminants under stressful circumstances, as well as the role of diet of hand-reared antelope in predisposition to urolith formation are highlighted.