Surgical Management of Obstructive Urolithiasis in an Ongole bullock.
Urolithiasis is a metabolic disorder observed in both sexes of animals, but clinical signs of obstructive urinary caliculi are primarily a problem of castrated adult males because of the anatomical confirmation of their urinary tract (Larson, 1996; Rodostits et al., 2000). In India, urolithiasis has been commonly reported in bullocks (Gera and Nigam, 1979). Present report described the obstructive urolithiasis and its surgical correction in an Ongole bullock.
History and Clinical Observations
A five year old, Ongole bullock weighing around 500kg, was presented with complaint of not passing urine since last two days. History revealed that the animal was anorectic, restless, frequently lying down and getting up since last twenty four hours. On physical examination, the animal was straining with prolapsed rectal mucosa, swollen perenial region, dry muzzle with sunken eyes indicating dehydration. Per rectal examination revealed abnormally distended urinary bladder. Based on the physical and clinical examination, the condition was diagnosed as urethral obstruction and animal was prepared for surgical correction.
Treatment and Discussion
The animal was prepared for aseptic surgery and anaesthesia was achieved by intravenous administration of mixture of Ketamine @ 5 mg /kg b.wt and Diazepam @ 0.2mg /kg b.wt IV followed by local infiltration with 2% Lignocaine Hcl at the operative site.
A 10cm long left paramedian incision parallel to penis was made anterior to rudimentary teats between the scrotum and umbilicus. The distended bladder was incised at the dorsal end of vertex to drain the accumulated urine. Bladder was exteriorized through laporotomy incision and multiple cystic caliculi of varying size in neck region were retrieved (Fig.1). Urinary bladder was flushed with normal saline and an indwelling catheter was passed through the neck of bladder to locate the site of urethral obstruction. The urethroliths were removed by conducting post scrotal urethrotomy distal to the sigmoid flexure ( Fig. 2). Catheter was then passed through the urethrotomy site to the prepucial opening. The catheter at the bladder end was fenestrated and its prepucial end was anchored to the prepucial sheath. The cystotomy incision was closed by double inversion suture pattern using no.2-0 chromic catgut. Laporotomy incision was closed in routine manner. Urethra was closed by simple continuous pattern using no. 2-0 chromic catgut over the indwelling catheter.
Post-operatively the animal was administered Inj. Meloxicam ([Melonex.sup.a])@ 0.5 mg/ kg b. wt., IM and Amoxicillin and Cloxacillin @ 10 mg/kg b.wt., IM for five days respectively. Intravenous fluid therapy (0.9% NaCl) was administered @15ml/kg b. wt. for seven days. Antiseptic dressing was carried out regularly.
In the present case, signs of distress and straining were subsided immediately after removal of obstruction and normal urine flow was re-established. Animal recovered uneventfully with normal urination and sutures and catheter were removed on twelveth post-operative day.
Urolithiasis is a disease of multifactorial origin. Factors like diet, age, sex, breed, genetic makeup, season, soil, water, hormone levels, mineral, infection etc play a role in genesis of urolithiasis (Udall and Chow,1969). The treatment of obstructive urolithiasis is primarily surgical intervention (Larson, 1996). But the choice of procedure depends on extent of tissue damage secondary to obstruction, value of the animal and owners expectation for continued use of animal.
Caliculi retrieved in the present case were smooth, round, numerous and chalky of variable sizes and gross morphology findings indicate, uroliths retrieved were phosphate caliculi and these findings are in accordance with Loretti et al. (2003). As the animal was fed on high concentrate diet with low roughages might have contributed to the formation of phosphate caliculi in the present case as opinioned by Radostits et al., 2000). Post-operative complications like uroperitonium and seepage of urine at the urethretomy site were not observed in the present case.
Gera, K.L. and Nigam, J.M. (1979). Urolithiasis in Bovines-A report of 193 clinical cases. Indian Vet. J. 56: 417-23.
Larson, B.L. (1996). Identifying, treating and preventing bovine urolithiasis. Vet. Med. 91: 366-77.
Loretti, A.P. et al. (2003). Clinical and pathological study of an outbreak of obstructive urolithiasis in feedlot cattle in southern Brazil. Pesquisa Veterinaria-Brasileira. 23: 61-64.
Radostits, O.M. et al. (2000). Veterinary Medicine - A Textbook of the Diseases of Cattle,Sheep, Pigs, Goats and Horses. Bailliere Tindall, London.
Udall, R.H. and Chow, F.H. (1969). The etiology and control of urolithiasis. Adv. Vet. Sci. Comp. Med. 13: 29-57.
P. Vidya Sagar (1), M. Raghunath (2) and P. Ravi Kumar (1)
Teaching Veterinary Clinical Complex N.T.R. College of Veterinary Science Sri Venkateswara Veterinary University (SVVU) Gannavaram - 521301 (Andhra Pradesh)
(1.) Assistant Professor, Department of Surgery and Radiology.
(2.) Associate Professor/ Head and Corresponding author.
(3.) Retired Professor, Department of Surgery and Radiology
(a) - Brand of Intas Animal Health, Ahmedabad
Australian Veterinary Association (AVA) Annual Conference
13-18th May' 2018
Brisbane, Queensland, Australia
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|Title Annotation:||Short Communication|
|Author:||Vidya Sagar, P.; Raghunath, M.; Kumar, P. Ravi|
|Article Type:||Clinical report|
|Date:||Jul 1, 2017|
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