Surgical Management of Urolithiasis in Small Ruminants by Urethral Process Amputation.
Obstructive urolithiasis occurs due to formation and lodgement of calculi along the course of urinary tract. Abnormally high concentrations of insoluble complexes in urine or nidus mineralization favour urolith formation (Smith and Sherman, 1994). Although the actual cause is not fully understood but multiple factors are associated with calculi formation. In ruminants, the calculi are usually lodged at the sigmoid flexor or at urethral process (Radostits et al., 2000; Kushwaha et al., 2014). The present report pertains to the management of obstructive urolithiasis in adult sheep and goat, by amputation of urethral process along with therapeutic management.
Materials and Methods
Adult male sheep (3) and goat (1) were presented with history of inability to urinate since 18-24 hrs. All animals had inappetance, grating of teeth, muscle twitching, tenesmus and performed futile urination attempts frequently. They had been fed grains and drank little water due to the cold climatic condition. Upon clinical examination, raised pulse and respiration rate but normal temperature was recorded in these animals. One sheep was dull but remaining showed slightly excited behaviour. Abdominal palpation revealed distended bladder. Urethral process examination revealed lodged calculi. Ultrasonography revealed calculi/sludge in intact distended bladder (Fig. 1) in all animals but calculi were detected in intact urethra of two sheep only (Fig. 2). It was decided to manage the case by urethral process amputation along with the operative care.
The animals were propped up on the rump. The penis was grasped through the skin at the base of scrotum and then forced cranially to expose the glans penis. After grasping the glans with dry gauze, the urethral process was amputated at its base. After the procedure, one sheep and a goat (that had clear urethra on USG) passed urine instantly. In the remaining two sheep, post amputation injection of the total dose of 5 mg Dicyclomine ([Spasmovet.sup.a]) was given IM. Repeated massaging of the preputial area upto 15 min lead to urination. All the cases were put on oral Ammonium chloride @ 200 mg/kg b.wt. [Meloxicam.sup.b] (Melonex) @ 0.3-0.5 mg/kg b.wt was prescribed for three days. Farmers were advised to perform preputial massage twice daily for a week. The change in diet (decrease in grain feeding, addition of common salt) along with frequent and easy access to drinking water was also advised. Upon telephonic conversation with animal owners, recurrence was not noticed up to a month post treatment.
Results and Discussion
Urolithiasis is a common clinical emergency of male ruminants seen most frequently in winter and summer seasons (Tamilmahan et al., 2014; Singh et al., 2008). In the current study, cases were seen in winter only. Decreased water intake along with deficiency of Vitamin A due to shortage of green fodder might have contributed to urolith formation (Radostits et al., 2000; Gugjoo et al., 2013). The grains contain more concentration of silica, might also have contributed (Wang et al, 1997). In contrast to the previous reported studies ( Amarpal et al., 2013) animals included in this study were all adults. Feeding grains, little water intake and the presence of high phosphate in water and soil in this geographied region might have played role.
Obstructive urolithiasis can be managed conservatively or surgically. The conservative treatment is employed when obstruction is partial, complete obstruction demands immediate surgical intervention (Amarpal et al., 2013; TamilMahan et al., 2014). In all current surgical procedures, the main aim is to bypass the urine till the calculi obstructing the urethra are dissolved (Amarpal et al., 2013). The initial procedure of urethral process resection resulted in resumption of urination in 50% of animals. The injection of antispasmodic helped in relieving the obstruction in the remaining animals. Recurrence rate following resection of urethral process in small ruminants is reportedly high (Tibary and Metre, 2004). In order to decrease the chances of recurrence rate medication to acidify the urine and alteration in the type of feed are important measures, the owners should be made aware of.
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M.B. Gugjoo (1), H. Athar, R.A. Ahmad, Mehraj Dar and M.R. Fazili
Veterinary Clinical Services Complex Faculty of Veterinary Sciences and Animal Husbandry Sher-e-Kashmir University of Agricultural Science and Technology-Kashmir (SKUAST-K) Shuhama, Alusteng Srinagar - 190006 (Jammu and Kashmir)
(1.) Corresponding author.
(a) - Brand of Vetoquinol India Pvt Ltd., Mumbai
(b) - Brand of Intas Animal Health, Ahmedabad
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|Title Annotation:||Clinical Article|
|Author:||Gugjoo, M.B.; Athar, H.; Ahmad, R.A.; Dar, Mehraj; Fazili, M.R.|
|Article Type:||Clinical report|
|Date:||Jul 1, 2017|
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