Ureteropyeloscopic removal of a nephrolith from a 19 year old Hanoverian gelding.
Authors: Moss Alexandra L, Acutt Elizabeth V, Ullal Tarini, Applegate Tanya J, Hackett Eileen S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Ureteropyeloscopic Removal of Equine Nephroliths Nephroliths represent a challenging complication of equine urolithiasis, traditionally managed through nephrectomy with inevitable loss of renal function. This case report documents a 19-year-old Hanoverian gelding presenting with abdominal straining and stranguria, found to have both a proximal urethral calculus and left-sided kidney stones. Over two consecutive days under standing sedation, clinicians performed perineal urethrostomy to relieve the urethral obstruction, then used the resulting access point to guide an endoscope into the renal pelvis for nephrolith retrieval. The horse recovered without complications, returned to ridden work within a fortnight, and remained free of urinary dysfunction at seven-month follow-up. This case demonstrates that ureteropyeloscopic removal is technically feasible in horses and critically preserves ipsilateral kidney function—a substantial advantage over nephrectomy, particularly given that equine urolithiasis frequently affects both kidneys bilaterally. Whilst this remains an advanced procedure requiring specialist equipment and expertise, it expands the treatment options available to veterinarians managing horses with nephroliths and merits consideration in referral settings where such intervention is possible.
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Practical Takeaways
- •Ureteropyeloscopic removal is a viable option for nephroliths in standing sedated horses and avoids the permanent kidney loss associated with surgical nephrectomy
- •Horses can return to work quickly (2 weeks) after successful endoscopic calculus removal
- •Consider this kidney-sparing technique when managing uroliths, especially in cases where bilateral kidney involvement is possible or likely
Key Findings
- •Ureteropyeloscopic removal of a nephrolith from the renal pelvis was successfully completed in a 19-year-old gelding standing under sedation
- •No post-operative complications occurred and the horse returned to athletic activity within 2 weeks
- •Kidney function was preserved with no recurrent urinary clinical signs at 7-month follow-up
- •This endoscopic approach offers functional kidney preservation compared to nephrectomy, particularly valuable since urolithiasis frequently affects both kidneys