One tip I have for urethral uroliths in general, is to attempt to flush the urethra via catheter. If a urinary catheter won't pass, or uroliths remain in the urethra (always check for these with radiographs), then retropulsing the urolith into the bladder is an option. They can then be easily removed via cystotomy. We perform this minimally invasively via a small incision at VSS. For retropulsion, imagine you are trying to gently fill the urethra up with saline like a balloon. You need to close off both 'ends' to obtain filling - the proximal urethra (bladder end), and the distal urethra (penis end). You can do this by applying pressure to the proximal urethra (bladder end) via rectal i.e. push ventrally onto the urethra via rectal, or alternatively you can perform this intra-operatively with your fingers around the proximal urethra, or gently plugging the urethra with your finger. Fill the urethra via urinary catheter into the distal penis (pinch off at this end as well to obtain filling pressure). Then when you feel the pressure from filling at the proximal urethra, release the pressure, continue to flush, and the hope is that the urolith will move with this 'flushing' pressure. Keep repeating this process until it is in the bladder. Having an assistant helps.
This goat had a urolith lodged in his urethra, which was obstructing urine outflow from the bladder.
I used to have a pet goat at university (flossy) and I love goats! So it made my day to see this especially handsome goat in the hospital this morning. The Animal Emergency Services helped him out overnight as some of the large animal vets were inaccessible or closed due to the Brisbane floods. Sadly for us (but happily for the goat), a large animal vet was found first thing in the morning to treat him. Good luck!
Comments