Difficulty urinating, bloody urine
A 21-year-old cutting horse gelding was experiencing problematic symptoms including difficulty urinating and bloody urine.
His owner, Dr. Peter Bernstein, had the sorrel horse named Peppy examined by his primary care veterinarian. His vet identified two stones in the gelding’s bladder. They decided it was best for the Quarter Horse to go to UC Davis Veterinary Hospital for treatment.
Dr. Scott Katzman recommended removing the bladder stones surgically while utilizing standing sedation through a new technique developed at UC Davis. It involves the combined efforts of equine surgery, ultrasonography, and anesthesia specialists.
A board-certified anesthesiologist provides epidural anesthesia maintaining standing sedation during surgery. Local anesthesia also helps keep the horse relaxed.
After removing the first stone, Dr. Pablo Espinosa performed a perineal urethrostomy (PU), which allowed for direct access to Peppy’s bladder.
The second stone was also visualized endoscopically and maneuvered into a laparoscopic retrieval pouch. Radial shock wave lithotripsy is utilized to break up the stone until all fragments contained within the pouch can be removed from the PU site. This technique allows for containment, stabilization, fragmentation and rapid removal of bladder stones in the standing sedated horse, according to the surgeons. They say this approach leads to improved outcomes.
The following day, the hospital repeated an endoscopy of the urinary tract, which revealed that no stone fragments remained. The veterinarians, students, and staff at the large animal hospital monitored Peppy closely after his surgery. He also received systemic anti-inflammatories and antibiotics.
“Peppy was feeling great again shortly after the surgery,” Dr. Bernstein, his owner said. “I’m so grateful to Dr. Katzman and everyone at UC Davis for coming up with an innovative solution to Peppy’s condition. Throughout the entire process, Dr. Katzman was so responsive and took wonderful care of Peppy.”
Dr. Bernstein works as a psychologist. He helps veterans recover from post-traumatic stress disorder (PTSD) and similar conditions. Dr. Bernstein says his bond with Peppy helps him de-stress from his job’s emotional rigors.
“I try to take a break every afternoon and spend time with the horses and get in a workout,” said Dr. Bernstein, who has worked with sports horses for 30 years. “Horses are an amazing outlet that way.”
Peppy made a full recovery and is back to his life as a cutting horse.