D. E. Larsen, DVM
I hurried along Berlin Road as the last of the daylight was fading into twilight. Hank had an old horse down with colic. I always dreaded colic calls. Many were simple fixes, but there was no place close to send them for abdominal surgery if it was a complex colic. Few clients would be willing to take their horse six or seven hundred miles for surgery.
I slowed as I approached Hank’s place. The old workhorse was down in the front yard. I could see several guys holding the horse to keep him from rolling. That was my instruction to Hank when I took the call. Often times a simple colic became a fatal colic when the horse would roll and end up twisting a gut.
“Good evening, Doc,” Hank said as I stepped out of the truck. “I’m sorry for calling you this evening. Old Bob has been getting worse for the last few hours. I could tell something wasn’t quite right with him earlier today, but the last few hours have been pretty rough. After talking with you, I got these guys to help hold him down.”
“Don’t worry about having called me, Hank. If you hadn’t called now, you would have called by midnight, and things would have far worse then.”
“Well, thanks for coming,” Hank said. “We moved him out front here so you would have a little light. It doesn’t look like we will be done before dark.”
I look Old Bob over. For a horse with colic who was down, he looked pretty good. His pulse was a little fast, and his gut sounds were slowed, but otherwise, he looked pretty good.
“Do you think he will stand for us?” I asked.
“Yes, he has been up and down for the last couple of hours. After talking with you, I just didn’t want him to lie down and roll before we could get him under control.”
The guys got up, I think they were a little relieved, and I slapped Old Bob on the butt, and he jumped right up.
“If you guys hold him tight, and maybe one of you lean against his ribs on each side, I will do a little rectal exam.”
I pulled on a plastic sleeve and lubed it well. Then, standing on his right side, I held his tail out of the way, and I eased my hand and arm into Bob’s rectum. He did not object. I advanced my arm and started to sweep the floor of his pelvis and posterior abdomen.
Bob’s pelvic urethra bounced with a massive spasm when I touched it. The urethra was full and expanded. That was a most unusual finding. I advanced my arm further, and Bob’s distended bladder filled the posterior abdomen.
“I am not sure Old Bob has been peeing,” I said. “Have you seen him pass in urine today?”
“To be honest with you, Doc, I don’t spend a lot of time watching the old guy pee,” Hank said. “Now that I think about it, I did see him all stretched out like he was trying to pee earlier this afternoon.”
“I think his urethra is obstructed,” I said as I removed my arm. I cleaned up Bob’s rectum and let his tail fall. “It’ll take me a few minutes to hopefully find my urethral catheter. I hope it is in the truck.”
I had to dig deep into the back of the vet box. The call for using a stud catheter does not occur often. I had debated about even buying one when I did my equipment order. But after some digging, I did find it, and the sterile pouch it was in was still intact.
“Lean a little harder, guys,” I said. “There is nothing we are going to do to this guy from here on out that he’s going to find pleasant.”
Old Bob was a good old horse, but when I started to try to get a hold of his penis and pull it out, he was not very cooperative. After struggling for a minute or two, I decided to do it the easy way.
“Okay, Bob, you have earned a little dose of Rompun. Rompun was a popular tranquilizer, and it also provided some pain relief. In most cases, it would allow bulls and horses to drop the penis out of the prepuce.
After a dose of Rompun, Old Bob’s head started to hang, and then, as if on cue, he dropped his penis out of the prepuce.
I passed the catheter up his urethra, and it came to a dead stop. I pulled it out and measured the distance on the side of Bob. The obstruction was just after the urethra turned out of the pelvic cavity and headed down toward his prepuce.
“I don’t know what it is, but I need to do a little surgery. If it’s a stone, we can maybe remove it. We can at least open his urethra and empty his bladder. And just doing that is going to make him feel a whole lot better.”
I clipped and prepped a surgery site over Bob’s urethra and also a spot above the base of his tail for an epidural. Bob was still well tranquilized from the Rompun injection. I injected six ccs of lidocaine into his epidural space. After a few minutes, I checked that it had adequately numbed the surgery site.
The light was poor, but finding urethra was a snap. I incised the skin over his urethra and quickly dissected down to the surface of the urethra. Incising the urethra yielded a gush of urine. I passed the stud catheter into the bladder and waited as the urine drained.
Then I enlarged the incision a little and inserted my gloved finger. There, immediately below my incision, I palpated a large stone. The stone was nearly two inches wide and wedged tightly in the descending urethra.
“Okay, Hank, I can feel a large stone right here,” I said as I inserted my finger and bounced it on the top of the stone. “I can remove it, I am sure. But I think it would be best to wait until morning when the light is better.”
“Is he going to be okay until then?” Hank asked.
“He will be fine,” I said. “I am going to leave this incision open, and he will pee out of this incision. I will put his tail in a plastic sleeve to protect it. I will give him a dose of antibiotics tonight.
It will take another hour before the tranquilizer wears off. But you can put him in a stall or in a pasture, and I will be back here about nine in the morning.”
“These guys are going to be at work. Are you going to need any help?”
“This old guy is a pretty good horse. I think I will be fine,” I said.
Bob was at the feed rack eating when I returned in the morning. He sort of shook his head at me when I approached the fence. I wondered if he was giving me credit for making him feel better. I doubt it.
We pulled Bob out of his stall and tied him to the fence. I removed the plastic sleeve from his tail and then put a wrap on it to keep it out of the way. I prepped the incision and the epidural spot and repeated the epidural. Bob was not bothered by any of it.
With my finger, I palpated the stone. It had not moved overnight.
I extended the incision a bit and pushed on the bottom of the stone through his tissues. It popped out of the incision, and I caught it in mid-air.
“That was pretty easy,” Hank said. “Can I have that stone for a mantlepiece?”
This was an impressive stone. It was almost heart-shaped, and two inches across at the top, and nearly an inch thick. Smooth and light brown, it was most likely a struvite stone.
“Sure, you can have it. You probably should rinse it well before you set it out for viewing. Most of the time, these result from an infection in the bladder. We are going to put Bob on some antibiotics for a week or so, and I will check him in a couple of weeks when I take the stitches out.”
I passed the catheter into Bob’s bladder and then down the urethra until it came out in the prepuce. Just to make sure things were open in both directions.
I closed the urethra carefully and then loosely closed the tissues over the urethra. Leaving a small opening at the bottom end of the incision to allow for drainage. Then I removed the tail wrap and gave another dose of Polyflex. I fixed Hank up with injections for the next week.
“I want you to look at this incision every day. If there is a small amount of drainage, that is okay. But if there is a lot of swelling or a lot of drainage, I want to hear from you. I’ll be back in two weeks.”
On recheck, Old Bob was well healed and acted like there had never been a problem. He was the only horse I ever treated with a urinary obstruction.
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