Endoscopic-assisted disruption of urinary calculi using a holmium:YAG laser in standing horses.
OBJECTIVE
To describe a technique for endoscope-assisted disruption and removal of urinary calculi using a holmium:YAG laser in sedated, standing horses.


METHODS
Retrospective study.


METHODS
Six horses with urinary calculi.


METHODS
A holmium:YAG laser was used to disrupt naturally occurring urinary calculi in horses (4 geldings, 1 stallion, 1 mare). Ischial urethrotomy was performed in male horses to provide a portal for the endoscope and laser fiber. Calculus fragments were removed by a combination of lavage, transendoscopic basket snare removal, forceps, and digital manipulation. Ischial urethrotomies healed by second intention. Follow-up was obtained by recheck examination and telephone interview of owners.


RESULTS
No major operative or postoperative complications occurred. Two calculi (1 stallion and 1 mare) were fragmented by a combination of laser ablation and manual disruption with a lithotrite. Postoperative dysuria occurred in the mare, but resolved after 1 month. Mean (+/- SD) follow-up was 306 +/- 149 days; no other complications were reported.


CONCLUSIONS
Calcium carbonate urinary calculi (up to 15 cm in diameter) in horses can be effectively fragmented with a holmium:YAG laser. It is not known if this technique would be completely effective for larger calculi or extremely dense calculi.


CONCLUSIONS
Calculus disruption by an endoscopically assisted holmium:YAG laser offers a minimally invasive method that can be performed in standing horses and that minimizes patient risk.
Judy
Carter E
CE
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA 95616-8747, USA.
Galuppo
Larry D
LD
D000818:Animals; D002119:Calcium Carbonate; D004724:Endoscopy / Q000379:methods / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D017602:Lithotripsy, Laser / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D008297:Male; D012189:Retrospective Studies; D014545:Urinary Calculi / Q000601:surgery / Q000662:veterinary*
D002119:Calcium Carbonate