title: Endoscopic-assisted electrohydraulic shockwave lithotripsy in standing sedated horses.
abstract: OBJECTIVE
  To report use of transendoscopic electrohydraulic shockwave lithotripsy for fragmentation of urinary calculi in horses.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Male horses (n = 21).
  
  
  METHODS
  Fragmentation of cystic calculi (median, 6 cm diameter; range, 4-11 cm diameter) was achieved by transurethral endoscopy in standing sedated horses using an electrohydraulic shockwave fiber introduced through the biopsy channel of an endoscope. The fiber was advanced until it contacted the calculus. Repeated activation of the fiber was used to disrupt the calculus into fragments <1 cm diameter. Visibility within the bladder was maintained by repeated lavage with saline solution.
  
  
  RESULTS
  Complete calculus removal was achieved in 20 horses (95%) with mean total surgical time of 168.6 minutes (range, 45-450). In the 20 horses with single calculi, 1-6 sessions were required to completely fragment the calculus. Except for 1 horse, in which perineal urethrotomy was eventually performed for complete fragment removal, fragments calculi were excreted via the urethra. Postoperative complications included hematuria because of severe mucosal erosion (n = 2), dysuria because of a trapped urethral fragment (2), small amount of urinary debris (1). One horse was euthanatized because of bladder rupture. Complete clearance of calculi and urinary debris was confirmed endoscopically 20 (3-45) days after the last session. Telephone follow-up (mean, 18.8 months; range, 7-24 months) revealed that horses had returned to previous activity levels without recurrence of clinical signs.
  
  
  CONCLUSIONS
  Transendoscopic electrohydraulic lithotripsy appears to be an effective method for fragmentation of low-density calcium carbonate cystic calculi in male horses.
authors.affiliation: Veterinary Clinic Starnberg, Starnberg, Germany. MRoecken@t-online.de
authors.forename: Michael
authors.initials: M
authors.lastname: Röcken
authors.forename: Anton
authors.initials: A
authors.lastname: Fürst
authors.forename: Martin
authors.initials: M
authors.lastname: Kummer
authors.forename: Gesine
authors.initials: G
authors.lastname: Mosel
authors.forename: Theo
authors.initials: T
authors.lastname: Tschanz
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Lischer
mesh_terms: D000818:Animals; D004724:Endoscopy / Q000379:methods / Q000662:veterinary*; D006734:Horse Diseases / Q000628:therapy*; D006736:Horses; D008096:Lithotripsy / Q000662:veterinary*; D008297:Male; D001744:Urinary Bladder Calculi / Q000628:therapy / Q000662:veterinary*