Management of Obstructive Urolithiasis in a Male Bovine Calf
Abhishek Verma1, Bhavna Salvi1,
1Department of Veterinary Surgery and Radiology,
Arawali Veterinary College, Sikar, Rajasthan, Email id: abhishek.verma164@gmail.com
Abstract
The passage examines urolithiasis in young male cattle, a condition more commonly observed in male ruminants owing to the anatomical configuration of their urethral tract. This condition is typified by symptoms such as anuria, decreased appetite, lethargy, despondency, and varying levels of abdominal distension, occasionally accompanied by swollen areas ventrally (indicative of urethral rupture), necessitating surgical intervention. Tube cystostomy emerges as the most effective treatment method for addressing obstructive urolithiasis in both cattle and small ruminants.
Key words: Urolithiasis, calf, Tube Cystotomy
Introduction
Urolithiasis refers to the formation of uroliths within the urinary system, often leading to obstruction of urine flow, primarily seen at the distal end of the sigmoid flexure in ruminants (Radostitis et al., 2000). This condition is more prevalent in male ruminants due to the anatomical structure of their urethral tract, characterized by a long, narrow, and tortuous pathway, unlike the shorter, wider, and straight urethra in females (Smith and Sherman, 1994). Various factors such as diet, age, breed, genetics, environmental conditions, and urinary tract infections contribute to the formation of uroliths (Udall and Chow, 1969). Urethral obstruction in calves can be fatal, necessitating emergency surgical intervention for correction. Medical treatment for obstructive urolithiasis in ruminants has generally shown limited success. Several surgical techniques have been described, including urethrotomy, urethrostomy, penile transaction with urethral fistulation, tube cystostomy, bladder marsupialization, and laparotomy with urethrotomy (Singh et al., 2010). Currently, surgical tube cystostomy is the most successful method for treating obstructive urolithiasis in both cattle and small ruminants.
Material and Method
Male calves aged between 3 to 5 months were presented to the Veterinary Clinical Complex, Arawali Veterinary College, Sikar, Rajasthan, exhibiting symptoms including anuria, inappetence, dullness, and depression. Physical examination revealed varying degrees of distended abdomen, some with oedematous swelling ventrally (urethral rupture). Needle paracentesis was performed to investigate uroabdomen. Epidural anaesthesia and local infiltration were administered prior to surgery. A paramedian incision was made cranially from the rudimentary teat, followed by dissection through skin, fascia, muscles, and peritoneum to expose the urinary bladder. A subcutaneous tunnel was created parallel to the prepuce for insertion of a Foley’s catheter, with its tip directed towards the incision. The catheter was then guided into the bladder through an avascular area, and its bulb inflated with 20 ml of sterile normal saline to secure it in place, suturing of peritoneum and muscular layers with Catgut No. 2 and closure of the skin with braided silk No. 1 suture was done. Post-surgery, the calf received Streptopenicillin and Meloxicam intramuscularly for 5 and 3 days respectively, along with oral administration of Ammonium Chloride (@200mg/kg) twice daily for 30 days. Regular dressing of the wound was conducted until complete healing. The catheter remained until normal urination resumed, with periodic clamping to assess patency, and skin sutures were removed after 14 days.
Results and Discussion
Obstructive urolithiasis presents significant economic challenges to farmers due to animal losses and treatment expenses, with a notably high mortality rate often resulting from urinary bladder or urethral rupture. This condition tends to be more prevalent during extreme winter and summer seasons. In winter, reduced water intake and vitamin A deficiency, attributed to limited green fodder availability, contribute to its occurrence (Radostitis et al., 2000). Vitamin A deficiency and infections lead to desquamated epithelial cells (Jones and Miesner, 2009). Conversely, excess sunlight and vitamin D play a role in summer urolithiasis, likely due to increased water loss and concentrated urine production (Kushwaha et al., 2007). While urolithiasis affects both genders equally, obstruction primarily occurs in males due to their longer and narrower urethra (Tamilmahan et al., 2014). Various factors contribute to urinary calculi formation, notably diet, with high phosphorus and low calcium diets predisposing animals to phosphate uroliths (Funaba et al., 2001). Treatment options include medical dissolution of calculi and surgical management. Medical treatment may offer temporary relief but is generally ineffective in the long term (Ewoldt et al., 2006). In severe cases, surgery is necessary, with surgical tube cystostomy being the preferred procedure. This relatively simple procedure, requiring minimal anaesthesia, often restores full urethral patency and has shown success even in cases with concurrent urethral rupture. Anti-inflammatory drugs help alleviate urethral spasm and inflammation, while calculolytic agents like ammonium chloride and sodium chloride, along with increased water intake, promote urine pH reduction and calculus dissolution through the Foley’s catheter. Regular catheter clamping helps maintain urethral patency by flushing debris and calculus material (Ewoldt et al., 2006). Complications of tube cystostomy may include tube blockage, urethral rupture, dislodgement, and infection.
Conclusion
Utilizing tube cystostomy offers a swift, feasible, field-friendly, and dependable approach to managing obstructive urolithiasis in ruminants. Combining surgical and medical interventions enhances the treatment repertoire for this condition in ruminants.
Reference
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