Tube Cystostomy for Treatment of Obstructive Urolithiasis in Goats
ACVIM 2008
Elizabeth Doré1; Lisle W. George2; Jeanne W. George3; Omar Maher1; Christiana M. Drake4; John A. Angelos2
1William R. Pritchard Veterinary Medical Teaching Hospital, 2Department of Medicine and Epidemiology, 3Department of Pathology, Microbiology and Immunology, 4Department of Statistics; University of California
Davis, CA, USA

The objectives of this study were to determine the outcome of the tube cystostomy in combination with urethral flushing for the treatment of obstructive urolithiasis in goats and to determine if urethrotomy negatively affects surgical outcome.

Medical records of male goats that had a tube cystostomy between January 1995 and December 2005 at the University of California were reviewed. Follow-up was obtained by a questionnaire mailed to referring veterinarians or owners and by telephonic communication with owners. Statistical analysis consisted of a survival analysis (Kaplan-Meier) and a log-rank type test to compare the survival between goats that had urethrotomy and goats that did not have urethrotomy. Significance was set at P < 0.05.

The study population consisted of 97 goats. Fifteen were intact males; 82 were wethers. There were 39 Pygmy, 13 Alpine, 9 Nubian, 7 LaMancha and 29 mixed/other breed goats. The age ranged from 7 months to 11 years (median: 3 years). Hospitalization ranged from 1 to 93 days (median: 5 days). Ninety five goats were discharged from the clinic. Follow-up information was available for 73 cases. Fifty two goats survived without any complications at least 12 months after the procedure, 20 goats had complications before 12 months and 1 goat was lost to follow-up after 8 months. Of these 52 cases, 23 had a re-occurrence of urolithiasis between 12 and 60 months after the procedure (median: 24 months). Out of these 23 cases, a second tube cystostomy was performed (n=11), owners elected euthanasia (n=9), the calculus was removed manually from the tip of the urethra (n=2) or a perineal urethrostomy was done (n=1). For 3 cases a third tube cystostomy was performed. An urethrotomy was performed in 34 goats and of these: 24 did not have any complications for at least 12 months, 6 had complications before 12 months and 4 were lost to follow-up. The survival time ranged from 20 days to 106 months (median: 24 months; mean: 34.9 months (SE±7.56)) for goats that had urethrotomy and from 7 days to 114 months (median: 27months; mean: 40.3 months (SE±6.72)) for goats that did not have urethrotomy. There were no statistical difference between the 2 groups (P = 0.807).

Tube cystostomy with urethral flushing has a fair to good prognosis for the treatment of caprine urolithiasis. The high risk of re-occurrence should be stressed to clients considering treatment of obstructive urolithiasis. Urethrotomy did not negatively impact outcome and should be considered for removal of some urethral calculi.

Originally presented at the ACVS Symposium, Chicago, IL, October 2007.

Speaker Information
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Elizabeth Doré

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