Unilateral nephrolithiasis with renal rupture in a horse

Abstract

SummaryA 22‐year‐old Thoroughbred mare presented to North Carolina State University Large Animal Hospital for evaluation of acute colic. After initial work‐up, the mare was diagnosed and treated for presumed gas colic. She was subsequently further diagnosed and treated for gastric ulcers and mild sand accumulation in her large colon, based on gastroscopy and abdominal radiographs, respectively. The mare initially responded well to medical management of colic, but on Day 3 of hospitalisation, developed a low grade fever and signs of mild discomfort returned. Abdominocentesis at that time revealed an aseptic peritonitis and she was placed on antibiotics andNSAIDs. When no significant improvement was achieved, the mare was taken to surgery 2 days later. In surgery, she was diagnosed with nephrolithiasis of the left kidney that had erupted through the renal capsule and into the retroperitoneal space, as well as into the abdomen. Two nephroliths were found in the omentum. The mare was subjected to euthanasia due to a poor prognosis and submitted for necropsy, where 54 nephroliths were identified, associated with the left kidney. This report describes significant unilateral nephrolithiasis (to the point of renal rupture) in a horse with no azotaemia or other clinical signs of urinary tract disease.