EQUINE VETERINARY EDUCATION / AE / MAY 2019


263


(Schott 2015). There is one report of a middle-aged Arabian mare that was treated with high dose corticosteroids and was still alive almost 3 years later (Gracia-Calvo et al. 2014). In cases of unilateral renal haematuria, surgical treatment (nephrectomy) may be considered. However, affected horses treated with unilateral nephrectomy frequently develop haemorrhage in the contralateral kidney (Schott 2010). In dogs, idiopathic renal haematuria typically occurs in


otherwise healthy large-breed individuals that are <2 years old, and there is no sex predilection (Berent 2015). Treatment options have included endoscopically guided sclerotherapy with povidone iodine and/or silver nitrate, partial occlusion of the renal artery and nephrectomy (Holt et al. 1987; Mishina et al. 1997; Berent et al. 2013; Adelman et al. 2017). Based on short-term follow-up, the use of povidone iodine sclerotherapy was recently reported to have been successful for the management of two affected dogs and might be considered for the treatment of horses in the future (Adelman et al. 2017). The case described in the present report illustrates


sonographic findings (pyelectasia, decreased cortical medullary ratio and marked increase in echogenicity of the renal pelvis) of an Arabian stallion that had developed idiopathic renal haematuria. A definitive source of haemorrhage was not determined, but more extensive ante- mortem diagnostic testing could be undertaken in future cases to help better attain an aetiological explanation. Long-term prognosis for idiopathic renal haematuria in horses is guarded.


Author’s declaration of interests The authors have no conflicts of interest to declare.


Ethical animal research


No approval was received as this was a clinical case report and no animals were used for research. Tissues, images, etc. were not used for research purposes.


Source of funding None.


Authorship


L.M. Martin, B.C. Jochems, J.C. Lattimer and D.D. Whelchel directly contributed to the evaluation and management of the case and manuscript preparation. P.J. Johnson contributed to the manuscript preparation. All authors have approved the submitted version of the manuscript.


Antimicrobial stewardship policy


No antibiotics were used in the management of this case while under the care of the authors.


Manufacturers' addresses 1Amneal Pharmaceuticals, Bridgewater, New Jersey, USA. 2Fuji Photo Optical Co. LTD Omiya City, Saitama, Japan. 3Philips North America Corp, Andover, Maine, USA.


References


Adelman, L.B., Bartges, J. and Whittemore, J.C. (2017) Povidone iodine sclerotherapy for treatment of idiopathic renal hematuria in two dogs. J. Am. Vet. Med. Assoc. 250, 205-210. https://doi.org/10. 2460/javma.250.2.205.


Berent, A. (2015) Interventional treatment of idiopathic renal hematuria. In: Veterinary Image-Guided Interventions, 1st edn., Eds: Weisse, C., Berent, A., Wiley-Blackwell, Oxford. pp. 301-308.


Berent, A.C., Weisse, C.W., Branter, E., Adams, L.G., Aarhus, A., Smee, N., Berg, R. and Bagley, D.H. (2013) Endoscopic-guided sclerotherapy for renal-sparing treatment of idiopathic renal hematuria in dogs: 6 cases (2010-2012). J. Am. Vet. Med. Assoc. 242, 1556-1563. https://doi.org/10.2460/javma.242.11.1556.


Gracia-Calvo, L.A., Duran, M.E., Martin-Cuervo, M., Vieitez, V., Jimenez, J. and Ezquerra, L.J. (2014) Persistent hematuria as a result of chronic hypertension secondary to nephritis in a stallion. J. Eq. Vet. Sci. 34, 709-714. https://doi.org/10.1016/j.jevs.2013.12.014.


Hitt, M.E., Straw, R.C., Lattimer, J.C., Shaw, D.P., Weide, K.D. and Smith, C. (1985) Idiopathic hematuria of unilateral renal origin in a dog. J. Am. Vet. Med. Assoc. 187, 1371-1373.


Holt, P.E., Lucke, V.M. and Pearson, H. (1987) Idiopathic renal hemorrhage in the dog. J. Small Anim. Pract. 28, 253-263. https:// doi.org/10.1111/j.1748-5827.1987.tb03880.x.


Kidd, J.A., Lu, K.G. and Frazer, M.L. (2014) Atlas of Equine Ultrasonography, 1st edn., Wiley, Oxford, UK. pp 419. https://doi. org/10.1002/9781118798119


Mishina, M., Watanabe, T., Yugeta, N., Maeda, H., Fujii, K., Wakao, Y., Takahashi, M. and Yamamura, H. (1997) Idiopathic renal hematuria in a dog; the usefulness of a method of partial occlusion of the renal artery. J. Vet. Med. Sci. 59, 293-295.


Pasquel, S.G., Agnew, D., Nelson, N., Kruger, J.M., Sonea, I. and Schott, H.C. II (2013) Ureteropyeloscopic anatomy of the renal pelvis of the horse. Equine Vet. J. Suppl. 45, 31-38.


Schott, H.C.II (2010) Hematuria. In: Equine Internal Medicine, 3rd edn., Eds: S.M. Reed, W.M. Bayly and D.C. Sellon, Elsevier Saunders, St. Louis. pp 1209-1213.


Schott, H.C.II (2015) Hematuria. In: Current Therapy in Equine Medicine, 7th edn., Eds: K.A. Sprayberry and N.E. Robinson, Elsevier Saunders, St. Louis. pp 456-459. https://doi.org/10.1016/j.cveq.2007. 09.002


Schott, H.C. II and Hines, M.T. (1994) Severe urinary tract hemorrhage in two horses. J. Am. Vet. Med. Assoc. 204, 1320.


Schumacher, J. (2007) Hematuria and pigmenturia of horses. Vet. Clin. North Am. Equine Prac. 23, 655-675. https://doi.org/10.1016/j.cveq. 2007.09.002.


Schumacher, J., Schumacher, J. and Schmitz, D. (2002) Macroscopic hematuria of horses. Equine Vet. Educ. 14, 201-210.


Toribio, R.E. (2007) Essentials of equine renal and urinary tract physiology. Vet. Clin. North Am. Equine Pract. 23, 533-561. https://d oi.org/10.1016/j.cveq.2007.09.006.


Vits, L., Araya, O., Bustamante, H., Mohr, F. and Galecio, S. (2008) Idiopathic renal hematuria in a 15-year-old Arabian mare. Vet. Rec. 162, 251-252. https://doi.org/10.1136/vr.162.8.251.


Supporting information


Additional Supporting Information may be found in the online version of this article at the publisher’s website:


Supplementary Item 1: Caudal facing cystoscopic video shows normal urine exiting the right ureteral orifice (time 0:07) and haemorrhagic urine exiting the left ureteral orifice (time 0:27).


© 2018 EVJ Ltd

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84