Treatment and additional findings:
The gelding was hospitalized for observation and during the night no
dysuria was observed. Rectal palpation was repeated next day and
revealed no abnormalities. A cystoscopy was performed which revealed the
presence of 2 urethral diverticula dorsal to the entrance of the
bladder, lined with normal epithelium (figure 1 and 2). The mucosa of
the bladder, the urethra and the two diverticula were hyperaemic with
evidence of urine accumulation in both diverticula. No ectopic ureter
was identified. There was normal voiding of urine from the ureters and
presence of sediment in the bladder. After cystoscopy, the rectal
palpation was repeated and revealed a gas distended structure dorsal to
the bladder. Transrectal ultrasound showed a gas distended structure and
a diffuse thickening of the bladder wall. The gas distended structure
was suspected to be the urethral diverticula filled with gas, however,
the extent of the diverticula could not be estimated. The complete blood
count was repeated and showed a moderate neutrophilic leucocytosis (WBC:
14,14 x 10^9/L; neutrophiles: 11,2 x 10^9/L) and the blood gas
analysis confirmed the slight hypokalaemia (2,8 mmol/L). Treatment was
initiated with broad spectrum antibiotics (trimethoprim-sulfamides, 25
mg/kg PO BID) and anti-inflammatories (meloxicam, 0,6 mg/kg PO SID) to
treat the present urinary infection. No further dysuria was observed and
next day the repeat transrectal palpation and transrectal ultrasound
didn’t allow identification of the diverticula No abnormalities of both
kidneys were identified during transabdominal ultrasound. On day 2 of
hospitalisation, the cystoscopy was repeated. The mucosa of the bladder,
the urethra and the two diverticula were less hyperaemic (figure 3 and
4) but urine accumulation in the diverticula was still present. Sediment
in the bladder was also still present and a lavage with an isotonic
polyionic solution (lactated Ringer) was performed. Surgical exploration
of the diverticula was declined by the owner due to financial
restraints. One day later, the gelding was discharged from the hospital
with systemic treatment.