Team 3 Takes on a Special Case

By Dr. Sheila McDonald DVM & Dr. Savannah Beavers DVM Photos by Megan Creel

In early December, Megan discussed Vendetta with Dr. Sheila McDonald who felt that an infection was a possibility, so she was started on antibiotics prescribed by Dr. Denton Moffat. Unfortunately, the problem worsened to the point that she had an episode of colic-like pain. At that point Dr. McDonald was suspicious that Vendetta may have a bladder stone, so she accompanied Dr. Savannah Beavers of Connect Veterinary Services to Megan's farm in late December, where it was discovered on rectal palpation that Vendetta did indeed have a bladder stone.

A s her foal was not yet weaned the plan was to attempt transurethral retrieval of the stone following weaning. This was a technique that Dr. McDonald had performed on multiple occasions and involves pushing a hand through the urethra into the bladder, introducing an instrument called an ecraseur which is used to break up the stone, then retrieving the fragments by hand. There was a concern, however, that due to the young age of the mare it would be difficult to push into the bladder manually.

Drs. Beaver and McDonald discussed the case with Dr. Alex Wales, who agreed to assist and to provide his facility in Lake Country for the procedure. Dr. Wales performed further research and found a paper describing a new technique that involves passing a retrieval bag into the bladder and under endoscopic guidance placing the stone into the bag. If the stone proves to be too large to pull through the urethra then an air hammer is used to break it up into fragments. Dr. Wales ordered the retrieval bag and Dr. Beavers borrowed an air hammer from her partner, following which Dr. Wales ‘MacGyver’ed a longer chisel attachment.

Everyone assembled at Wales Equine Clinic and Vendetta was sedated and placed in stocks. Dr. Beavers adeptly performed an epidural anesthetic, her tail was wrapped, and the area under her tail was surgically prepped by Dr. Wales' assistant Daniela (photo #1).

The urethra was palpated and it was found that it was not possible to pass a hand into the bladder. The endoscope was introduced and a large stone visualized (photo #2).

The retrieval bag was introduced into the bladder and the stone placed in the bag using rectal manipulation. The stone was too large to be pulled through the urethra and so the air hammer was deployed. The chisel attachment was introduced inside the retrieval bag until it was fitted snugly against the stone which was stabilized rectally (photo #3).

Following several blasts (and a lot of trepidation) the stone was broken into multiple fragments. Unfortunately the bag was torn and the fragments had to be removed by copious flushing and digital grasping (photo #4).

When no further fragments could be seen with the endoscope the procedure was terminated (photo #5).

Everyone agreed that good teamwork utilizing individual skills resulted in a successful outcome using a new technique.

Vendetta was able to go home right afterwards and that evening Megan reported that she already seemed much improved. Vendetta is a special horse to Megan, her granddam West Jet was owned by Michael Rabe who was like a father to her. Megan rode and trained West Jet, plus Michael bred her to Foxhunter to produce Foxy Lady. Sadly Michael became ill with cancer and he gave Foxy Lady to Megan just before he died. Megan later bred Foxy Lady to Valentino to produce Vendetta. With the new foal Megan now has worked closely with four generations of this family. Vendetta will be started under saddle this spring and will likely stay with Megan for life.