Management of obstructive urolithiasis in a ram by tube cystostomy: A case report

Abstract

A two-year-old ram was presented with a history of anuria and straining to urinate for the past 48 hours. Clinical examination revealed abdominal distension, restlessness, and signs of discomfort suggestive of urinary obstruction. Ultrasonographic evaluation confirmed a uroabdomen with hyperechoic sediments, indicating obstructive urolithiasis. Considering the clinical status and severity of obstruction, a tube cystostomy was performed under sedation, epidural anaesthesia and inverted L block anaesthesia. A Foley’s catheter was inserted into the urinary bladder to establish urinary diversion. Postoperatively, fluid therapy, antibiotics, anti-inflammatory agents, and urine acidifiers were administered. The ram showed progressive improvement in general condition with restoration of normal appetite and relief of abdominal pain within 48 hours. The Foley’s catheter was maintained until urethral patency was re-established and then removed. Meanwhile feeding of Ammonium chloride helped to resolve urinary obstruction. This case highlights the clinical relevance and effectiveness of tube cystostomy as lifesaving surgical intervention for managing obstructive urolithiasis in small ruminants, especially when urethral catheterization or retrograde hydropropulsion is unsuccessful.