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Although relatively rare, bladder stones remain an important cause of discomfort in horses, causing bloody urine, weight loss, and incontinence. Stones vary in size, and some can become large, weighing more than 14 lb (6.5 kg). According to experts, treatments aren’t a guaranteed solution. Diagnostic and treatment costs can be exorbitant, complications following surgery can’t always be avoided, and stones all too frequently recur. Treatment options have advanced, providing more options for long-term solutions.

One group of veterinary surgeons recently described a novel method of removing bladder stones*. Using a minimally invasive approach, the surgeons inserted into the urethra a laparoscope with a “retrieval pouch.” Stones were placed inside the pouch before being broken into small pieces either manually or with the assistance of a laser, shockwave, or other device. Using the pouch ensured that fragments were not left behind in the urinary bladder, serving neither as a nidus for future stone growth nor as a source of further bladder irritation.

“For horses at risk of developing bladder stones, such as those with a history of them, some owners attempt to alter a horse’s diet to minimize the chance of recurrence,” explained Kathleen Crandell, Ph.D., a Kentucky Equine Research (KER) nutritionist.

Lowering the pH of the urine and decreasing excessive intake of protein, calcium, phosphorous, and magnesium may minimize stone formation. Several methods have been suggested:

  • Offering urinary acidifiers such as ammonium chloride, ammonium sulfate, and vitamin C has been attempted but proved unpalatable and rather ineffective. Anorexia and hypersalivation have also been reported following administration of ammonium sulfate and ammonium chloride;
  • Changing from an alfalfa– or clover-based forage to grass hay is often advocated, yet no clinical trials supporting this recommendation exist; and
  • Increasing water intake is encouraged in other species, though this can be challenging in horses. Some reports of increasing dietary salt intake to ultimately increase water intake exist, but this technique also appears unreliable.

Always seek the assistance of an equine nutritionist before making major changes to your horse’s diet, and be sure to seek help from your veterinarian if you notice any of the following signs: straining to urinate, blood in the urine (hematuria), urine scalding of the hind limbs (in mares), weight loss, and colic.

*Katzman, S.A., B. Vaughan, J.E. Nieto, et al. 2016. Use of a laparoscopic specimen retrieval pouch to facilitate removal of intact or fragmented cystic calculi from standing sedated horses: 8 cases (2012-2015). Journal of the American Veterinary Medical Association. 249(3):304-310.

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