# Urinary Calculi, Perineal Urethrostomy, and Stricturing



## urglik (Oct 13, 2009)

hi folks,

pleased to be here.

my friends name is yoolie. he is a 2 year old nigerian wether. he became
blocked with 3 stubborn calculi that the doctor gave me after he underwent a perineal urethrostomy (pu).

i was thinking about having them bronzed (just kidding...).

the aftercare of a pu is a daily affair and difficult (especially living alone). it took 2 months to fully heal and stop seeping which is normal it being a delicate area. often the seepage from above the urethra would dry on top of the urethra.

i made the mistake of using a healing salve on his exposed urethra as i was treating the surgical area. the goat sees this new urethral opening as a wound and wants to close it. and i helped...

when i took yoolie back to the hospital when he strictured, they managed to get a catheter into his bladder, slightly nipped the urethral opening to enlarge it and the catheter stayed in for a week.

a week after it came out he appeared to be dribbling his urine. i massaged his opening and it flowed a little better than stopped. concerned, i took him to the hospital and on the way he urinated twice without dribble, the last time with a flow that would not have concerned me.

the opinion of the doctors at this point is another p.u. or euthanasia.
i do not want to do another p.u. during the summer months and finances are an issue only because they are not there right now. i do not value money above yoolie

they did consider and research the possibility of using a stint used for arteries at the urethral opening but this was discarded due to the fact that it is a mesh that opens and closes and the skin would grow through it. they are very dedicated and resourceful folks and this was their idea as a research project as several of the doctors lamented how, during their many years, a p.u., usually winds up in failure. this is the large animal hospital at michigan state univ.

at this point yoolie has a partial catheter that does not enter his bladder and we hope to leave it there for 2 weeks while the urethral opening is stretched slightly by the plastic end of the catheter. with this approach, i was told that the possibility of infection is much less and he was not given an antibiotic..

i am supporting yoolie with a variety of items that i give as a drench
and am considering an antibiotic called bio-mycin given sub-q.

upon their recommendation i give yoolie 5-7 grams of ammonium chloride daily and a tsp of salt in water twice a day to encourage urine flow.

i have elected to give him nutri-drench, a goat probiotic, echinacea and pau d'arco for immune support and cranberry juice, cider vinegar, uva ursi (for 5-7 days), cleavers, and marsh mallow for urinary health.

yoolie and his sister, marva, browse and graze on a couple of acres with a wide variety of vegetation. i feed only hay and healthy snacks. no alfalfa.

what i would like to do is take a maintenance approach with yoolie's condition since their isn't a fix it a forget option. some medical conditions just aren't fun, but we deal with it. quality of life is a big issue.

besides the nutritional and herbal support, i would like to massage his urethral opening well every day with a light massage oil like sweet almond oil to keep it supple and moisturized. i believe this may help to keep his opening open.

if after a time he is stricturing closed again (i hope at least a month) than a partial catheter would be put in for 2 weeks. this entails sedation.

only part of the plastic end is exposed about 3/4 inch and yoolie seems to leave it alone, though it is hard for him to get at and he can't reach it, barely.

it sure would be nice if goats and of course yoolie had a better prognosis after a p.u.

i would love to hear what ya'll think. thank you.

urg


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## liz (Oct 5, 2007)

Oh my, what an ordeal you and Yoolie have been through, I've never experienced the UC with my boys and hope I never do but it really sounds as though you have done everything that can be done medically....how is Yoolie handling this? Do you feel that he is just miserable or is he his normal self? He looks like he's a handsome and sweet boy and though I can't offer any input as far as what more can be done, I do offer my prayers to help you overcome any setbacks he may have :hug:


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## freedomstarfarm (Mar 25, 2011)

Welcome from New Jersey :wave: 
It sounds like you are doing everything you can for your little guy. I wish I knew of something that could help. He looks very handsome. I hope he heals well this time.


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## urglik (Oct 13, 2009)

thank you for the welcome and your warm wishes. yoolie appears to be doing well physically and mentally. for 1 day after the last two catheters he seemed a little out of sorts. he may have been uncomfortable from the catheter being inserted and/or effected by the anesthesia. perhaps in the future i may ask about pain meds for a day. 

yoolie is indeed fun to look at and a fun , loving, and silly goat. here is one last pic of him with his sister marva. i'll save any more for the pictures section.

thanks for your interest.


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## freedomstarfarm (Mar 25, 2011)

They are just adorable!! 

I just read a bit about the UC in my goat vet book. It doesn't say much.
Heres what it says about prevention... The main predisposing cause of this condition is dirty drinking water buckets. Goats will not drink dirty water and if their water is not clean they will ration themselves. Stall-fed males on a high concentrate/low roughage diet are particularly at risk. Decreasing the concentrate may help to avoid the problem. It may also be prudent to avoid concentrates that are high in calcium. 

Not that any of that applies to your preticular case but I thought the dirty water bucket was a interesting point. I do always notice how my goats love the fresh water we give them 2 or 3 times a day. When we started we had gotten one of those low water troughs thinking it would be great and we could do the water once a week like our horse. :doh: Well now it is a part of the goat playground equipment! They loved it only when the water was brand new.


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## urglik (Oct 13, 2009)

howdy,

thanks for everyones interest. sorry for the late reply to your post, friend at freedomstarfarm. i do appreciate your contribution. your point about a clean water bucket is well taken. ample water intake is important and i've found goats to be picky consumers, contrary to folk lore. i'm sure this isn't news to goat people.

i took yoolie to see my regular vet today. i discussed my hopes for yoolie and she told me that she had kept a partial catheter in a dog for 6 months. she suggested that we leave the catheter in for a significant period of time in hopes that the skin around the circumference of the urethra hole will change in nature and be less apt to stricture in the future. 

apparently infection is not a major issue internally and some antibiotic cream on the skin around the catheter would be helpful. i'll monitor the position of the catheter and the sutures holding it in place.

at this point it feels like a hopeful prognosis and i feel like we have some breathing room.

giving thanks a day at a time...


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## freedomstarfarm (Mar 25, 2011)

Glad to hear that the vet is hopeful! ray: That he will heal well an dnot have any reoccurring issues.


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## urglik (Oct 13, 2009)

howdy,

i have been waiting to update this post when i had something significant to report.

my attempts at a partial catheter for a period of time worked somewhat but it 

became clear that this method was insufficient due to the catheters inability to flow 

well and the difficulty of keeping it in place. in researching stuff i looked at what 

was done for human males that stricture. one approach is a skin graft. i brought this 

to the attention of yoolie's doctor at the michigan state large animal clinic. he

talked to a soft tissue surgeon in the small animal clinic who does a procedure on 

cats and dogs when they stricture that differs from a standard perineal 

urethroscopy that is done on goats. on nov 9 of last year yoolie was again 

operated on but with this different approach.

that was just over 4 months ago. with yoolie's last perineal urethrostomy, he 

began stricturing 3 months after the operation and was almost totally closed after

4 months. at this point, yoolie is showing no signs of stricturing. this is 

significant. from my understanding, when a goat develops impassable calculi and a

perineal urethrostomy is performed, 90% of the time the goat will stricture closed.

i will be able to post a more technical explanation of what was done soon.

if anyone needs more information, they can contact dr kent ames at the michigan 

state large animal clinic or dr bryden stanley at the small animal clinic. :wahoo:


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## ksalvagno (Oct 6, 2009)

Great that Yoolie is doing well. I hope he continues to do well. Sounds like you are doing everything you can. I think my only suggestion would be to make sure that his food intake is at least (and better to be a little more) 2:1 calcium to phosphorus.


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## urglik (Oct 13, 2009)

thank you.


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## liz (Oct 5, 2007)

My goodness...what a very fortunate little goat Yoolie is! You have a heart of gold and what you have done for your pet goes above and beyond what many would see as a lost cause. :hug: 

It's good to hear from you again and thank you for the update! I'm glad that he is doing well with the new procedure :stars:


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## naturalgoats (Jan 3, 2011)

Wow! you really do care about your baby! I'm so glad he is doing well and was interested to see this topic... I wasn't on the goatspot when it was started. I would be interested in getting more technical detail if you felt like posting it! :thumb: 
M.


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## urglik (Oct 13, 2009)

thank you for the kind words.

indeed after yoolie first began to stricture, the general attitude at the clinic was that i had to prepare myself for yoolie's eventual passing due to this issue. when dr ames, who has been there for 35 years i believe, said this is the way things have been throughout his experience, i just couldn't understand how this could be and how nothing better had been developed. i believe in part this it has to do with the difference in priorities for people between livestock and pets. (though i would never call yoolie or his sister marva livestock). this can translate into a difference in funding/research priorities for particular ailments. i believe the cost for services at the small animal clinic (cats and dogs) is significantly higher than the large animal clinic. 

for me it was just not giving up on a friend that i love with a mindset that failure was not an option. i received a lot of support through everything from the folks at the clinic. it wasn't long before most everyone at the clinic knew yoolie. i don't think it was because of his ailment or the number of times we were there. when i took yoolie there a month ago because he was blocked and drippy again (which has passed and he is now peeing "like a racehorse") i counted 16 people in the room at one time. doctors, residents, interns, students, because yoolie was there. 

i stopped by two creek goats and enjoyed the site m. i immediately went out and removed the baking soda bin from the goathouse and will include beet pulp in yoolie's diet. thank you. regarding more info on yoolie's procedure, i am awaiting a layman's technical explanation of the procedure from dr stanley and look forward to posting it here. i think everyone felt it would be best to wait to see how things progressed before saying we had found something new. i talked to her recently and she is traveling and will be able to write up something soon. 

from what i understand, a normal pu is where the urethra is cut essentially crosswise and brought through the abdomen about 1/4 inch a few inches below the anus. the top part of the urethral tube is slit back to the abdominal wall and spread open (spatulated). then each side of the urethra is then sutured to the skin. the size of the urethral opening is the same as before. 

dr stanley's approach was to slit the side of the urethra (as opposed to cutting it crosswise) perhaps 3/4 to 1 inch long and using either skin or a very fine synthetic suture she sutured each side of the slit to the abdomen leaving a fairly long urethral opening which was expected to stricture closed on each end somewhat but minimally.

yoolie strictured just inside the urethral opening. when the urethra is slit and spatulated, this leaves a small exposed part of the cut where the two sides come back together which i remember to be right at the abdominal wall. this is a "wound" which the goat wants to close right where the urine leaves the body through a relatively small hole (often undersized due to early castration). so with a long slit of the side of the urethra and very fine work, there is little stricturing and a large opening to handle that which occurs. this is the feeling i get, though it may be a bunch of hooey

today, yoolie's urine stream is as wide and as solid as i have ever seen it and i doubt he will stricture closed again.


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## Di (Jan 29, 2008)

That's pretty amazing! Congrats! Looking forward to reading the vet report.

When I had my first "emergency" with a goat it was soon after I got them...a case of Polio...I rushed her to the vet, limp and obviously dying (in my barn clothes and boots, lol). There we were in a room for dogs, lol. Me and my goat...the large animal vet was out on a call and they got her back asap...thankfully...she got it when I said "please think "pet" not livestock, in this case".


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## urglik (Oct 13, 2009)

dear di,

what was the outcome with your friend?

it reminds me of my first trip to my local vet when yoolie first developed calculi and was totally blocked.

i imagine we have both come a long way since then...

urg


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## Di (Jan 29, 2008)

Oh yes, for sure, I am becoming and "old hand" at this now! The vet sent her home with me with instructions for giving more antibiotic/thiamine. Said "if she lives, she should get her sight back and be fine." I laid her out in a stall and kept turning her and giving her shots, she was up standing after about 6 hours, been fine ever since.


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## urglik (Oct 13, 2009)

sweet!


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## urglik (Oct 13, 2009)

hi folks,

i received some information from dr bryden stanley regarding yoolie's operation today. here is the link to it in my google docs account.

https://docs.google.com/open?id=1aynWvR ... e2dXfdTwg7


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## naturalgoats (Jan 3, 2011)

Very cool! thanks so much for posting!
M.


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## Di (Jan 29, 2008)

That is very interesting, do you mind sharing the cost of the surgical repair with us?


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## liz (Oct 5, 2007)

I hope that Yoolie continues to do well! Amazing how he was able to be saved by doing the surgery and truly very heartwarming to me that you were able to provide for him.


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## GoatMoma (Jun 29, 2011)

I pray your friend is doing great! I had a similar experience with my dwarf pygmy. What works for us to prevent UC is 1/2 tsp of 4way 2x acid pak I buy at livestock concepts per gallon of drinking water. I give them a little of the Nutrena Animal Feed, which has Ammonia Chloride in the mix already, in the mornings. Then its free choice browse and grass hay with some minerals as treats, along with other treats like raisins. Its been a year and so far so good!


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## urglik (Oct 13, 2009)

howdee!,

well yoolie is right as rain. dr bryden thought there would be a small amount of stricturing on each end then settle down. that appears to be what has happened. 

his urine stream is wide and strong. she feels it should be good for a lifetime.

the cost of the operation was 450.00.

the best thing about urinary calculi is avoiding it!

don't neuter to young! no grain for wethers! 

currently yoolie gets a drench of ammonium chloride daily. 7 grams in a cup of water. he probably ends up getting 6 .i try to keep his urine ph around 7.
he gets beet pulp a couple times a day. medium grassy hay (no alfalfa) and free choice manna pro minerals and plenty of browse. 

i took away the baking soda since it is alkaline. any thoughts on the necessity of baking soda?

yoolis!


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## Katherine (Nov 27, 2012)

Hi 
I just brought my almost 5 mo.... ollie home from the vet today he had pu done on sat eve... thanks so much for your post it has been most helpfull. has given me much hope.. Im so happy for yoolie ,his sis and you.


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## clearwtrbeach (May 10, 2012)

Welcome :welcome: sorry you are having to go through all of that. I hope he gets better sooner than later.


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## Alanna (Dec 4, 2012)

*Going through the same thing!*

Hi there! I am so happy to read that Yoolie is doing well! I am going through the same thing with my wether Dodge, and have learned some valuable information regarding the baking soda, and no grain. Dodge was neutered before I purchased him, and I think it was done way too early. As a result, he had to have the PU done to save his life. He was ok for a while after the surgery, and I began giving him a tincture of Uva Ursi tea, marshmallow root, cranberry and echinacea teas, and ginger caplets, all dissolved, brewed, and mixed together with ammonium chloride. Unfortunately, his urine dribbles, and is scalding his skin. It also collects on the scrotum, left intact for whatever reason, and the inside of his legs, etc. He has to be scrubbed daily with a surgical debriding solution and I am currently trying to get infection and swelling cleared up with Vetricyn and Silver Diazemiade (sp?) cream. I have contacted Dr Ames and am awaiting a response, Dodge and Yoolie's cases are so much the same I believe that the procedure would also work for my Dodge. He is a tough nugget and has the will to live. He's been through so much and he keeps on fighting. Failure is not an option for us, either. Take care and I will keep the thread updated with Dodge's progress!


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## rgdlljames (Sep 8, 2011)

urglik - Thank you so much for posting your experience! We bought 2 wethers at about 2 wks old (they were fixed already) and they both came down with UC. One we couldn't save because we didn't know about the PU surgery and the other did have it done. His name is Louie and he is doing great! He pees out the back like a fire hose! LOL We were so fortunate that it worked for him. 
Alanna (who posted above) is my best friend and her boy ended up with UC, had the surgery but didn't fare so well. As you can see from her post he has had a long struggle so far. So, thank you again for your post. It has given Alanna (and I because I love Dodge too) hope that she can get him help.


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## Alanna (Dec 4, 2012)

I just spoke with Dr Ames at MSU large animal clinic! I hold great hope. He is going to speak with Dr Stanley, and we are beginning the process of getting him in for evaluation and surgery. They are hopeful, as am I, that he has a great shot at doing as Yoolie!


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## Alanna (Dec 4, 2012)

I am excited to say, I spoke with Dr Ames again today after emailing some pictures, and Friday the 14th Dodge is going down to MSU for surgery! So happy, and so hopeful!


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## Alanna (Dec 4, 2012)

*Dodge's PU complete and successful!*

Hi all-

Well, on Friday Dodge had his PU with Dr Bryden Stanley - what an amazing surgeon! Dodge is doing very well. He did not bleed at all on the ride home, and oozed only a little when we got out of the car. He didn't even bleed when peeing! Today he is getting pretty stir-crazy - he wants to get back out with his playmates, but we are keeping him separate for a couple of weeks while everything heals as it should. He pees like a fire hydrant - straight out! As soon as the swelling goes down, there shouldn't be any dripping at all.

The staff at MSU Veterinary school - I can't say enough about their caring and compassion. Amazing people, every single one of them. We were treated very well, and Dodge was treated as what he is - a beloved pet.


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## Smootzie79 (Nov 13, 2013)

How are Yoolie and Dodge doing now? Have either of these had any complications since surgery?


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## Alanna (Dec 4, 2012)

Hi all, I am happy to report that Dodge has had a fantastic year. He is just shy of the year anniversary of his major surgery at MSU, I can't believe it's been that long!  He is doing very well! I have to keep him shaved, about once a month, and scrub the area with a debriding solution to keep him clean. He is happy, healthy and urinates like a fire hose! He is playful, curious - in other words, he's a normal goat. Loves playing with his siblings and friends, and climbing all over his mother. (me).


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## ksalvagno (Oct 6, 2009)

That is wonderful!


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