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Draft Gelding With Swollen Penis

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Draft Gelding With Swollen Penis

Postby Andrian » Fri Oct 02, 2015 5:18 pm

Hi Dr. Bentz, last July(08) our 22 y/o Belgian draft gelding developed an issue where he could not urinate on his own. He had a lot of sediment and appeared to have an infection so he was put on tocoprim for two weeks and methionine for about two months to help increase his PH and break up the crystals. Since then we have been cathing him twice a day. Although we were trying to figure out what could be the cause of this issue he seemed to be doing fine.  Then last November I noticed he developed ventral/belly edema which eventually lessened but never fully went away. About 2 months ago his outermost part of the sheath swelled up and then that went away after a few days. Then about a month ago his penis/sheath swelled up literally within a day. I know he had no trauma, but it was bitter cold and my vet said frostbite could have caused the swelling.(He did get two areas with sores that healed up) Prior to the penis swelling he has always been able to retract his penis with out an issue. The last month our vet has been out numerous times and we have tried DSMO and Furizone on his penis BID then wrapping it with saran wrap and we made a sling to hoist his penis up to help reduce the swelling. We also changed his feed to a higher protein(14% from Safe choice to Nutrena senior), cleaned his sheath and penis numerous times checking for beans, and crud, started him on selenium and vitamin E all per vet recommendations. Blood work comes back perfect, but on and off it shows he is slightly anemic, but kidney function and other results were WNL. He is eating and drinking fine, bombing around the pasture like a normal horse. He does not appear to be in any pain. But None of our efforts worked reduce the swelling... We also discussed diuretics and steroids, but we all agreed this would not fix the issue and possibly create more problems and would use that as a last alternative. My vet finally did a minor surgery where she cut slits in his sheath and "Stuffed" his swollen penis back inside him and then used a "purse string" stitch hoping this would help reduce the swelling. So far it has not helped. I decided to get a second opinion with a different vet and he did an ultrasound of the bladder and what ever else he could see. We discovered that he has a walnut size mass at the neck of the bladder and upon palpation of the pelvic bone the vet mentioned that it was "jagged" indicating he may have had a past fracture or possibly bone cancer. He said his prostate felt enlarged(possible causing a urethral stricture)  He also said that there could also be a neurological cause or a combination. What I don't understand how this all happened so quickly, unless its cancer. The second vet suggested to take our horse to Cornell University for a full work up. While I know this information is basic and vague, I was hoping that some light could be shed on possible causes of his prostatitis - could it be diet or cancer? what could casuse sheath/penis swelling and inability to urinate. Are there other areas to look at or explore? If he does fine with the penis being tucked back in, can we do this for however long he lives rather than have surgery?(of course let it out and check it daily or every other day)

Being an RN, I know this is a serious issue that we will probably never fix this. But we are willing to go the extra mile of care with him because he is one of those horses  I swear is part human because he is so smart and he is the utmost gentleman and is always respectful. He is a one of a kind horse that you rarely meet. Thank you for your time. Any suggestions welcomed. Sincerely, Judi
Andrian
 
Posts: 49
Joined: Sat Mar 15, 2014 4:08 pm

Draft Gelding With Swollen Penis

Postby Deependu » Sat Oct 03, 2015 5:36 am

Judi:

without the ability to directly examine and evaluate your horse Im afraid you cannot expect a diagnosis of this whole thing from me over the internet. Your horse's history in my opinion is strongly suggestive of a neurologic problem affecting the bladder and the sphincter muscles way back your first vet diagnosed an "infection". The heavy sediment in the urine and the inability to adequately urinate on his own may suggest this. Im unclear on this "mass" that was diagnosed. Horses dont really get prostatitis and so although its possible, Im pretty skeptical of that diagnosis. It is possible that some of these signs are caused by urinary obstruction due to a mass. An endoscopic exam of the bladder is easily done to see if there is one and to get a biospy of it is there is one. This is not a diet issue. The sheath swelling and inability to urinate could be post renal obstruction or the neurological condition I described that has progressed, it may even be fulminant cauda equina syndrome if there is a spinal cord lesion in the area where all the nerves to the penis and rectum come off the spinal cord. This causes inability to urinate normally and inability to retract the penis which quickly leads to severe sheath and penis swelling. At 22 years of age, cancer is definately a consideration. Tucking the penis back in will never be successful in this managment and your horse may wind up requiring an amputation of the penis and possibly a perineal urethrostomy in order to control these signs. I echo the suggestion of taking him to Cornell for evaluation. You do not have enough information and diagnostics here yet to make the decision on how to proceed with management and treatment of this. Good luck to you. I hope this information helps you and your horse. Feel free to contact me again if you have any other questions or problems.
Deependu
 
Posts: 67
Joined: Fri Feb 07, 2014 6:18 pm


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