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Bladder lesions and blood in mare's urine

I have done several searches and can’t find any threads related to mares with bladder lesions and passing blood clots. Can anyone point me in a direction that might yield some help?

My 26 y/o semi-retired Hanoverian mare recently began passing blood clots. First, she fully voids her bladder, then she parks out again and strains to urinate several times more within a few minutes. This secondary effort is when she typically passes a blood clot or two (see photo below – between the size of a quarter and a 50-cent piece).

Had her scoped and the test revealed significant lesions in her bladder. She had 10 days of SMZs and a follow-up scope showed improvement, but some lesions were still present. Urine culture revealed normal/expected bacteria levels.

Next treatment step was 14 days of Banamine + hydroxypyridine tablets. She did fine at first, then went off her feed, so I discontinued the meds at 11 days. Her appetite is back, but so are the blood clots (maybe they were never gone?).

The scopes showed no visible evidence of bladder stones; a biopsy revealed no cellular dysplasia.

The vet says cystitis is a relatively uncommon ailment in horses. Apparently not a lot of research (or treatments) available. Only one treatment left to try, which is a few days in the hospital for repeat flushing with DMSO. I’m not enthusiastic.

She is in light work 5 days/week (3 groundwork; 2 mounted). Thirty minutes of walk, trot, and these days maybe a canter circle or two if we’re feeling up to it.

It’s always hard to know how much discomfort she may be in. She has a history of abnormally heavy and frequent heat cycles (and a uterus with an abnormally high number of cysts), so I’m always dealing with that variable, making it tough to know how she’s really feeling on any given day. Plus, she has arthritis, cushings, and incisor disease. Oy.

Can anyone point me to any threads or resources that may be helpful re: bladder issues? Has anyone here dealt with this before?

Thanks in advance - I appreciate any suggestions.



I just posted with urinary incontinence in a gelding. It’s been 2 years since it started, and it hasn’t gotten better, nor has it gotten worse. My guy does not full void his bladder, so we have some other issues, but we have been to 2 veterinary teaching hospitals, and neither could give us much home. He enjoys being worked, so I have been riding him to keep him happy, hoping that one day, we will figure it out. Sorry you are going through the same types of issues.

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