Gelding dribbling urine and straining - full bladder - vet says "nothing is wrong" and put him on Bute - thoughts?

[Dr_Doolittle]

So this is a horse belonging to one of my students (17 hand 13 year old TB): a couple of days ago he started to try to pee; stretching out, grunting - but just dribbling, no urine stream.

(Otherwise he seems fine: pooping, eating drinking, doesn’t seem uncomfortable other than this.)

I thought it might be a bean/dirty sheath, but his was done about a month ago (no bean found), and when the vet came out yesterday they confirmed that it wasn’t a dirty sheath. His bladder was full, so they put in a catheter and he finally got some relief! (poor animal), but all they did was have her put him on Bute - no other treatment or diagnostics.

He is NO better today, and the vet told her that “they can’t do anything” (and don’t have a rectal ultrasound available) - so she’s thinking of calling out another vet service. (This vet service is rather ahem limited IME…)

After searching the Forum, I read a post about a horse with this issue having bladder stones - might that be it? Horse doesn’t get alfalfa hay FWIW.

Thoughts and insights would be appreciated, TIA!

[VolteSomeday]

Any neuro symptoms? Not to be alarmist, but another vet needs to see this horse.

[Dr_Doolittle]

No, he is otherwise completely normal! And yes, the owner is going to call another vet -, I told her this is serious and that he can’t continue like this

[leighbo009]

My old guy (who has since passed, began when he was 10ish, so not old) had dribbling urine & it never resolved. He started dribbling & then I never saw him attempt to pee again.

We went to university vet & didn’t get much out of it. They scoped the bladder & found ulcers in the bladder. Typical ulcer meds (misoprostol) did not touch them, but treating him with steroids got rid of the ulcers in the bladder. We went to this university many times without any great understanding of issue, and went to another university as well and they also did not come to any conconlusion. He was very happy, very much the same horse, no neuro effects, couldn’t tell anything was wrong besides the dribbling urine.

He had no other neuro symptoms, but I wonder (once it was too late) if I should have pushed harder for EPM treatment. it lasted 5 years before he passed (unknown causes). His later years he started having neuro issues & we treated with EPM drugs & it got slightly better, but never effected the bladder, but I wonder if we would have done it earlier if it would have helped the bladder issues.

During the later years, we found out about https://www.pathogenes.com/clinical-trial & their drug. I wish I would have tried it earlier on. Maybe something to bring to your vet (or whatever vet you end up with). The NeuroQuel study, one of the cretira was dribbles or retains urine.

Unfortunately he passed peacefully on the Sunday of a holiday weekend, so no way I could get a Autopsy done, but I wish I could have so I had answers.

[IPEsq]

I would push to get another vet. I would be wary of using NSAIDs for anything that might be kidney related.

They definitely can get bladder stones. Happened to a friend of mine but I can’t recall the details, and it was a mare. She has to watch how much calcium is in the diet.

[LCDR]

My old retiree gelding had these signs too. Vet did an xray and found a stone lodged in his urethra blocking the urine flow. She sedated him and used humongous hemostats inserted into his penis to crunch up the stone. Word got around the barn in a heartbeat and every female boarder showed up to watch. Barn manager even called her mother so she wouldn’t miss the show. The horse did fine afterwards. Vet needed a fresh shirt after her horse urine shower.

[Dr_Doolittle]

Oh my!

Sorry folks, I tried to reply a number of times yesterday afternoon, but it kept giving me an error message when I tried to post!

Thanks for everyone’s responses and insights

She did call a different vet practice, they do have a mobile ultrasound unit and can do further diagnostics, but they can’t get out until Friday – she’s hoping that they can see him earlier.

I will update the thread when I have more info!

[hoopoe]

this issue may be one where you need to take the horse to the facility. This is a serious and painful situation . It is absolutely not one I would wait 4 days to resolve with a barn call

[Dr_Doolittle]

Well, she doesn’t have a rig so would need to arrange for somebody to take her.

[FjordBCRF]

Id do whatever is needed to get him seen ASAP, including an emergency after hours call if that’s the only other option.

If they can see him IN clinic sooner, I’d definitely be getting something arranged. Poor guy, good luck!

[Haven_tJumpedInALongTime]

I had a horse that had the exact same symptoms. He ended up having a large tumor by or in his bladder.

[MunchingonHay]

Ages ago (30+yrs) I used to ride my neighbor’s horse. We were out on the trail and took lunch and stopped to eat, tied the horses out to rest. He kept stretching out to pee, but there was a dribble like you mentioned.

I do not want to freak you out, but he had cancer of the penis. I do not remember the course of action taken regarding this cancer, or even how they diagnosed it; but it was so long ago it would not matter since modern med is so much better now than in the '90s.

[Dr_Doolittle]

Yikes, poor horse!

I won’t share that with her since it’s probably the worst possible case scenario.

[sparkygrace]

Was the gelding tested for a bladder infection? Years ago, I had a gelding with the same problem. My vet suggested Vitamin C and the problem cleared up within a week. It may be something that simple. Or, not.

[Dr_Doolittle]

Okay, so update!

The original vet practice (which seems bipolar; this AM they said “we can come out to look at him but won’t be able to do anything” - they did take blood last time, no elevated white count but elevated protein indicating inflammation in the bladder - then they called her back, saying that they did have the ultrasound on the truck so could come out today and scope!) I told her to go ahead and say yes so she didn’t have to wait until Friday.

When they ultrasounded, they said the bladder isn’t full (phew!, so he must be passing urine!), no wall abnormalities so no tumors there, no big artifacts like stones - but lots of little crystals.

They are doing a vinegar flush, no antibiotics or steroids: vitamin C and cranberry supplements to change ph of urine (just like when we homo sapiens get UTIs), change crystal formation, and get rid of mucus.

For at least 6 weeks - and Bute - for less than 6 weeks.

I mentioned that since he is ulcer prone (went through treatment and is now on Outlast), that Bute is hard on the stomach so she might consider Tylenol instead.

For those who do use Tylenol (this is a pretty recent discovery - at least to me!), how much is recommended?

TIA, and thanks also for all the input so far

[Dr_Doolittle]

The vet thinks it’s Oxalates or calcium in whatever plants he’s eating (they also said that it may be as a result of him being off for a couple of weeks and going back to work? Which didn’t really make sense to me as in: “Correlation doesn’t equal causation.”)

Anyway, no alfalfa ever! Poor horse, with his tendency to ulcers it’s too bad that that’s off the table for him.

They want him on “half a scoop” of bute per day for 10 days; that has to be what, 1 g? The horse is probably close to 1,400 pounds, so I’m dubious as to whether that’s going to have much impact on his comfort level.

ETA - two scoops per feeding for two days, then half that amount for three days. Owner is a little confused by all of this, this is her first horse

Apparently, it took them a while to place the catheter, poor animal! So he’s likely going to be sore for a day or two.

After they did the vinegar flush, twice, they put him back in his stall. His owner was messing with his haynet when he broke out of the stall and went “on walkabout” - which in OTTB terms apparently means flat out “on a mission” galloping out of the barn, through the gravel parking lot and up the gravel road and around the outdoor rings, swinging back around the parked trailers and a house and then galloping back into the parking lot where he finally allowed himself to be caught.

Fortunately, he was unharmed.

Horses, man!

The owner was funny, though - she said “he was literally full of piss and vinegar!”

[skydy]

Will you be getting a second opinion? I think it would be worth it. #1 vet practice sounds dubious to me.

[MapleFarm]

Acetaminophen dosage - 30mg/kg 2x/day was what I’ve been prescribed. It helped a lot more than bute for my horse - totally different type of issue though. It isn’t an anti inflammatory, just pain relief.

15% CBD at .03mg/kg has been shown to help with pain if given alongside nsaids (the study, I don’t believe, included standalone CBD) (Interlandi et al. (2024) ).

[jvanrens]

@Dr_Doolittle

The vet thinks it’s Oxalates or calcium in whatever plants he’s eating (they also said that it may be as a result of him being off for a couple of weeks and going back to work? Which didn’t really make sense to me as in: “Correlation doesn’t equal causation.”)

Anyway, no alfalfa ever! Poor horse, with his tendency to ulcers it’s too bad that that’s off the table for him.

From the minimal research I’ve done Oxalates cause a calcium absorption issue. Alfalfa is a relatively good source of calcium. So I don’t know why he can’t have alfalfa.

This article from MadBarn (with sources) explains some of it. Of course they recommend their product, you can skip right to the footnotes at the bottom if you prefer.

Oxalate Toxicity in Horses: Causes, Signs, Prevention & Treatment | Mad Barn

[sparkygrace]

@Dr_Doolittle

When they ultrasounded, they said the bladder isn’t full (phew!, so he must be passing urine!), no wall abnormalities so no tumors there, no big artifacts like stones - but lots of little crystals.

That’s exactly what was found in my gelding. Crystals. (It was not an infection, I remembered incorrectly because it was so long ago.) The Vitamin C cleared it up. Glad the vet figured out the problem.