Percutaneous nephrostomy in short-term management of ureterolithiasis and renal dysfunction in a filly

Percutaneous nephrostomy was used to provide urine output in a 3-year-old Thoroughbred filly with azotemia and obstructive ureterolithiasis. Previous left ureteral surgery had failed to provide clinical improvement, and the filly became more azotemic. Nephrostomy was performed in the standing patient, with ultrasonographic guidance and local anesthesia. Continuing IV fluid therapy and diuresis through the nephrostomy tube resulted in a decrease in clinical signs of azotemia. However, the filly developed a cecal impaction, which ruptured during surgery because of colic, and was euthanatized.