Journal of Advanced Biomedical & Pathobiology Research Vol.2 No.2, June 2012, 40-44

Hydronephrosis in a goat kid (Capra hircus) due to Congenital Urethral Malformation Jalal-ud-Din Parrah1a, Bashir Ahmad Moulvi2b, Hakim Athar3c, Mohammed Osamah Kalim4d, Hilal Musadiq Khan7e Faisal Hassan Dedmari5f, Manmeet Singh6g

Article Info Received: 27th February 2012 Accepted:14th June 2012 Published online: 15th June 2012

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Division of Veterinary Surgery and Radiology FVSc and AH, SKUAST-K, India 7 Incharge Sheep Research Station, FVSc and AH, SKUAST-K, India a [email protected], [email protected], c [email protected], [email protected] e [email protected], [email protected] g [email protected]

ISSN: 2231-9123

© 2012 Design for Scientific Renaissance All rights reserved

ABSTRACT This communication presents a case of hydronephrosis associated with the congenital urethral malformation in a newborn male goat which was presented with history of anuria, and swelling near pre scrotal area. Clinical examination showed absence of penis and presence of blind ended urethral diverticulum distended with urine. Ultrasonographic examination showed presence of hydronephrois that was more severe in right kidney. Urethrostomy was performed and urine was drained from the urethral diverticulum. To the authors knowledge hydronephrosis due to congenital urethral defects have not been previously described in a goat.

Keywords: Hydronephrosis, Urethral, Ultrasonographic, Urethrostomy 1. Introduction Hydronephrosis a condition which develops when there is dilatation of the renal pelvis due to obstruction to free flow of urine. The obstruction may be anywhere in the tract-from the urethra to the renal pelvis. It can be congenital or acquired (Shastri and Rao 2003). Congenital anomalies of the urinary system other than pervious urachus are rarely reported in ruminants (Sharma and Sing, 1993, Temizsoylu, 2005, Omidi et al., 2011). Abnormalities of penis occur rarely in sheep and goat (Pugh, 2002). Hypospadias is a rare congenital malformation of the urethra in domestic mammals. Congenital cystic diseases of liver, kidney and pancreas have been reported in goats (Krotec, 1996). There are very few reports of urethral diverticulum in goats and kids (Fuller et al 1992; Karras et al 1992, Cruz-Arambulo et al, 2003, Sharma et al 2011). Diagnosis of hydronephrosis is made on the basis of ultrasonography. In humans, Hydronephrosis is graded as mild (grade 1), moderate (grade 2), or sever (grade 3) (Kriegshauser, Carroll, 1993). A case of congenital urethral diverticulum, absence of penis along with hydronephrosis in a male Bakerawal kid and its successful surgical management is placed on record.

Journal of Advanced Biomedical & Pathobiology Research Vol.2 No.2, June 2012, 40-44

2. Case History and observation A two days old Bakerwal kid from the Mountain Sheep Research Station, Shuhama was referred with the history of swelling over pre-scrotal region and anuria. The animal on the day of birth had normal milk intake. However on the day of presentation, the animal did not take any milk. On palpation the swelling was revealed to be fluid filled sac. There was no penis and the swelling had no opening (Fig 1). The urethral process was absent. The kid was tachycardic but had a normal rectal temperature (39.1oC). No other malformation apart from laxed tendons at all fetlock joints was visible. Ventral abdomen along with the flank was clipped and shaved. Needle centesis of the structure yielded presence of fluid which was confirmed as urine upon its chemical examination. The urinary bladder, kidneys, spleen and liver were subjected to ultrasonography. No abnormality was recorded in the spleen and liver. The urinary bladder was distended with urine. The longitudinal ultrasound of both the kidneys showed a large hypoechoic area in the center of each kidney suggestive of hydronephrosis. The hypoechoic area was comparatively bigger in the right one (Fig 2 and 3). 3. Treatment Taking into account the emergency nature of the case, it was decided to be operated upon immediately. Pre-scrotal area was prepared aseptically with Povidone-Iodine scrub solution. The animal was sedated with diazepam @ 0.2 mg/kg b.wt (I/V), and 1% lignocaine was locally infiltrated at the site. Surgical correction was carried out successfully under local anesthesia after sedating the animal.. A stab incision was made in the urethral diverticulum and urine was drained out. Urethrostomy was performed by excising the portion of the said swelling. Urethra and skin were sutured separately with 2-0 silk (Mersilk) in a simple interrupted pattern. Postoperatively the kid was injected with penicillin G procaine at a dose of 25.000 IU/kg/day, IM, for five days. The animal recovered uneventfully. 13th day postoperative ultrasonographic examination revealed that the kidneys were normal in echotexture (Fig 4 & 5). 4. Discussion The development of the external male genitalia is a complex process, involving genetic programming, cell differentiation, hormonal signaling, enzyme activity, and tissue remodeling. A disturbance in these processes might lead to disruption of the fusion of the urogenital folds at different sites along the urogenital tract. Environmental toxicants and xenoestrogens, acting during fetal life, have been partly implicated in an increasing incidence of hypospadias, as well as other reproductive tract abnormalities (Baskin et al., 2001). Congenital anomalies of the urinary system frequently present in multiples and are often seen with abnormities of the other system (King et al., 2002, Temizsoyolu, 2005). However congenital urethral abnormalities are very rare and sporadic cases of congenital urethral diverticulum have been reported in kids and lambs with the ventral swelling of the prepuce caused by the accumulation of urine in the urethral out pocket. This sac is formed due to the failure of the urethral wall closure (Al-Ani et al., 1998). Most of the cases have been reported to exhibit hermaphodritism in addition to the hypospadias which was however not seen in the 41

Journal of Advanced Biomedical & Pathobiology Research Vol.2 No.2, June 2012, 40-44

present case. Hypospadias has been classified based on the location of the urethral opening as glandular, penile, scrotal, perineal and anal (Alam et al., 2005). Urethral diverticulum might be single or multiple. Obstructive uropathy with resultant hydronephrosis has been reported as the eventual outcome of most urologic affections (El-Kammar et al 2012). Hydronephrosis in goats has been reported to occur due to urethral obstruction (Morin and Badertscher, 1990), urolithiasis (Kümper, 1994), neoplasia, and induced ureteric obstruction (El-Kammar et al, 2012), the complete ureteric obstruction causes the progressive dilatation of the renal pelvis and destroys the renal function (Gulmi et al., 2002). The ultrasonographic examination revealed that the right kidneys large anechoic renal pelvis than the left kidney giving the right kidney a cyst like appearance. These findings are similar to those of (El-Kammar et al., 201)2. The cause of the unique hydronephrosis in the present case was the accumulation of urine in absence of the urethral opening through which it could have been voided that produced stasis of urine which with its back pressure caused hydronephrosis. The case was successfully managed with urethrostomy to create opening for the flow of urine and the subsequent resolution. 5. Conclusions The present paper stresses the need for early correction of the congenital urethral anomalies of goat to avoid possible complications like hydronephrosis. References Alam, MR; Shin, SH; Lee, HB; Choi, IH and Kim, NS (2005). Hypospadias in three calves: a case report. Veterinary Medicine-Czech., 50: 506-509. Al-Ani, F.K., Khamas1,W.A., Al-Qudah1, K.M, Al-Rawashdeh O. (1998). Occurrence of congenital anomalies in Shami breed goats: 211 cases investigated in 19 herds.Small Ruminant Research. 28 (3), 225-232 Baskin, LS (2000). Hypospadias and urethral development. Journal of Urology., 163: 951956. Cruz-Arambulo, R.J., Tan, L., Callan, R. J., Van Metre, D.J., Park, R.D. (2003): What is your diagnosis? [Communication between the urethra and corpus spongiosum, urethral stricture mild cystitis, and presence of a urethral diverticulum]. Journal of American Veterinary Medical Association, 222, 1211-1212. El-Kammar, M.H., Alsafy, M.A.M.,. Mohammed, M.I and EL-Neweshy M.S. (2012). Ureteric obstruction and hydronephrosis in baladi goats: Topographical anatomy, ultrasonographical, hematological and pathological findings. Small Ruminant Research 104: 169– 178 Ellenbogen, P.H., Scheible, F.W., Tanner, L.B., and Leopold G. R. (1978). Sensitivitiy of grayscale ultrasound in detecting urinary tract obstruction. American Journal of Roentgenology, 978;130:731-733. Fuller, D.T., Baird, A.N., Morris, E.L., Kraemer DC (1992): What is your diagnosis? [Hypospadias and urethral diverticulum in goat]. Journal of American Veterinary Medical Association, 201, 1431-1432. 42

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Gulmi, F.A., Felsen, F.A., Vaughan, E.D., (2002). Pathophysiology of urinary tract obstruction. In: Retik, A.B., Vaughan, E.D., Wein, A.J. (Eds.), Campbell’s Urology. , eighth ed. WB Saunders, Philadelphia, pp. 411–456. Karras, S., Modransky, P., Welker, B.(1992) Surgical correction of urethral dilation in an intersex goat. Journal of American Veterinary Medical Association, 201 (10): 1584-1586. King, W.W., Young, M.E., Fox, M.E. (2002): Multiple congenital genitourinary anomalies in a polled goat, Contemporary Topics in Laboratory Animal Science, 41, 39-42. Kriegshauser, J.S., Carroll, B.A., (1991) The urinary tract. In: Rumack CM, Wilson SR, Charboneau JW, eds. Diagnostic Ultrasound St. Louis: Mosby Year Book,242. Krotec, K., Meyer, B.S., Freeman, W., Hamir, A.N. (1996). Congenital cystic disease of the liver, pancreas, and kidney in a nubian goat (Capra hircus). Veterinary Pathology. 33(6), 708-10. Kümper H. (1994). Urolithiasis in male sheep and goats. Clinical picture, therapeutic possibilities and prognostic evaluation (Article in German). Tierarztl Prax. 22(3):234-41. Morin, D.E and Badertscher, R.R. 2nd. (1990) Ultrasonographic diagnosis of obstructive uropathy in a caprine doe. Journal of American Veterinary Medical Association.197(3):378-80. Newman, S.J., Leichner, T., Crisman, M., Ramos, J. (2000). Congenital cystic disease of the liver and kidney in a pygmy goat. Journal of Veterinary Diagnostic Investigation. 12(4), 374-8. Omidi, A., Monjezi, S., and Nabipourm, A. (2011) Hypospadias, diverticulum, and agenesis in the penile shaft of a goat kid (Capra hircus). Comparative Clinical Pathology. 20(4), 417-419. Pugh, D. G. (2002). Sheep and Goat medicine. First edition. Saunders pp 139. Sharma, A.K., Kuamr, S., Kumar, H., and Dass, L.L. (2011). Surgical Management of Urethral Dierticulum in Male Goats. Indian Veterinary Journal 88 (10), 35-36. Shastri, G.A., and Rao, P.R. (2001). The Urinary System In: Veterinary Pathology 7th edition CBS Publishers & Distributors, New Delhi pp 381. Temizsoylu, M. D. (2005). Penile urethral diverticulum in a kid. Faculty of Veterinary Medicine, Ankara University, 52, 185-187.

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Journal of Advanced Biomedical & Pathobiology Research Vol.2 No.2, June 2012, 40-44

Fig 1: Photograph showing kid with urethral diverticulum and penile aplasia

Fig 4: B Mode Longitudinal Ultrasonogram of the Right Kidney 13 days postoperatively

Fig 2: B mode Longitudinal Ultrasonogram of the Right Kidney showing severe dilation of renal pelvis

Fig 5: B Mode Longitudinal Ultrasonogram of the Left Kidney 13 days postoperatively

Fig 3: B mode Longitudinal Ultrasonogram of the Left Kidney showing moderate dilation of renal pelvis

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