Brynn's Surgery -- Third Time A Charm?
As long-time blog readers know, our blind filly Brynn was born with multiple health problems, but her only real quality of life issue is urine leaking from screwed-up internal plumbing. Her ureter -- the tube that takes urine from the kidney to the bladder -- instead is hooked up to her vagina, so the urine pools there and then dribbles out almost constantly. (I say 'ureter' singular because she has only one working kidney.)
We have to bathe her every day and apply Desitin to her legs to try and prevent urine scalds from developing. But now that summer is upon us and the days are getting warm, the combination of the heat, her own sweat and the urine makes for a very corrosive brew ... and even daily baths don't completely prevent the urine scalds this time of year.
When she was younger, we took her to Washington State University's veterinary teaching hospital twice for surgeries to correct this problem, but both operations -- called a urethral extension -- failed to fix it. The anatomy of her 'private parts' is not exactly normal in shape or location, which makes this a very challenging procedure to perform on her.
So we waited a year for her to grow bigger before attempting another operation. The more room there is inside her makes it a bit easier for the surgeon to work back there. Our equine vet, Dr. Erin Taylor, is also a board-certified veterinary surgeon who has done this procedure before on mares with normal anatomy, and she offered to try on Brynn.
Thus this morning I drove Brynn to Erin's clinic in Missoula, Blue Mountain Veterinary Hospital. I took the photo above of Erin doing some exploratory work to figure out the best approach. The green plastic jacket she's wearing is her "pee protection suit," since Brynn can squirt urine quite a ways. Or, as Erin referred to Brynn today, it's about the princess and the pee.
What we found is the scar tissue from the previous surgeries, and it became clear that trying the same urethral extension would most likely fail again. At the most critical place where the sutures have to hold the extension together -- deep inside her -- the tissue is too thin and weak to sustain the pressure. This is why the extensions broke down before, and unfortunately, a year of growth has not altered her internal landscape.
As a result, Erin tried a different technique, which involved cutting around the end of the ureter to "release" it so urine could flow back towards her bladder. This is really hard to explain -- I just don't have the anatomical vocabulary, and without you seeing what it looks like, I'm not sure a verbal explanation would make much sense any way. But her ureter enters the vagina just past a ridge of tissue, and it is this ridge that allows the urine to flow forward into the vagina and prevents the urine from flowing back down to the bladder ... which lies behind that ridge. The purpose of the procedure today was to re-direct the ureter's flow of urine around the ridge and towards the bladder. Almost like a dam bypass channel.
It's too soon to know whether this will work. I brought Brynn home from the clinic this evening. Erin thought it might take a week or more before we'll know for sure whether this helped her or not, depending on how the surgery site heals.
Brynn also had blood in her urine today, which we had not seen in several months. This means she may have another kidney infection developing. We'll have her blood work back tomorrow and will know then what her kidney values are.
At this point all we can do is keep our fingers crossed.
I can imagine that summers are especially uncomfortable for Brynn with her peeing leakage.
I hope this third time, with the good doctors expertise, worked!
We'll keep good thoughts going for sweet Brynn.
Posted by: Boundforglory | June 23, 2008 at 08:09 AM
Sending precious Bryn best wishes for a successful surgery!
Posted by: Nina | June 22, 2008 at 05:28 PM
Prayers for Brynn headed to Montana from St. Louis. I was wondering how she was doing and sure hope that this works. It would be wonderful!
Posted by: Suzanne | June 21, 2008 at 06:48 AM
Hi Alayne and Steve- I really hope this works for Brynn. She is such a sweetheart and deserves at least this break! If not, Auntie Heather will still be happy to give her baths when I visit. :)
Big hugs for Moosie.
Heather and Timmy Reeves
Posted by: H.Reeves | June 20, 2008 at 08:55 PM
We're hoping for the best for Brynn and all of you. I have a good, hopeful feeling about this. She's sure a little trooper, :)
Posted by: Margaret | June 20, 2008 at 08:54 AM
Poor, sweet baby! I hope this works for you, Brynn!
Posted by: Moon Rani | June 20, 2008 at 05:33 AM
Yay for Dr. Erin and her "pee suit"!
Hope this surgery "takes" with Miss Brynn so she can get back to enjoying summer and growing big and strong.
PS - EVERYONE VOTE FOR ANIMAL HERO OF THE YEAR SO RDR CAN CONTINUE THEIR GOOD WORK!
Posted by: Lisa | June 19, 2008 at 11:10 PM
Brynn I'm thinking positive thoughts and prayers for you!
Posted by: Shirley * James * Portland, OR | June 19, 2008 at 09:33 PM
ATTENTION ALL BLOG READERS: I urge you to log on to the Animal Planet and vote for Steve or Alayne for Animal Hero of the Year--this could mean $10,000 for the RDR!!!! DO IT TODAY!!
http://animal.discovery.com/
Steve--I know you and Alayne are very humble but maybe you can vote for Alayne and but it on the blog which was suggested in a round about way by another blog reader!
Posted by: Shirley * James * Portland, OR | June 19, 2008 at 09:33 PM