
I took our blind foal Brynn into Missoula today for an echocardiogram of her heart. Our small animal internal medicine specialist, Dr. Dave Bostwick, had offered to use his state-of-the-art ultrasound equipment to do the echocardiogram. (His machine even does cool stuff like color Doppler imaging to trace blood flow.) So I trailered Brynn to Dave’s clinic, where our equine vet, Dr. Bill Brown, and his vet tech Linda, met us.
In the photo Bill is on the left reading the images on the screen, Dave is in the center using the ultrasound probe on Brynn’s heart, and Linda is holding Brynn. The echocardiogram revealed that Brynn has something called a Ventricular Septal Defect, a fancy term for "hole in the wall." Specifically, she has a hole in the muscular wall that separates the left and right sides of her heart. When her heart beats, instead of all the blood on the left side going out the aorta and into the body, some blood gets squirted back into the right side of the heart. That’s what is causing the murmur Bill detected last week.

The bad news is that Brynn is at risk of right-sided heart failure as she ages. The good news — and this really was good news — is that this kind of defect does NOT put her at risk for anesthesia. So we still might be able to surgically correct her ectopic ureter problem, where her kidney is bypassing the bladder. This is why we wanted to do the echocardiogram, to find out exactly what is going on with her heart and what that might mean for future treatment options.
While Brynn was in the clinic Dave also ultrasounded her bladder, which we found actually had urine in it. This means that she may only have one kidney that is bypassing the bladder, rather than both kidneys. That is also good news.
After finishing the ultrasound at Dave’s practice, I drove Brynn over to Bill’s clinic. There we gave her a plasma infusion to boost her antibody levels. While she was sedated for the plasma infusion, Bill inserted an endoscope (a lighted scope) up her urethra to try and see where the ureter from the kidney was coming out. Surprisingly, he found her uterus full of urine, which may answer at least part of the question.
(Confused by all the "u" words that sound alike? Me, too. The ureter is the tube that carries urine from the kidney to the bladder; in Brynn’s case at least one ureter doesn’t connect to the bladder but is dumping the urine elsewhere, apparently in her uterus. The urethra is the tube that carries urine from the bladder and excretes it outside the body.)
Bill also did an ultrasound of Brynn’s kidneys and found one was pretty normal looking and the other was not, with a big hole in the middle. (Uh oh, another hole.) He couldn’t tell what might have caused it.
Our next step at this point is for Bill to consult with an equine kidney specialist at Michigan State University. Meanwhile, Brynn was a wonderful patient throughout all the diagnostic procedures today, but she was ready to head back home when it was all over!
(Click on photos for larger image.)
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