1
|
Holmes AE, Chew BH, Laughlin R, Buckley J, Kiewice E, Dancel MJ, Blasko D, Wong VKF, Halawani A, Koo KC, Corl D, Fasolo P, Levy O, Thiel J, Bailey MR, Eichman J, Meegan JM, Haulena M. Application of novel burst wave lithotripsy and ultrasonic propulsion technology for the treatment of ureteral calculi in a bottlenose dolphin (Tursiops truncatus) and renal calculi in a harbor seal (Phoca vitulina). Urolithiasis 2024; 52:21. [PMID: 38189835 PMCID: PMC10774161 DOI: 10.1007/s00240-023-01515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Marine mammals may develop kidney stones, which can be challenging to treat. We describe burst wave lithotripsy (BWL) and ultrasonic propulsion to treat ureteral calculi in a 48-year-old female bottlenose dolphin (Tursiops truncatus) and to reduce renal stone burden in a 23-year-old male harbor seal (Phoca vitulina). BWL and ultrasonic propulsion were delivered transcutaneously in sinusoidal ultrasound bursts to fragment and reposition stones. Targeting and monitoring were performed with real-time imaging integrated within the BWL system. Four dolphin stones were obtained and fragmented ex vivo. The dolphin case received a 10-min and a 20-min BWL treatment conducted approximately 24 h apart to treat two 8-10 mm partially obstructing right mid-ureteral stones, using oral sedation alone. For the harbor seal, while under general anesthesia, retrograde ureteroscopy attempts were unsuccessful because of ureteral tortuosity, and a 30-min BWL treatment was targeted on one 10-mm right kidney stone cluster. All 4 stones fragmented completely to < 2-mm fragments in < 20 min ex vivo. In the dolphin case, the ureteral stones appeared to fragment, spread apart, and move with ultrasonic propulsion. On post-treatment day 1, the ureteral calculi fragments shifted caudally reaching the ureteral orifice on day 9. On day 10, the calculi fragments passed, and the hydroureter resolved. In the harbor seal, the stone cluster was observed to fragment and was not visible on the post-operative computed tomography scan. The seal had gross hematuria and a day of behavior indicating stone passage but overall, an uneventful recovery. BWL and ultrasonic propulsion successfully relieved ureteral stone obstruction in a geriatric dolphin and reduced renal stone burden in a geriatric harbor seal.
Collapse
Affiliation(s)
- Arturo E Holmes
- Dept. of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ben H Chew
- Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, British Columbia, Vancouver, Canada
| | - Robert Laughlin
- The Mirage Hotel, Hard Rock International, Las Vegas, NV, USA
| | - Jean Buckley
- Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, British Columbia, Vancouver, Canada
| | - Erica Kiewice
- The Mirage Hotel, Hard Rock International, Las Vegas, NV, USA
| | | | - David Blasko
- The Mirage Hotel, Hard Rock International, Las Vegas, NV, USA
| | - Victor K F Wong
- Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, British Columbia, Vancouver, Canada
| | | | - Kyo Chul Koo
- Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | | | - Jeff Thiel
- Ctr. for Industrial and Medical Ultrasound, Applied Physics Lab, Univ. of Washington, Washington, USA
| | - Michael R Bailey
- Dept. of Urology, University of Washington School of Medicine, Seattle, WA, USA.
- Ctr. for Industrial and Medical Ultrasound, Applied Physics Lab, Univ. of Washington, Washington, USA.
| | - Jammy Eichman
- National Marine Mammal Foundation, San Diego, CA, USA
| | | | | |
Collapse
|