This case report describes the use of computed tomography for the diagnosis and surgical planning in a horse with bilateral nephrolithiasis. An adult Warmblood stallion (460 kg) was presented with chronic weight loss, hypercalcemia and azotemia. Ultrasonographic examination identified hyperechoic masses in both kidneys and dilation of the right renal pelvis. A solid mass was evident upon transrectal examination on the left side. Computed tomography (CT) of the caudal abdomen was performed and provided good quality images that facilitated exact determination of the size, position and extent of renal mineralization. The nephrolith of the right kidney was better demarcated when compared to the one of the left kidney and was therefore selected for nephrotomy. The horse developed a surgical site infection that led to euthanasia 3 weeks post-surgery. CT of the caudal abdomen in an adult horse is feasible and the three-dimensional understanding of renal mineralization provided a great advantage for the selection and planning of the most appropriate treatment option.
