To say James Kier is a horseman is an understatement. He’s been riding since he was five years old growing up on the plains of Kansas. Competing on his trusty steed, Smooth Knitty Kitty, Kier has won world-champion buckles from the American Cutting Horse Association and United States Cutting Horse Association.
“I’m a competitive showman,” Kier admits. “My horse runs hard, stops hard, turns around fast. You sure can’t do that with a catheter bag hanging down your leg.”
Yet, that was the depressing prospect Kier faced following a failed transurethral resection of the prostate (TURP).
“My wife, Patty, and I had just moved to Gatesville, Texas, to be close to our daughter and husband,” Kier explains. “I didn’t feel very good so I went to the local clinic on Friday. I thought I was having some prostate issues and wanted to get a referral to a urologist. The physician took a blood sample and told me he would call me that afternoon no matter what the results were.”
The physician didn’t call, and Kiers went to a horse show the next morning. “When I got there, I was having to pee more than normal,” Kier remembers. “By the time I went to show my horse, I was feeling really sick.”
Kier managed to complete his event, but had to head to the bathroom immediately afterward. Patty loaded his horse into the trailer and drove the them home. Kier fell asleep on the drive, but woke en route with a large bulge in his abdomen.
“I felt terrible. I made my wife stop in the middle of the road so I could go into the horse trailer and try to pee. Nothing would come out. I thought the bulge in my stomach was going to erupt.”
A Missed Diagnosis
On Monday, Patty was able to reach the physician who’d seen Kier on Friday. The doctor told her to take Kier to the emergency room right away. The nearest ER was 30 miles away in Waco. “After we arrived, an internal medicine specialist there told me I was in total kidney failure,” Kier recalls.
Blockage from his prostate pushed urine back into Kier’s kidneys—causing early kidney failure. “I’d probably been in kidney failure since Friday, but the first doctor I saw never read my blood test.”
Kier was catheterized and 1100 ccs of urine was drained from his bladder. He stayed in the hospital a few days until his kidneys were functioning again, but the delay in proper treatment cost him.
“My bladder was dead,” he says. “Here I am, a horse guy with a younger wife. We have a very active lifestyle and go to horse shows every week. They gave me a catheter and a bag.”
Kier underwent a TURP in Waco with the hopes of turning things around. “Afterward, I still couldn’t pee. The urologist who performed my surgery told me I would never be able to urinate on my own again and would have to wear self-catheterize for the rest of my life.”
Kier admits the news hit him hard. “I was very depressed. My total life had changed. From January to May, I wasn’t able to do a damn thing. My life went from riding horses every day and competing every weekend to sitting in a chair.”
Turning Things Around

During a visit to see his sister in Fort Worth, Kier met a physician who recommended he see Dr. Trey Moore. A few days later, Kier was in Moore’s office. “He walked in and was Mr. Personality. Very nice guy. He told me there were lots of things we could do, not to give up. He made me feel like there was a chance to get my life back.”
Dr. Moore sent Kier to see one of his partners, Dr. Wendy Leng, a specialist in bladder control and voiding dysfunction. She conducted urodynamics testing to determine the exact condition of Kier’s bladder. Afterward, Dr. Leng told him, “I don’t give very many people this news, but your bladder is still trying to work. I’m very optimistic for you.”
Encouraged by Dr. Leng’s findings, Dr. Moore performed a cystoscopy to check out Kier’s urethra and bladder. “I found residual obstruction and decided to perform a repeat TURP to remove the residual tissue,” Dr. Moore explains.
Kier underwent his second TURP a few days later, just before Memorial Day 2015. “My post-op catheter and bag were removed the day after Memorial Day, and I’ve been peeing on my own ever since,” Kier enthuses. “Dr. Moore is a miracle doctor. The first urologist I saw gave me the kiss of death. If I’d listened to him and given up, my life would be very different.”
It was about six months before Kier was cleared to ride Smooth Knitty Kitty, but as Kier explains, “When you’ve lost something that you took for granted and the man gives you your life back, you do what he says.”

To say that life back in the saddle is good is an understatement. Kier has been riding his way to coveted championship buckles ever since. In 2016, he was named the American Cutting Horse Association’s Non-Pro World Champion. In 2017, he became the United States Cutting Horse Association Non-Pro World Champion. And in 2019, he out raced the competition to become the United States Cutting Horse Association Select Class World Champion and its Non-Pro World Champion. The 2020 season started with impressive showings at the both the Fort Worth and Houston Stock Shows until the coronavirus shut down competitions.
“After Dr. Moore fixed me up, I was as good as I ever was—probably better,” Kier insists. “I’m retired and I retired to have fun and show horses. My life is great again. My wife is the happiest woman in the world because we can enjoy the active lifestyle we love.”
Dr. Moore says seeing Kier’s joy is very rewarding. “By collaborating with my partner, Dr. Leng, we were able to determine that he had good bladder function. This allowed me to remove prostate tissue with a short procedure and get him back to his activities. I still keep the coffee mug he gave me with a photo of him and his championship horse in my office as a reminder not to give up on anyone.”
Now Kier recommends Dr. Moore to his friends.
“We’re all old timers with prostate issues still trying to ride and show horses,” he says. “I tell them about Dr. Moore because I know what a relief it is to finally meet a doctor who’s actually optimistic and doesn’t treat you like you’re a number. Dr. Moore cares for you like he’s a friend. If it wasn’t for him, I’d probably be sitting in a chair feeling sorry for myself. I love that man.”
Are you having prostate issues?
Urology Partners offers state-of-the-art treatment options to help you enjoy life again. Read more or schedule an appointment with one of our board-certified urologists by calling 866-367-8768 or schedule an online appointment.