Management and outcome of cats with ureteral calculi: 153 cases (1984–2002)

Andrew E. KylesDepartments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Elizabeth M. HardieDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Brent G. WoodenDepartments of Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Christopher A. AdinDepartments of Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.
Present address is Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

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Elizabeth A. StoneDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Clare R. GregoryDepartments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Kyle G. MathewsDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Larry D. CowgillDepartments Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Shelly VadenDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Thomas G. NylandDepartments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Gerald V. LingDepartments of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Abstract

Objective—To determine outcome of medical and surgical treatment in cats with ureteral calculi.

Design—Retrospective study.

Animals—153 cats.

Procedure—Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information.

Results—All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure.

Conclusions and Clinical Relevance—Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function. (J Am Vet Med Assoc 2005;226:937–944)

Abstract

Objective—To determine outcome of medical and surgical treatment in cats with ureteral calculi.

Design—Retrospective study.

Animals—153 cats.

Procedure—Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information.

Results—All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure.

Conclusions and Clinical Relevance—Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function. (J Am Vet Med Assoc 2005;226:937–944)