• 1. Klahr S. Pathophysiology of obstructive nephropathy. Kidney Int 1983;23:414426.

  • 2. Narins RG. Post-obstructive diuresis: a review. J Am Geriatr Soc 1970;18:925936.

  • 3. Atamer T, Artim-Esen B, Yavuz S, et al. Massive post-obstructive diuresis in a patient with Burkitt's lymphoma. Nephrol Dial Transplant 2005;20:19911993.

    • Search Google Scholar
    • Export Citation
  • 4. Kyles AE, Hardie EM, Wooden BG, et al. Management and outcome of cats with ureteral calculi: 153 cases (1984–2002). J Am Vet Med Assoc 2005;226:937944.

    • Search Google Scholar
    • Export Citation
  • 5. Zaid MS, Berent AC, Weisse C, et al. Feline ureteral strictures: 10 cases (2007–2009). J Vet Intern Med 2011;25:222229.

  • 6. Kyles AE, Hardie EM, Wooden BG, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984–2002). J Am Vet Med Assoc 2005;226:932936.

    • Search Google Scholar
    • Export Citation
  • 7. Westropp JL, Ruby AL, Bailiff NL, et al. Dried solidified blood calculi in the urinary tract of cats. J Vet Intern Med 2006;20:828834.

    • Search Google Scholar
    • Export Citation
  • 8. Baum N, Anhalt M, Carlton CE Jr, et al. Post-obstructive diuresis. J Urol 1975;114:5356.

  • 9. Francis BJ, Wells RJ, Rao S, et al. Retrospective study to characterize post-obstructive diuresis in cats with urethral obstruction. J Feline Med Surg 2010;12:606608.

    • Search Google Scholar
    • Export Citation
  • 10. Fröhlich L, Hartmann K, Sautter-Louis C, et al. Postobstructive diuresis in cats with naturally occurring lower urinary tract obstruction: incidence, severity and association with laboratory parameters on admission. J Feline Med Surg 2016;18:809817.

    • Search Google Scholar
    • Export Citation
  • 11. Schmiedt C, Tobias KM, Otto CM. Evaluation of abdominal fluid: peripheral blood creatinine and potassium ratios for diagnosis of uroperitoneum in dogs. J Vet Emerg Crit Care (San Antonio) 2001;11:275280.

    • Search Google Scholar
    • Export Citation
  • 12. Hamdi A, Hajage D, Van Glabeke E, et al. Severe post-renal acute kidney injury, post-obstructive diuresis and renal recovery. BJU Int 2012;110:E1027E1034.

    • Search Google Scholar
    • Export Citation
  • 13. Pearce D, Soundararajan R, Trimpert C, et al. Collecting duct principal cell transport processes and their regulation. Clin J Am Soc Nephrol 2015;10:135146.

    • Search Google Scholar
    • Export Citation
  • 14. Feldman EC. Polyuria and polydipsia. In: Ettinger SF, Feldman EC, eds. Textbook of veterinary internal medicine. 7th ed. St Louis: Saunders Elsevier, 2010;156159.

    • Search Google Scholar
    • Export Citation
  • 15. Davis H, Jensen T, Johnson A, et al. 2013 AAHA/AAFP fluid therapy guidelines for dogs and cats. J Am Anim Hosp Assoc 2013;49:149159.

  • 16. Garcia de Carellan Mateo A, Brodbelt D, Kulendra N, et al. Retrospective study of the perioperative management and complications of ureteral obstruction in 37 cats. Vet Anaesth Analg 2015;42:570579.

    • Search Google Scholar
    • Export Citation
  • 17. Kulendra NJ, Syme H, Benigni L, et al. Feline double pigtail ureteric stents for management of ureteric obstruction: short- and long-term follow-up of 26 cats. J Feline Med Surg 2014;16:985991.

    • Search Google Scholar
    • Export Citation
  • 18. Berent AC, Weisse CW, Todd K, et al. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006–2010). J Am Vet Med Assoc 2014;244:559576.

    • Search Google Scholar
    • Export Citation
  • 19. Horowitz C, Berent A, Weisse C, et al. Predictors of outcome for cats with ureteral obstructions after interventional management using ureteral stents or a subcutaneous ureteral bypass device. J Feline Med Surg 2013;15:10521062.

    • Search Google Scholar
    • Export Citation
  • 20. Harris RH, Yarger WE. The pathogenesis of post-obstructive diuresis. The role of circulating natriuretic and diuretic factors, including urea. J Clin Invest 1975;56:880887.

    • Search Google Scholar
    • Export Citation
  • 21. Sophasan S, Sorrasuchart S. Factors inducing post-obstructive diuresis in rats. Nephron 1984;38:125133.

Advertisement

Factors associated with postobstructive diuresis following decompressive surgery with placement of ureteral stents or subcutaneous ureteral bypass systems for treatment of ureteral obstruction in cats: 37 cases (2010–2014)

View More View Less
  • 1 1Department of Surgical and Radiological Sciences, University of California-Davis, Davis, CA 95616.
  • | 2 2Department of Medicine and Epidemiology, University of California-Davis, Davis, CA 95616.
  • | 3 3School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 4Department of Clinical Studies–Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Abstract

OBJECTIVE

To describe postobstructive diuresis (POD) in cats undergoing surgical placement of ureteral stents or subcutaneous ureteral bypass systems for treatment of ureteral obstruction in cats and to identify factors associated with duration and maximum severity of POD.

DESIGN

Retrospective case series.

ANIMALS

37 client-owned cats with ureteral obstruction treated between August 2010 and December 2014.

PROCEDURES

Medical records were reviewed, and data extracted included signalment, history, results from physical examinations and clinical laboratory analyses, treatment, urine output, and outcome. Data were evaluated to identify factors associated with POD duration and maximum severity, alone or in combination.

RESULTS

Serum concentrations of creatinine, potassium, phosphorus, and BUN before surgery positively correlated with duration and maximum severity of POD. Absolute changes in serum concentrations of creatinine, potassium, and BUN from before surgery to after surgery positively correlated with POD duration. Cats with anuria before surgery had longer POD than did other cats; however, there was no difference in POD duration or maximum severity with unilateral versus bilateral ureteral obstruction. Thirty-four of 37 (92%) cats survived to hospital discharge, which was not associated with whether ureteral obstruction was unilateral or bilateral. Azotemia resolved in 17 of the 34 (50%) cats that survived to hospital discharge.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of the present study indicated that several factors were associated with POD duration and maximum severity, alone or in combination, and that with intensive management of fluid and electrolyte derangements, regardless of the extent of the original azotemia, a high percentage of cats survived to hospital discharge.

Abstract

OBJECTIVE

To describe postobstructive diuresis (POD) in cats undergoing surgical placement of ureteral stents or subcutaneous ureteral bypass systems for treatment of ureteral obstruction in cats and to identify factors associated with duration and maximum severity of POD.

DESIGN

Retrospective case series.

ANIMALS

37 client-owned cats with ureteral obstruction treated between August 2010 and December 2014.

PROCEDURES

Medical records were reviewed, and data extracted included signalment, history, results from physical examinations and clinical laboratory analyses, treatment, urine output, and outcome. Data were evaluated to identify factors associated with POD duration and maximum severity, alone or in combination.

RESULTS

Serum concentrations of creatinine, potassium, phosphorus, and BUN before surgery positively correlated with duration and maximum severity of POD. Absolute changes in serum concentrations of creatinine, potassium, and BUN from before surgery to after surgery positively correlated with POD duration. Cats with anuria before surgery had longer POD than did other cats; however, there was no difference in POD duration or maximum severity with unilateral versus bilateral ureteral obstruction. Thirty-four of 37 (92%) cats survived to hospital discharge, which was not associated with whether ureteral obstruction was unilateral or bilateral. Azotemia resolved in 17 of the 34 (50%) cats that survived to hospital discharge.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of the present study indicated that several factors were associated with POD duration and maximum severity, alone or in combination, and that with intensive management of fluid and electrolyte derangements, regardless of the extent of the original azotemia, a high percentage of cats survived to hospital discharge.

Contributor Notes

Mr. Ben-Aderet was a first-year veterinary student at the time of the study.

Address correspondence to Dr. Culp (wculp@ucdavis.edu).