• 1. Kyles AE, Hardie E, Wooden E, 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
  • 2. Roberts SF, Aronson L, Brown D. Postoperative mortality in cats after ureterolithotomy. Vet Surg 2011;40:438443.

  • 3. Livet V, Pillard P, Thollot-Goy I, et al. Placement of subcutaneous ureteral bypasses without fluoroscopic guidance in cats with ureteral obstruction: 19 cases (2014–2016). J Feline Med Surg 2017;19:10301039.

    • Search Google Scholar
    • Export Citation
  • 4. Culp WT, Palm C, Hsueh C, et al. Outcome in cats with benign ureteral obstructions treated by means of ureteral stenting versus ureterotomy. J Am Vet Med Assoc 2016;249:12921300.

    • Search Google Scholar
    • Export Citation
  • 5. Berent AC, Weiss CW, Todd KL, et al. Use of locking-loop pigtail nephrostomy catheters in dogs and cats: 20 cases (2004–2009). J Am Vet Med Assoc 2012;241:348357.

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

  • 7. Steinhaus J, Berent A, Weisse C, et al. Clinical presentation and outcome of cats with circumcaval ureters associated with a ureteral obstruction. J Vet Intern Med 2015;29:6370.

    • Search Google Scholar
    • Export Citation
  • 8. Berent AC, Weisse C, Bagley D. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstructions: 69 cases (2006–2010). J Am Vet Med Assoc 2014;244:559576.

    • Search Google Scholar
    • Export Citation
  • 9. 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
  • 10. 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
  • 11. Berent AC. Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostic and therapeutic options. J Vet Emerg Crit Care (San Antonio) 2011;21:86103.

    • Search Google Scholar
    • Export Citation
  • 12. Cray M, Berent A, Weisse C, et al. Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats. J Am Vet Med Assoc 2018;252:744753.

    • Search Google Scholar
    • Export Citation
  • 13. Reid G, Habash M, Vachon D, et al. Oral fluoroquinolone therapy results in drug adsorption on ureteral stents and prevention of biofilm formation. Int J Antimicrob Agents 2001;17:317319.

    • Search Google Scholar
    • Export Citation
  • 14. Wormser C, Clarke DL, Aronson LR. Outcomes of ureteral surgery and ureteral stenting in cats: 117 cases (2006–2014). J Am Vet Med Assoc 2016;248:518525.

    • Search Google Scholar
    • Export Citation
  • 15. Cai T, Mazzoli S, Lanzafame P, et al. Asymptomatic bacteriuria in clinical urological practice: preoperative control of bacteriuria and management of recurrent UTI. Pathogens 2016;5:E4.

    • Search Google Scholar
    • Export Citation
  • 16. Lennon GM. Double pigtail ureteric stent versus percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol 1997;31:2429.

    • Search Google Scholar
    • Export Citation

Advertisement

Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009–2015)

View More View Less
  • 1 Department of Veterinary Interventional Radiology and Interventional Endoscopy, Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 2 Department of Veterinary Interventional Radiology and Interventional Endoscopy, Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 3 Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
  • | 4 Lamb Consulting, 404 Thompson Ave W, West Saint Paul, MN 55118.

Abstract

OBJECTIVE To determine outcomes of subcutaneous ureteral bypass (SUB) device placement for treatment of benign ureteral obstruction in cats.

DESIGN Retrospective case series.

ANIMALS 134 cats with SUB devices placed in 174 obstructed ureters during 144 hospitalizations.

PROCEDURES Medical records of cats that underwent SUB device placement for treatment of benign ureteral obstruction between 2009 and 2015 were reviewed. The SUB device was placed by use of fluoroscopic and surgical methods. Signalment, history, diagnostic imaging results, postprocedural results, duration of hospitalization, complications, and short- and long-term outcomes were recorded.

RESULTS Ureteral obstructions were caused by ureterolithiasis (114/174 [65.5%]), stricture (28/174 [16.1%]), both ureterolithiasis and stricture (29/174 [16.7%]), or pyonephrosis (1/174 [0.6%]); in 2 (1.1%) cats, the cause was not recorded. Fifty-two of the 134 (39%) cats had bilateral ureteral obstruction. At admission, 127 (95%) cats were azotemic. Median serum creatinine concentrations at admission and 3 months after SUB device placement were 6.6 and 2.6 mg/dL, respectively. Median renal pelvis diameters before and after the procedure were 9.2 and 1.5 mm, respectively. Postsurgical complications included device occlusion with blood clots (14/172 [8.1%]), device leakage (6/172 [3.5%]), and kinking of the device tubing (8/174 [4.6%]). Cats survived to hospital discharge after 135 of the 144 (94%) hospital admissions. The most common long-term complication was catheter mineralization (40/165 [24.2%]), which was documented a median of 463 days after device placement. A high postoperative serum ionized calcium concentration was significantly associated with SUB device occlusion.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that SUB device placement may be a viable option for treatment of cats with benign ureteral obstruction.

Abstract

OBJECTIVE To determine outcomes of subcutaneous ureteral bypass (SUB) device placement for treatment of benign ureteral obstruction in cats.

DESIGN Retrospective case series.

ANIMALS 134 cats with SUB devices placed in 174 obstructed ureters during 144 hospitalizations.

PROCEDURES Medical records of cats that underwent SUB device placement for treatment of benign ureteral obstruction between 2009 and 2015 were reviewed. The SUB device was placed by use of fluoroscopic and surgical methods. Signalment, history, diagnostic imaging results, postprocedural results, duration of hospitalization, complications, and short- and long-term outcomes were recorded.

RESULTS Ureteral obstructions were caused by ureterolithiasis (114/174 [65.5%]), stricture (28/174 [16.1%]), both ureterolithiasis and stricture (29/174 [16.7%]), or pyonephrosis (1/174 [0.6%]); in 2 (1.1%) cats, the cause was not recorded. Fifty-two of the 134 (39%) cats had bilateral ureteral obstruction. At admission, 127 (95%) cats were azotemic. Median serum creatinine concentrations at admission and 3 months after SUB device placement were 6.6 and 2.6 mg/dL, respectively. Median renal pelvis diameters before and after the procedure were 9.2 and 1.5 mm, respectively. Postsurgical complications included device occlusion with blood clots (14/172 [8.1%]), device leakage (6/172 [3.5%]), and kinking of the device tubing (8/174 [4.6%]). Cats survived to hospital discharge after 135 of the 144 (94%) hospital admissions. The most common long-term complication was catheter mineralization (40/165 [24.2%]), which was documented a median of 463 days after device placement. A high postoperative serum ionized calcium concentration was significantly associated with SUB device occlusion.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that SUB device placement may be a viable option for treatment of cats with benign ureteral obstruction.

Contributor Notes

Address correspondence to Dr. Berent (Allyson.berent@amcny.org).