Peer-reviewed veterinary case report
Subcutaneous ureteral bypass in cats using ultrasound guidance
By Butty, Emmanuelle Marie & Labato, Mary Anna·Published in Journal of feline medicine and surgery·2021·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Subcutaneous ureteral bypass device placement with intraoperative ultrasound guidance, with or without microsurgical ureterotomy, in 24 cats.
- Species:
- cat
Plain-English summary
A 10-year-old cat with a blocked ureter underwent a procedure to place a subcutaneous ureteral bypass (SUB) device using ultrasound guidance. This method was effective in treating the obstruction, even in cats with a history of chronic kidney disease. The surgery was successful for all cats involved, and the average survival time after the procedure was about 4.25 years. Interestingly, performing a microsurgical ureterotomy during the surgery did not improve outcomes and actually made the procedure longer. Overall, the SUB device placement showed promising results for managing ureteral obstructions in cats.
People also search for: cat ureter blockage treatment · subcutaneous ureteral bypass for cats · cat kidney disease surgery · cat ureter obstruction symptoms
Abstract
OBJECTIVES: The aim of this study was to describe a method of subcutaneous ureteral bypass (SUB) device placement with intraoperative ultrasound guidance, with or without microsurgical ureterotomy, for the treatment of benign ureteral obstruction(s) in cats. A secondary aim was to describe the complications and outcomes in our population, and compare the two groups with and without ureterotomy. METHODS: The medical records of cats with benign ureteral obstruction(s) treated with SUB device placement with intraoperative ultrasound guidance between April 2013 and June 2018 were reviewed. RESULTS: Twenty-four cats with 30 obstructed ureters had a SUB device placement with intraoperative ultrasound guidance in 26 surgeries. A microsurgical ureterotomy was performed in 14/26 surgeries. Median age was 10.07 years (range 4-16.6). Eleven of 24 cats (46%) had a previous history of chronic kidney disease (CKD). All cats, including two patients with minimal pelvic dilation (⩽4 mm), had a successful intrapelvic placement of the SUB device. Median survival time was 1555 days (4.25 years); this was not significantly different between the two groups ( = 0.4494). Stone analysis and bacterial culture, where available for review, revealed calcium oxalate in 12/12 and a negative culture in 6/7. The ureterotomy significantly prolonged the procedure duration (180 vs 125 mins) without significantly decreasing the short- and long-term complications ( = 0.1588 and = 0.2921, respectively), or the survival time ( = 0.8437). CONCLUSIONS AND RELEVANCE: SUB device placement with intraoperative ultrasound guidance is an effective alternative for the treatment of ureteral obstruction. Ultrasound guidance may be a more accessible option when a trained veterinarian does not have access to fluoroscopy. Microsurgical ureterotomy did not show any advantage and prolonged the anesthesia. Our median survival time emphasizes a good outcome of SUB device placement, even in cats with a previous history of CKD.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33754880/