Outcomes of ureteral surgery and ureteral stenting in cats: 117 cases (2006-2014).

OBJECTIVE To evaluate and compare outcomes in cats following ureteral surgery or ureteral stent placement. DESIGN Retrospective case series. ANIMALS 117 cats. PROCEDURES Data regarding signalment, history, concurrent disease, clinical signs, clinicopathologic tests, surgical procedures, and perioperative complications (including death) were recorded. Follow-up data, including presence of signs of chronic lower urinary tract disease, chronic urinary tract infection, reobstruction, and death, if applicable, were obtained by records review or telephone contact with owners. Variables of interest were compared statistically between cats treated with and without stent placement. Kaplan-Meier analysis and Cox regression were performed to assess differences in survival time between cats with and without ureteral stents. RESULTS Perioperative complications referable to the urinary tract were identified in 6 of 43 (14%) cats that had ≥ 1 ureteral stent placed and 2 of 74 (3%) cats that underwent ureteral surgery without stenting. Perioperative mortality rates were similar between cats with (4/43 [9%]) and without (6/74 [8%]) stents. After surgery, signs of chronic lower urinary tract disease and chronic urinary tract infection were significantly more common among cats with than cats without stents. Nineteen of 87 (22%) cats with follow-up information available had recurrent obstruction; incidence of reobstruction did not differ between cats with and without stents. Median survival time did not differ between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE The potential for signs of chronic lower urinary tract disease and chronic infection, particularly among cats that receive ureteral stents, warrants appropriate client counseling. Judicious long-term follow-up for detection of reobstruction is recommended.

[1]  D. Bagley,et al.  Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008-2012). , 2015, Journal of the American Veterinary Medical Association.

[2]  V. Viateau,et al.  Indwelling double pigtail ureteral stent combined or not with surgery for feline ureterolithiasis: complications and outcome in 15 cases , 2014, Journal of feline medicine and surgery.

[3]  D. Bagley,et al.  Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006-2010). , 2014, Journal of the American Veterinary Medical Association.

[4]  D. Bagley,et al.  Predictors of outcome for cats with ureteral obstructions after interventional management using ureteral stents or a subcutaneous ureteral bypass device , 2013, Journal of feline medicine and surgery.

[5]  L. Adams,et al.  Nephroliths and ureteroliths: a new stone age , 2013, New Zealand veterinary journal.

[6]  A. Shipov,et al.  Ureteral obstruction in dogs and cats. , 2013 .

[7]  M. Martano,et al.  Double-J ureteral stenting in nine cats with ureteral obstruction. , 2012, Veterinary journal.

[8]  D. Bagley,et al.  Endoscopic placement of ureteral stents for treatment of congenital bilateral ureteral stenosis in a dog. , 2012, Journal of the American Veterinary Medical Association.

[9]  S. Johnston,et al.  Veterinary Surgery: Small Animal , 2012 .

[10]  C. Adin,et al.  Complications of upper urinary tract surgery in companion animals. , 2011, The Veterinary clinics of North America. Small animal practice.

[11]  J. Westropp,et al.  Cats and Calcium Oxalate , 2011, Journal of feline medicine and surgery.

[12]  D. C. Brown,et al.  Postoperative mortality in cats after ureterolithotomy. , 2011, Veterinary surgery : VS.

[13]  D. C. Brown,et al.  Use of indwelling, double-pigtail stents for treatment of malignant ureteral obstruction in dogs: 12 cases (2006-2009). , 2011, Journal of the American Veterinary Medical Association.

[14]  A. Berent Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostic and therapeutic options. , 2011, Journal of veterinary emergency and critical care.

[15]  C. Weisse,et al.  Feline ureteral strictures: 10 cases (2007-2009). , 2011, Journal of veterinary internal medicine.

[16]  J. Denstedt,et al.  Current Status of Ureteral Stent Technologies: Comfort and Antimicrobial Resistance , 2010, Current urology reports.

[17]  W. Różański,et al.  Relationship between urinary tract infection and self-retaining Double-J catheter colonization. , 2009, Journal of endourology.

[18]  Jean de la Rosette,et al.  Ureteral stenting and urinary stone management: a systematic review. , 2008, The Journal of urology.

[19]  B. Song,et al.  Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases. , 2008, Journal of endourology.

[20]  P. Kass,et al.  Evaluation of trends in urolith composition in cats: 5,230 cases (1985-2004). , 2007, Journal of the American Veterinary Medical Association.

[21]  J. Solomon,et al.  Evaluation of palliative stenting for management of malignant urethral obstructions in dogs. , 2006, Journal of the American Veterinary Medical Association.

[22]  A. Gedik,et al.  Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent , 2006, International Urology and Nephrology.

[23]  E. Hardie,et al.  Management and outcome of cats with ureteral calculi: 153 cases (1984-2002). , 2005, Journal of the American Veterinary Medical Association.

[24]  E. Hardie,et al.  Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984-2002). , 2005, Journal of the American Veterinary Medical Association.

[25]  S. Griffey,et al.  Comparison of 3 techniques for ureteroneocystostomy in cats. , 2005, Veterinary surgery : VS.

[26]  E. Hardie,et al.  Management of ureteral obstruction. , 2004, The Veterinary clinics of North America. Small animal practice.

[27]  J. Bartges,et al.  Update: Management of calcium oxalate uroliths in dogs and cats. , 2004, The Veterinary clinics of North America. Small animal practice.

[28]  R. Autorino,et al.  Early and Late Complications of Double Pigtail Ureteral Stent , 2002, Urologia Internationalis.

[29]  D. Bagley,et al.  Fluoroscopic Placement of Double-Pigtail Ureteral Stents , 2001, Diagnostic and therapeutic endoscopy.

[30]  G. Reid,et al.  Advances in ureteral stent technology , 2000, World Journal of Urology.

[31]  C. Riedl,et al.  Bacterial Colonization of Ureteral Stents , 1999, European Urology.

[32]  C. Gregory,et al.  A mucosal apposition technique for ureteroneocystostomy after renal transplantation in cats. , 1996, Veterinary surgery : VS.

[33]  G. Reid,et al.  Examination of bacterial and encrustation deposition on ureteral stents of differing surface properties, after indwelling in humans , 1995 .

[34]  J. Sobel,et al.  Bacterial adherence in the pathogenesis of urinary tract infection: a review. , 1987, Reviews of infectious diseases.

[35]  J. Costerton,et al.  Bacterial biofilms in nature and disease. , 1987, Annual review of microbiology.