Page 1218 - Clinical Small Animal Internal Medicine

1156 Section 10 Renal and Genitourinary Disease

now preferred over the feline ureteral stent due to the
VetBooks.ir minimal complications both shortterm and longterm.
Over 93% of cats survived to hospital discharge after
admission. The longest period for which an SUB device
has remained in place is nine years (personal communi­
cation AB), and the short‐ and long‐term complications
seen with this device are fewer and less severe than those
seen with ureteral stents in cats (see Table 123.5).
The use of a SUB device to treat cats with ureteral
obstruction has been associated with the highest sur­
vival rate to date. In that study, 135 out of 144 (94%)
cats survived to hospital discharge, and 90%, 83%, 80%
and 74 % of cats were alive after one, three, and six
Figure 123.19 Lateral radiographs of a feline patient following months and one year respectively after SUB placement.
the placement of a subcutaneous ureteral bypass. The most common complication was stent obstruction
(25%) requiring SUB system replacement. However,
ureteral strictures, very proximal ureteral obstructions, with the use of tetrasodium ethylenediaminetet raacetic
or in which stent placement was unsuccessful. Based on acid (tEDTA) solution, the rate of reobstruction declined
experience in over 300 cats in the authors’ practice, it is to 4.5%.

Acknowledgment

Andrew Moore, Canadian Veterinary Urolith Centre.
Dr Stephanie Nykamp, Radiologist, University of Guelph.

Further Reading

Berent AC, Weisse CW, Bagley DH, Lamb K. Use of recommendations on the treatment and prevention of
subcutaneous ureteral bypass device for treatment of uroliths in dogs and cats. J Vet Intern Med 2016; 30:
benign ureteral obstruction in cats: 174 ureters in 134 1564–74.
cats (2009–2015). J Am Vet Med Assoc 2018; 253: Milligan M, Berent AC. Medical and interventional
1309–27. management of upper urinary tract uroliths. Vet Clin
Deroy C, Rossetti D, Ragetly G, Hernandez J, Poncet C. North Am Small Anim Pract 2019; 49: 157–74.
Comparison between double‐pigtail ureteral stents and Weese JS, Blondeau J, Boothe D, et al. International Society
ureteral bypass devices for treatment of ureterolithiasis for Companion Animal Infectious Diseases (ISCAID)
in cats. J Am Vet Med Assoc 2017; 251: 429–37. guidelines for the diagnosis and management of
Lulich JP, Berent AC, Adams LG, Westropp JL, Bartges JW, bacterial urinary tract infections in dogs and cats. Vet J
Osborne CA. ACVIM Small Animal consensus 2019; 247: 8–25.