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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.

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Organ survival in the short-term period post-transplant has improved dramatically over the past few decades. Whether this has translated to a long-term survival benefit remains unclear. This study quantifies the progression of nonrenal solid organ transplant outcomes from 1989 to 2009 in liver, lung, heart, intestine and pancreas transplants. Long-term graft survival was analyzed using data on adult solid organ transplant recipients from the UNOS/SRTR database and is reported as organ half-life and yearly attrition rates. Liver, lung, heart, intestine and pancreas half-lives have improved from 5.8 to 8.5, 1.7 to 5.2, 8.8 to 11, 2.1 to 3.6 and 10.5 to 16.7 years, respectively. Long-term attrition rates have not shown the same consistent improvement, with the yearly attrition rate 5-10 years post-transplant for liver, lung, heart and pancreas changing from 4.7 to 4.3, 10.9 to 10.1, 6.4 to 5.1 and 3.3 to 4.2, respectively. Attrition rates for intestine and pancreas transplantation alone display more variability due to smaller sample size but exhibit similar trends of improved first-year attrition and relatively stagnant long-term attrition rates. With first-year survival and attrition rates almost at a pinnacle, further progress in long-term survival will come from targeting endpoints beyond first-year rejection and survival rates.

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