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Subcutaneous ureteral bypass (SUB) is a standard treatment for feline ureteral obstruction, but is usually performed under fluoroscopic guidance. We examined the treatment results, complications, and long-term outcome of SUB placed under ultrasound guidance and intraoperative radiography, without fluoroscopic guidance, in 13 cats. As reported in previous studies, the increased BUN and creatinine values improved after SUB placement under ultrasonic guidance, and the general condition of the cats improved. The postoperative infection rate was slightly higher in the present study than in previous studies; however, the long-term outcome was favorable, and SUB placement under ultrasound guidance for ureteral obstruction in cats was considered effective. As a sub-study on the prevention of SUB catheter obstruction, we examined the relationship between dietary content change and urine specific gravity, but did not obtain clear results because of the limited number of cases. Further study is necessary to clarify this issue.

Pulmonary thromboembolism (PTE) secondary to immune-mediated hemolytic anemia (IMHA) is rarely diagnosed in cats. In this report, a 3-year-old cat was referred to our private hospital with dyspnea, anorexia, and anemia. On the thoracic radiography, cardiac enlargement and pulmonary edema were noted. Echocardiography revealed right ventricular and right atrium enlargement with mild tricuspid regurgitation (tricuspid regurgitation velocity 3.28 m/s). A thrombus was recognized in the main pulmonary artery on the right parasternal short-axis view. Blood examination suggested regenerative anemia and autoagglutination. The findings suggested immune-mediated hemolytic anemia and PTE. Antithrombotic therapy (dalteparin) and immunosuppressive therapy (prednisolone) were administered under oxygen supplementation in the ICU cage. After treatment, regenerative anemia and right-heart failure were improved. During follow-up, the cat remained hemodynamically stable, and the owner reported no cardiac-related clinical signs. Further blood examination confirmed the anemia was improved. Prednisolone was discontinued on Day 56, and the cat continues in good health, administered only mycophenolate mofetil. The clinical outcome of PTE secondary to the IMHA throughout 100 days of periodical observation was reported.

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