Feline ureteral obstructions Part 1: medical management

Clarke, Dana L.

doi:10.1111/jsap.12844

Cited by 17 publications

(41 citation statements)

References 91 publications

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“…4,8 Other causes of UO include acquired ureteral stricture, ureteritis, pyelonephritis/pyonephrosis, ureteral neoplasia, blood clots, dried solidified blood calculi, congenital abnormalities (ureteral stenosis with or without ectopia, circumcaval ureter), surgical trauma and retroperitoneal fibrosis. 2,4,5,9–14…”

Section: Introductionmentioning

confidence: 99%

Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012–2018)

Lemieux

Vachon

Beauchamp

et al. 2021

Journal of Feline Medicine and Surgery

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Objectives The aim of the study was to describe renal pelvis (RP) and ureteral ultrasonographic measurements in a population of cats with confirmed benign ureteral obstruction (UO) by antegrade pyelography. The secondary objective was to further describe clinical findings associated with minimally dilated obstructed kidneys in an attempt to better understand its occurrence. Methods Retrospective case series of cats diagnosed with benign UO were confirmed by antegrade pyelography. Medical records were reviewed and signalment, diagnostic imaging results, serum creatinine (SCr) concentration and urine culture results were recorded. Each obstructed kidney was categorized into two groups: group 1 included all RP measurements ⩽4 mm and group 2 included all RP measurements >4 mm. Results A total of 82 cats with 114 obstructed ureters met the inclusion criteria. Fifty (61%) cats had a unilateral UO and 32 (39%) had a bilateral UO. Thirty (26%) kidneys were included in group 1 while 84 (74%) were included in group 2. Nine (8%) kidneys had an RP dilation ⩽2 mm. Median RP and ureteral diameters were 6.6 mm (range 1.1–37.0 mm) and 3.2 mm (range 0.0–11.0 mm), respectively. RP size correlated positively with ureteral diameter in the study population ( P <0.0001), but not in group 1 when analyzed separately ( P = 0.47). UO was secondary to stones in 80 (70%) ureters. Seventeen (21%) cats had a positive urine culture. At admission, 79 (96%) cats were azotemic with a median preoperative SCr concentration of 444 µmol/l (range 108–1326 μmol/l). The mean (95% confidence interval [CI]) preoperative SCr concentration was significantly higher in group 1 (762 µmol/l [498–1165 μmol/l]) than in group 2 (409 µmol/l [333–502 μmol/l]). RP size in the two groups correlated negatively with preoperative SCr concentration ( P = 0.0002). Conclusions and relevance Feline UO may be associated with minimal RP dilation and the severity of RP and ureteral dilation can be highly variable. Absence of significant RP dilation does not rule out UO in cats.

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Section: Introductionmentioning

confidence: 99%

Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012–2018)

Lemieux

Vachon

Beauchamp

et al. 2021

Journal of Feline Medicine and Surgery

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“…Ureterolithiasis is the main cause of ureteral obstruction in felines, and calcium oxalate is the most often stone found (ZAID et al, 2011). Conservative management include treatment with fluid therapy, continuous infusion of mannitol, amitriptyline, alpha-adrenergic blockers (prazosin) and glucagon (CLARKE, 2018a). In humans, more than 98% of small diameter ureteral stones (≤ 5 mm) pass spontaneously up to the bladder, and the treatment consists mainly in treatment of pain relief (SEGURA et al, 1997).…”

Section: Clinic and Surgerymentioning

confidence: 99%

“…Aciduria is also a risk factor and genetic anomalies may be involved (BARTGES & CALLENS, 2015). When medical treatment for ureteral obstruction does not resolve the obstruction, surgical intervention is imperative for the restoration of renal function (CLARKE, 2018a).…”

Section: Clinic and Surgerymentioning

confidence: 99%

“…Causes of ureteral obstruction in cats include uroliths, neoplasms, trauma, inflammation, fibrosis, congenital stenosis and blood clots. There is an increase in the diagnosis of ureterolithiasis in cats in recent years (CLARKE, 2018a). Although, more than 98% of feline ureteral stones are composed of calcium oxalate (BERENT, 2011), this type of urolith tends to develop more frequently in mature and elderly cats (KIRK et al, 1995).…”

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confidence: 99%

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Bilateral ureterolithiasis in a 7-month-old cat

et al. 2021

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Feline ureteral obstruction can have several causes; however, ureterolithiasis has been increasing in occurrence. The restriction of urinary flow induced by the obstruction has harmful consequences to the body and can lead to acute renal failure. Calcium oxalate ureterolithiasis is reported in older cats, aged mean 12 years old. A case of bilateral ureteral obstruction in a 7-month-old mixed breed cat is described in this report. Imaging tests such as abdominal ultrasonography, radiography and excretory urography were performed to determine the diagnosis. The surgical procedure of bilateral ureterotomy was then performed, which allowed the improvement of the urinary flow of both kidneys and the resolution of clinical signs caused by uremia. The quantitative analysis of both uroliths revealed the composition of 100% monohydrate calcium oxalate. Calcium oxalate stones can also cause ureteral obstruction in young cats; although, are less common in this age. When conservative treatment fails, surgical intervention becomes necessary for the rapid return of renal function. To author’s knowledge this is the first report of a ureterolithiasis caused by calcium oxalate in a young cat.

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“…There are multiple surgical and interventional procedures for the treatment of feline ureteral obstructions, including ureteral surgery, placement of stents and subcutaneous ureteral bypass systems, with each technique having defined potential risks and complications (Horowitz et al 2013;Manassero et al 2014;Berent et al 2011;Berent et al 2014;Berent et al 2018;Clarke 2018a;Clarke 2018b;Kulendra et al 2014a;Kulendra et al 2014b;Roberts et al 2011). Early diagnosis of ureteral obstruction and rapid treatment by pelvic decompression should promote maximal renal functional recovery based on data gathered from in vivo experiments in dogs (Wilson 1977).…”

Section: Discusssionmentioning

confidence: 99%

Renal pelvic rupture, intrapelvic haematoma and retroperitoneal haemorrhage associated with obstructive ureterolithiasis in a cat

Cockburn¹,

Battersby²,

Doyle³

2020

J of Small Animal Practice

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A neutered female cat presented with a 9-day history of hyporexia and depression. The referring veterinarian had identified moderate non-regenerative anaemia, haematuria and suspected unilateral obstructive ureterolithiasis. Subsequent ultrasonography revealed moderate distension of the left renal pelvis with echogenic material, ureteral distension and ureterolithiasis. A partial ureteral obstruction was suspected. After 4 days of medical management, there was further distension of the renal pelvis with well-delineated echogenic material and an accumulation of perinephric fluid. A left nephroureterectomy was performed. Renal pelvic rupture with intrapelvic haematoma and retroperitoneal haemorrhage was confirmed by histopathology. Eighteen months following surgery, the cat remained clinically well with normal renal values.

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Feline ureteral obstructions Part 1: medical management

Cited by 17 publications

References 91 publications

Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012–2018)

Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012–2018)

Bilateral ureterolithiasis in a 7-month-old cat

Renal pelvic rupture, intrapelvic haematoma and retroperitoneal haemorrhage associated with obstructive ureterolithiasis in a cat

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