Feline Ureteral Strictures: 10 Cases (2007–2009)

Abstract

Background: Feline ureteral obstructions have emerged as a common problem. Ureteral strictures rarely are reported as a cause and the predisposing factors and clinical course of this condition have not been described.Objectives: Evaluate cases of feline ureteral strictures and characterize historical features, clinical signs, diagnostic imaging, surgical and endoscopic findings, histopathology, treatment modalities, and short-and long-term outcomes.Animals: Ten cats diagnosed with ureteral strictures based on compatible findings from at least 2 of the following: ultrasonography, ureteropyelography, surgical exploration, or histopathology.Methods: Retrospective study.Results: Median age, serum creatinine concentration, and size of the renal pelvis were 12 years, 3.7 mg/dL, and 11.75 mm, respectively. Six of 10 cats had hyperechoic periureteral tissue on ultrasound examination at the stricture site. Four cats had evidence of a circumcaval ureter at surgery. Eight cats had an intervention including ureteral stent placement (n 5 6) and traditional surgery (n 5 2). Seven of 8 cats had decreases in serum creatinine concentration and renal pelvic parameters preceding discharge and 6 had persistently improved results at their last examination. All patients survived to discharge. Median survival time was 4294 days (range, 14 to 4858 days) with 6/10 cats still alive.Conclusions and Clinical Importance: Ureteral strictures may occur in cats secondary to ureteral surgery, inflammation, a circumcaval ureter, impacted ureterolithiasis, or for unknown causes. With appropriate and timely intervention, the prognosis for long-term survival is good. In addition to ureteral reimplantation or ureteronephrectomy, ureteral stenting or SC ureteral bypass may be considered as future therapeutic options.

Estudo da ocorrência de litíase renal e ureteral em gatos com doença renal crônica

“…No atinente à ocorrência de nefrolitíase e de DRC, independente de ambas as condições representarem causa ou consequência uma da outra, os dois eventos passaram a ser caracterizados de forma simultânea em gatos (Ross et al 1999, Lekcharoensuk et al 2005, Kyles et al 2005a, 2005b, Zaid et al 2011, sendo importante a investigação das duas afecções em gatos que manifestarem um ou outro problema. No presente estudo, ficou evidente a elevada ocorrência de litíase renal e/ou ureteral em gatos com DRC (65,27%).…”

“…O aumento emergente dos cálculos renais nos últimos 20 anos tem sido associado à prevalência de litíase por oxalato de cálcio (CaOx) (Ling et al 1998, Kyles et al 2005a, 2005b, Kirk & Bartges 2006, Ross et al 2007, Zaid et al 2011, Adams 2013, seguindo a tendência da litíase renal em pacientes humanos (Zatz 2002).…”

Uso de glucagon no manejo de obstrução ureteral em um gato com doença renal crônica: relato de caso

“…A principal causa de obstrução ureteral em gatos é a ureterolitíase com prevalência de mais de 70%. Outras causas incluem a estenose ureteral (congênita ou adquirida), neoplasia, ureter circuncaval, tampão purulento ureteral e coágulos solidificados (Zaid et al, 2011;Horowitz et al, 2013;Berent et al, 2014).…”

“…A estenose ureteral concomitante a urolitíase localizada em outro local que não o da obstrução, indica a predisposição a formação de estenose em gatos. Isto sugere que a ureterolitiase pode induzir a injúria da mucosa, ou que a presença da estenose leva ao decréscimo do fluxo urinário e assim predispondo a ureterolitíase (Zaid et al, 2011).…”

Traitement des lithiases urétérales obstructives par la mise en place de stents pyélo-vésicaux chez le chat

“…Ainsi, malgré une survie à 1 an de 91 % [3], une mortalité périopératoire de 18 à 20 % est observée [3,14]. Des complications sont observées dans 30 à 50 % des cas, avec au premier rang 6 à 16 % d'uroabdomen liés à des fuites sur le site chirurgical et nécessitant des reprises chirurgicales dans 12 % des cas, des récidives dans près de 40 % des cas, et de nombreux cas de sténoses urétérales [2,3,14,15].…”