Respective associations between ureteral obstruction and renomegaly, urine specific gravity, and serum creatinine concentration in cats: 29 cases (2006–2013)

Bua, Anne-Sophie; Dunn, Marilyn; Pey, Pascaline

doi:10.2460/javma.247.5.518

Cited by 10 publications

(13 citation statements)

References 16 publications

(11 reference statements)

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“…However, there was a large overlap in values between these groups. This finding has already been observed in several studies on pelvic dilatation 1,3,11,12,26,35,36 or ureteral diameter 3 . In humans, ureteral dilatation in the acute phase of renal colic does not occur in 30% of patients 18,37 .…”

Section: Discussionsupporting

confidence: 66%

Comparison of nonenhanced computed tomography and ultrasonography for detection of ureteral calculi in cats: A prospective study

Testault¹,

Gatel

Vanel³

2021

Veterinary Internal Medicne

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Background Radiographs and ultrasound (US) are the primary imaging modalities used to assess ureteral calculi in cats. Reports describing the use of nonenhanced computed tomography (CT) are scarce. Hypothesis/Objectives To compare US and nonenhanced CT for detection, number and localization of ureteral calculi in cats. Animals Fifty‐one cats with at least 1 ureteral calculus, and 101 ureters. Methods Prospective case series. All cats underwent an US followed by a nonenhanced CT. Cats were included in the study if at least 1 ureteral calculus was diagnosed on either modality. Number of calculi and their localization (proximal, middle, and distal) were recorded on both modalities. Pelvic dilatation and maximal ureteral diameter were recorded with US. Results More calculi were detected by nonenhanced CT (126) compared to US (90), regardless of localization (P < .001). More ureters were affected on nonenhanced CT (70) compared to US (57; P < .001). The number of calculi detected was significantly different between US and nonenhanced CT in the proximal (P = .02) and distal ureteral region (P < .001). Bilateral calculi were more frequent with nonenhanced CT (19 cats) compared to US (9 cats; P < .001). A pelvic size superior to 5 mm and a maximal ureteral diameter value superior to 3 mm were always associated with ureteral calculi. Conclusions and Clinical Importance Computed tomography is an emerging imaging modality in cats with a suspected ureteral obstruction. Combination of CT and US can be beneficial for case management.

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Section: Discussionsupporting

confidence: 66%

Comparison of nonenhanced computed tomography and ultrasonography for detection of ureteral calculi in cats: A prospective study

Testault¹,

Gatel

Vanel³

2021

Veterinary Internal Medicne

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“…30,31 Renal parenchymal and/or capsular fibrosis associated with CKD could limit RP dilation and/or renomegaly in an obstructed kidney owing to decreased compliance of fibrotic tissue despite increased pressure within the renal urine collection system. 32 However, to the authors’ knowledge, this theory is not proven in veterinary medicine and further prospective studies are needed to explore this hypothesis. Performing renal biopsies at the time of surgery or renal histology following death may aid in determining the underlying process preventing RP dilation.…”

Section: Discussionmentioning

confidence: 95%

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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“…6 Renal size and the degree of pelvic dilatation are variable in cats with normal renal function, and normal values overlap with values observed in cats with renal disease or urinary obstruction. 6,7 Two studies found that a renal pelvic diameter >13 mm was consistently associated with ureteral obstruction, 7,8 but the majority of obstructed kidneys have less marked pelvic dilatation, so may appear similar to kidneys affected by CKD or pyelonephritis, which also frequently exhibit pelvic dilatation. 8 For these reasons, cats considered equivocal for ureteral obstruction at ultrasonography are candidates for antegrade pyelography.…”

Section: Introductionmentioning

confidence: 96%

Ultrasonography in the diagnosis and management of cats with ureteral obstruction

Lamb

Cortellini

Halfacree

2017

Journal of Feline Medicine and Surgery

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Objectives The objective was to identify clinical or ultrasonographic results associated with ureteral obstruction or outcome in cats with azotaemia. Methods This was a retrospective cross-sectional study of cats with azotaemia (serum creatinine >180 μmol/l) that had ultrasonography of the urinary tract, ultrasound images available for review and received treatment for azotaemia. Cats with pre-renal azotaemia or urethral obstruction were excluded. Associations between clinical and ultrasonographic results and the dependent variables 'tentative diagnosis of ureteral obstruction', 'pyelography positive for ureteral obstruction' and 'death in hospital' were tested using binary logistic regression. Results In total, 238 cats satisfied the inclusion criteria. Median age was 7 years (range 2 weeks to 20 years), duration of clinical signs was 7 days (range 1 day to 6.3 years) and serum creatinine was 417 μmol/l (range 184-2100 μmol/l). Tentative diagnosis of ureteral obstruction in 92/238 (39%) cats was significantly associated with unilateral enlarged kidney on palpation, and dilated renal pelvis and calculi within the ureter on ultrasonography. Pyelography was performed in 49/92 (53%) cats (16 bilateral) with a tentative diagnosis of ureteral obstruction, and was positive for obstruction in 46/65 (71%) instances. No significant differences in ultrasonographic signs were found between cats with obstructed and non-obstructed ureters. Receiver-operating characteristic analysis of renal pelvic diameter as a diagnostic test for ureteral obstruction found an area under the curve not significantly different from 0.5. There was good agreement between results of radiography and ultrasonography for presence of urinary calculi (kappa 0.67). Treatment was medical in 171 (72%) cats and surgical (ureteral stent or bypass device) in 67 (28%). Death in hospital was significantly associated with serum creatinine and presence of peritoneal fluid, but not with clinical diagnosis, ultrasonographic signs or treatment method. Conclusions and relevance Ultrasonography may be used to identify azotaemic cats at greatest risk of ureteral obstruction, but when using pyelography as the reference test ultrasonography appears to be inaccurate for diagnosis of ureteral obstruction.

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Respective associations between ureteral obstruction and renomegaly, urine specific gravity, and serum creatinine concentration in cats: 29 cases (2006–2013)

Abstract: Results indicated renomegaly was not associated with ureteral obstruction in cats, and abdominal palpation was an unreliable method for detection of renomegaly. The most consistent abnormal finding for cats with ureteral obstruction was hypercreatininemia.

Cited by 10 publications

References 16 publications

Comparison of nonenhanced computed tomography and ultrasonography for detection of ureteral calculi in cats: A prospective study

Comparison of nonenhanced computed tomography and ultrasonography for detection of ureteral calculi in cats: A prospective study

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

Ultrasonography in the diagnosis and management of cats with ureteral obstruction

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