Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat
Case summary A 9-month-old male domestic longhair cat presented following iatrogenic ureteral trauma after an attempted laparoscopic ovariectomy. Prior to identifying that the cat was male, both ureters were transected approximately 4 mm from the renal pelves. Initial management involved a left-side...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-03-01
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| Series: | Journal of Feline Medicine and Surgery Open Reports |
| Online Access: | https://doi.org/10.1177/2055116919831856 |
| _version_ | 1819113718078767104 |
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| author | Joseph A Sapora Robert J Hardie Natashia Evans |
| author_facet | Joseph A Sapora Robert J Hardie Natashia Evans |
| author_sort | Joseph A Sapora |
| collection | DOAJ |
| description | Case summary A 9-month-old male domestic longhair cat presented following iatrogenic ureteral trauma after an attempted laparoscopic ovariectomy. Prior to identifying that the cat was male, both ureters were transected approximately 4 mm from the renal pelves. Initial management involved a left-sided Boari flap neoureterocystostomy, cystonephropexy and right ureteronephrectomy. Thirty-six hours later, the cat developed uroabdomen due to leakage from the neoureterocystostomy site. At a tertiary referral institution, the ureter was reconstructed via end-to-end anastomosis and a left-sided subcutaneous ureteral bypass (SUB) device was placed in the event the anastomosis failed. Five weeks after SUB placement, the cat was dysuric and stranguric. A urine culture was negative and clinical signs were attributed to sterile cystitis secondary to device placement. Blood urea nitrogen (BUN) was 22 mg/dl and creatinine was 1.2 mg/dl. Contrast pyelography confirmed device patency, but no contrast was identified through the ureteral anastomosis. At 12 months, BUN and creatinine were 1.5 mg/dl and 25 mg/dl, respectively, and a subclinical urinary tract infection was identified ( Enterococcus faecalis ). Antibiotic therapy was not prescribed in order to prevent multidrug resistance. At 42 months, BUN was 38 mg/dl and creatinine was 2.0 mg/dl. The cat had occasional and intermittent signs of pollakiuria and stranguria but was otherwise doing well. Relevance and novel information To our knowledge, this is the first case report to describe the use of a SUB device for management of traumatic proximal ureteral injury in a cat with one kidney. The case outcome provides valuable information about the direct effect of the SUB device and the presence of chronic Enterococcus species infection on long-term renal function. |
| first_indexed | 2024-12-22T04:33:51Z |
| format | Article |
| id | doaj.art-ace341920455487ab27d0cf5cea68464 |
| institution | Directory Open Access Journal |
| issn | 2055-1169 |
| language | English |
| last_indexed | 2024-12-22T04:33:51Z |
| publishDate | 2019-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Feline Medicine and Surgery Open Reports |
| spelling | doaj.art-ace341920455487ab27d0cf5cea684642022-12-21T18:38:56ZengSAGE PublishingJournal of Feline Medicine and Surgery Open Reports2055-11692019-03-01510.1177/2055116919831856Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old catJoseph A Sapora0Robert J Hardie1Natashia Evans2University of Wisconsin School of Veterinary Medicine, Madison, WI, USADepartment of Surgical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, USAThe Animal Referral Hospital Homebush, NSW, AustraliaCase summary A 9-month-old male domestic longhair cat presented following iatrogenic ureteral trauma after an attempted laparoscopic ovariectomy. Prior to identifying that the cat was male, both ureters were transected approximately 4 mm from the renal pelves. Initial management involved a left-sided Boari flap neoureterocystostomy, cystonephropexy and right ureteronephrectomy. Thirty-six hours later, the cat developed uroabdomen due to leakage from the neoureterocystostomy site. At a tertiary referral institution, the ureter was reconstructed via end-to-end anastomosis and a left-sided subcutaneous ureteral bypass (SUB) device was placed in the event the anastomosis failed. Five weeks after SUB placement, the cat was dysuric and stranguric. A urine culture was negative and clinical signs were attributed to sterile cystitis secondary to device placement. Blood urea nitrogen (BUN) was 22 mg/dl and creatinine was 1.2 mg/dl. Contrast pyelography confirmed device patency, but no contrast was identified through the ureteral anastomosis. At 12 months, BUN and creatinine were 1.5 mg/dl and 25 mg/dl, respectively, and a subclinical urinary tract infection was identified ( Enterococcus faecalis ). Antibiotic therapy was not prescribed in order to prevent multidrug resistance. At 42 months, BUN was 38 mg/dl and creatinine was 2.0 mg/dl. The cat had occasional and intermittent signs of pollakiuria and stranguria but was otherwise doing well. Relevance and novel information To our knowledge, this is the first case report to describe the use of a SUB device for management of traumatic proximal ureteral injury in a cat with one kidney. The case outcome provides valuable information about the direct effect of the SUB device and the presence of chronic Enterococcus species infection on long-term renal function.https://doi.org/10.1177/2055116919831856 |
| spellingShingle | Joseph A Sapora Robert J Hardie Natashia Evans Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat Journal of Feline Medicine and Surgery Open Reports |
| title | Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat |
| title_full | Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat |
| title_fullStr | Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat |
| title_full_unstemmed | Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat |
| title_short | Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat |
| title_sort | use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9 month old cat |
| url | https://doi.org/10.1177/2055116919831856 |
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