Abstract
BackgroundThe objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices.ResultsMedical records of cats that underwent SUB device placement were retrospectively reviewed. Signalment of the cat, laterality of the ureteral obstruction, surgery, anesthesia and hospitalization duration, bacterial culture results and follow-up data were retrieved.Thirty-two cats met the inclusion criteria. Four cats (12.5%) had a positive intraoperative culture, with two of them being treated successfully. Ten cats out of 28 (35.7%) were documented with a positive urine culture during follow-up period, with a median time between discharge and identification of the first positive urine culture of 159 days (range 8–703 days). Bacteriuria resolved in 60% of cats (6/10). Escherichia coli was the most common organism, isolated in 4 out of 10 postoperative urine cultures. Overall, subclinical bacteriura was documented for 6 of 32 (18.8%) cats and 5 of 32 (15.6%) cats displayed clinicals signs suggestive of persistent UTI. One cat had subclinical bacteriuria. Three cats died during the follow-up period.There was a significant difference between negative and positive urine bacterial culture groups in median hospitalization duration (5 days versus 6 days, P = 0.022) and in median body condition score (5/9 versus 4/9, P = 0.03). Cats with a longer hospital stay and with a lower body condition score were more likely to have a positive urine culture during follow-up period.ConclusionsSUB device placement surgery is associated with complications such as chronic bacteriuria. Bacteriuria in our study resolved with appropriate antibiotic treatment in more than half of cats. Risk factors identified for positive urine culture were a longer hospitalization duration and a decreased body condition score.
Highlights
The objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices
Infections were successfully cleared with an appropriate antibiotic treatment in 50 to 78% of cats. 13 to 50% of cats had persistant bacteriuria, diagnosed as lower urinary tract signs and a persisting positive urine culture despite appropriate treatment based on microbial culture [1, 2, 6]
Bacteriuria resolved with appropriate antimicrobial treatment in 6 out of 10 cats (60%) according to the results from an antimicrobial susceptibility test, performed on a urine sample from the SUB port 1 week after the antimicrobial treatment was stopped
Summary
The objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices. Development of bacteriuria following device placement is documented by positive urine culture from 21 to 30.8% of cats [1, 2, 6, 7]. Cats with a positive urine culture at the time of SUB device placement were significantly more likely to have bacteriuria after the surgery and to have persistant bacteriuria in one study [1]. The purpose of the study was to report the incidence and risk factors associated with positive intraoperative and postoperative urine cultures and to determine the long-term outcome in cats with subcutaneous ureteral bypass. We hypothesized that duration of surgery and anesthesia would be associated with positive urine bacterial cultures
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