Treatment of ureterolithiasis in feline patients

Abstract

Ureterolithiasis is becoming more frequently diagnosed in feline patients as diagnostic imaging has become more available and the understanding of the clinical signs suggestive of this disease process has grown. The presence of ureteral stones can be diagnosed by radiography and ultrasonography. As 98% of ureteral stones in cats are calcium oxalate, medical management may not be an option for the majority of cases. Subcutaneous ureteral bypass, nephroureterectomy, ureteral stenting and lithotripsy are all techniques that can be used for the treatment of ureteral obstruction caused by ureteral stones; this article focuses on the subcutaneous ureteral bypass device (SUB). This paper outlines how ureterolithiasis is diagnosed, briefly outlines treatment options then focuses on how the SUB device is placed. Postoperative care following a SUB placement is discussed as these patients need careful medical management in the immediate postoperative period to resolve azotaemia without causing fluid overload as well as lifelong follow-up care to ensure the SUB device stays patent and to support renal function.