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Updated: Nov 29, 2025
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Published on: January 7, 2019
Complications and survival after subcutaneous ureteral bypass device placement in 24 cats: a retrospective study
Emily Vrijsen1,2, Nausikaa Devriendt1, Femke Mortier1
1Small Animal Department, Ghent University, Merelbeke, Belgium.
Insights
Subcutaneous ureteral bypass (SUB) device placement in cats resulted in a high complication rate (nearly 80%) and shorter median survival time than previously reported. Older cats and those with higher hematocrit faced increased risks.
Area of Science:
- Veterinary Medicine
- Surgical Procedures
- Urology
Background:
- Subcutaneous ureteral bypass (SUB) devices are used to manage ureteral obstructions in cats.
- Previous studies have documented survival and complication rates, but further investigation is warranted.
- Understanding risk factors for complications and mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To document survival rates, complication incidence, and associated risk factors following subcutaneous ureteral bypass (SUB) device placement in feline patients.
- To identify predictors of mortality before discharge in cats undergoing SUB procedures.
- To compare current findings with previously reported outcomes for SUB placement in cats.
Main Methods:
- Retrospective analysis of medical records for cats that underwent SUB placement between January 2016 and August 2019.
- Statistical assessment of overall, intraoperative, perioperative, short-term, and long-term complications using univariate and multivariate logistic regression.
- Identification of risk factors for mortality prior to discharge.
Main Results:
- Nearly 80% of the 24 included cats experienced complications, most commonly SUB obstruction, urinary tract infections, and pyelonephritis.
- Five cats (20.8%) died before discharge, and six (25.0%) required revision surgery.
- Older cats had increased risks for perioperative complications and lower survival to discharge; elevated hematocrit was linked to short-term complications.
Conclusions:
- The complication rate following SUB placement in this cohort was higher, and the median survival time was shorter than previously reported.
- Complications, particularly long-term, are frequent and may require intensive monitoring and management.
- Owners should be thoroughly informed about the potential for significant complications and the demanding, costly follow-up care associated with SUB devices.
Objectives:
The aim of this study was to document survival, complications and risk factors for the development of complications and mortality prior to discharge after placement of a subcutaneous ureteral bypass (SUB) device in cats.
Methods:
The medical records of cats with SUB placement between January 2016 and August 2019 were retrospectively analysed. The development of complications (overall, intraoperative, perioperative, short- and long-term complications) and risk factors for mortality prior to discharge were statistically assessed with univariate binary logistic regression. All variables with a P value ⩽0.10 in the univariate analysis were assessed in a multivariate model. Variables were significant if P <0.05.
Results:
Twenty-four cats were included; 12 (50.0%) received a unilateral SUB, 11 (45.8%) a bilateral nephrostomy tube with single cystostomy catheter and the remaining cat (4.2%) two unilateral SUBs. Nearly 80% of the cats developed complications, ranging from mild to fatal, including (partial) SUB obstruction (33.3% of complications), lower urinary tract infection (20.8%), pyelonephritis (20.8%) and sterile cystitis (12.5%). Five cats (20.8%) died prior to discharge. Six cats (25.0%) underwent revision surgery. The overall median survival time (MST) was 274 days (range 1-311 days). Complications were most common in the long-term period (14/16 cats), followed by the short-term (9/18 cats), perioperative (10/23 cats) and intraoperative (4/24 cats) periods. Older cats had an increased risk for developing perioperative complications (P = 0.045) and were less likely to survive to discharge (P = 0.033). An increased haematocrit at presentation was a risk factor for the occurrence of short-term complications (P = 0.03).
Conclusions And Relevance:
Although complications similar to those previously described were observed, the complication rate was higher and the MST shorter than previously reported in cats undergoing SUB placement. Despite good short-term survival, the development of complications may necessitate regular and intensive control visits. Owners that consider SUB placement should be informed that follow-up can be strenuous and expensive.
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