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Published on: December 20, 2014
Transmural migration of a subcutaneous ureteral bypass into the intestine in three cats
J Boullenger1, F Lafuma1, C Baudin Trehiou1
1Centre Hospitalier Vétérinaire Languedocia, 34080 Montpellier, France.
Insights
Subcutaneous ureteral bypass devices in cats can migrate into the small intestine, causing gastrointestinal issues and urinary infections. Early consideration of this complication is crucial for effective treatment and management.
Area of Science:
- Veterinary Medicine
- Surgical Complications
- Feline Health
Background:
- Subcutaneous ureteral bypass (SUB) is a treatment for feline ureteral obstruction.
- Common complications include occlusion, urinary tract infection (UTI), and sterile cystitis.
Observation:
- This case series details three cats experiencing transmural migration of SUB catheters into the small intestine.
- This migration led to gastrointestinal signs, concurrent UTI, and SUB device occlusion.
Findings:
- Surgical intervention, including intestinal resection and anastomosis, was required in all cases.
- Two systems were removed, and one was replaced.
- A good medium-term outcome was observed, though one cat experienced persistent UTI post-replacement.
Implications:
- Transmural migration should be suspected in cats with SUB experiencing persistent UTI, GI signs, or device obstruction.
- This diagnosis is possible even with normal imaging findings like ultrasound or contrast studies.
- Awareness of this complication can guide diagnosis and treatment in affected feline patients.
Abstract:
Subcutaneous ureteral bypass™ is a device placed in cats with ureteral obstruction. The most common complications include system occlusion, urinary tract infection and sterile cystitis. In this case series, we describe three cats with subcutaneous ureteral bypass devices placed where transmural migration of subcutaneous ureteral bypass catheters into the small intestine resulted in gastrointestinal signs, urinary infection and subcutaneous ureteral bypass occlusion. The system was changed in one case and removed in the other two. In all cases, an intestinal resection and anastomosis was performed. All cats had a good medium-term outcome, and urinary infection persisted in the case for which the subcutaneous ureteral bypass system was changed. Transmural migration of the device should be considered in cats with subcutaneous ureteral bypass presenting with persistent urinary tract infection, gastrointestinal signs or device obstruction, even if imaging studies such as ultrasound or contrast studies do not demonstrate any abnormalities.
