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Characterization and outcomes of cats with cardiomyopathy undergoing subcutaneous ureteral bypass device placement
Claire Cassou1, Christina Plante2, Catherine Vachon2
1Department of Clinical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Insights
Mild cardiomyopathy in cats undergoing subcutaneous ureteral bypass (SUB) placement did not impact outcomes. However, fluid overload and high creatinine levels at admission were associated with shorter survival times in these feline patients.
Area of Science:
- Veterinary Cardiology
- Feline Medicine
- Nephrology
Background:
- Limited data exists on cats with both cardiomyopathy and ureteral obstruction treated with subcutaneous ureteral bypass (SUB).
- Understanding the impact of cardiac conditions on surgical outcomes is crucial for feline patient care.
Purpose of the Study:
- To characterize cardiomyopathies in cats undergoing SUB placement.
- To assess perioperative and long-term outcomes in these cats.
- To determine associations between left atrial size, fluid overload (FO), and survival.
Main Methods:
- Retrospective review of 94 cats undergoing SUB placement (2010-2022).
- Medical records analyzed for physical exam, serum creatinine, echocardiography, and outcomes.
- Cats categorized into cardiomyopathy present (CM+) or absent (CM-) groups.
Main Results:
- Cardiomyopathy was diagnosed in 40% of cats, mostly mild hypertrophic types.
- No significant differences in hospitalization, survival, renal recovery, or FO between CM+ and CM- cats.
- Fluid overload (45% of cats) was linked to shorter survival (P=0.005) and higher creatinine (P<0.001).
Conclusions:
- Mild cardiomyopathy is a common comorbidity in cats undergoing SUB placement and does not negatively affect outcomes.
- Fluid overload and elevated admission creatinine are negative prognostic indicators in cats treated with SUB.
- Further research is needed on advanced cardiac disease in cats undergoing SUB.
Background:
Limited data exist on the characterization and outcomes of cats with cardiomyopathy and benign ureteral obstruction treated by subcutaneous ureteral bypass (SUB) placement.
Hypothesis/Objectives:
Characterize cardiomyopathies, assess perioperative and long-term outcomes, and determine if an association exists between left atrial size and fluid overload (FO) or survival.
Animals:
Ninety-four cats presented for SUB placement between 2010 and 2022 at the Veterinary Teaching Hospital of the University of Montreal.
Methods:
Retrospective review of medical records including physical examination, serum creatinine concentration, echocardiography, and outcome. Cats were grouped as: cardiomyopathy present (CM+) or absent (CM-).
Results:
Echocardiography was performed in 64/94 (68%) cats. Cardiomyopathy was diagnosed in 26/64 (40%) cats, including 85% (22/26) hypertrophic or hypertrophic obstructive cardiomyopathy. The majority of cats (22/26) had mild cardiomyopathy, with normal left atrial size (left atrial-to-aortic root diameter ratio in right parasternal short axis [LA:AoSAX] < 1.6). No significant difference in duration of hospitalization, survival time, renal recovery, or frequency of FO was found between CM+ and CM- cats. Fluid overload occurred in 45% (29/64) of the cats, and was associated with shorter survival (median [IQR]: 430 [40; 1260] days vs 1020 [494; 1668] days; P = .005). Admission serum creatinine concentration was higher in cats with FO (mean ± SD: 11.12 ± 5.93 mg/dL vs 6.16 ± 5.44 mg/dL; P < .001) and was associated with worse prognosis (P = .01). The LA:AoSAX was not associated with FO (P = .26) or survival (P = .39).
Conclusions And Clinical Importance:
Mild cardiomyopathy was a common comorbidity but did not affect outcome and should not be considered a contraindication for SUB placement. However, the impact of more advanced cardiac disease remains unknown. In contrast, FO and higher serum creatinine concentration at admission predicted shorter survival.
