Manejo e desfecho de gatos com cálculo ureteral / Management and outcome of cats with ureteral calculi

Abstract Journal of the American Veterinary Medical Association                                                March 15, 2005, Vol. 226, No. 6, Pages 937-944 doi: 10.2460/javma.2005.226.937

Management and outcome of cats with ureteral calculi: 153 cases (1984–2002)

Andrew E. Kyles, BVMS, PhD, DACVS Elizabeth M. Hardie, DVM, PhD, DACVS Brent G. Wooden, DVM Christopher A. Adin, DVM, DACVS Elizabeth A. Stone, DVM, MS, DACVS Clare R. Gregory, DVM, DACVS Kyle G. Mathews, DVM, MS, DACVS Larry D. Cowgill, DVM, PhD, DACVIM Shelly Vaden, DVM, PhD, DACVIMThomas G. Nyland, DVM, DACVR Gerald V. Ling, DVM

Objective

To determine outcome of medical and surgical treatment in cats with ureteral calculi.

Design

Retrospective study.

Animals

153 cats.

Procedure

Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information.

Results

All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure.

Conclusions and Clinical Relevance

Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function. (J Am Vet Med Assoc 2005;226:937–944)

----------------------------------------- Surgical treatment

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