Multicenter Retrospective Evaluation of Transmural Migration of Subcutaneous Ureteral Bypass Devices Within the Digestive Tract in Cats

Overview

Journal J Vet Intern Med

Specialties General Medicine
Veterinary Medicine

Date 2022 Aug 17

PMID 35976072

Authors

Emilie Veran

Catherine Vachon

Julie Byron

James Howard

Allyson Berent

Chick Weisse

Romain Javard

Ashley Spencer

Sarah Gradilla

Carrie Palm

William Culp

Andreanne Cleroux

Marilyn Dunn

Affiliations

Soon will be listed here.

Abstract

Background: Placement of a subcutaneous ureteral bypass (SUB) device is an effective method to relieve all causes of ureteral obstruction in cats. Complications involving migration within the gastrointestinal tract have been seldomly described.

Objectives: To characterize transmural migration of SUB devices within the digestive tract in cats.

Animals: Eleven migrated SUB catheters identified in 8 cats between 2017 and 2021.

Methods: Retrospective review of medical records of cats with a SUB device in which migration into the gastrointestinal tract was identified.

Results: The median time from SUB device placement to implant migration was 928 days (201-2298 days). Seven cats had obstruction of the SUB device and a positive urine culture at diagnosis. The migration was identified by ultrasound in 6/11, pre-operative contrast radiography in 2/2, and only at time of surgery in 3 SUB devices. All cats underwent surgical correction. Four nephrostomy and 7 cystotomy catheters migrated. Migration occurred into the duodenum (3/11), jejunum (7/11), and colon (1/11). SUB devices were removed in 7 cats and replaced in 2 cats, with 1 cat diagnosed with 2 migration events. Gastrointestinal resection and anastomosis were performed in 7/8 cats and an enterotomy in 2 cats. Six cats survived to discharge. The median follow-up time after migration diagnosis was 365 days (range, 0-1114 days) and 2 cats are still alive.

Conclusions And Clinical Importance: Although a rare complication, migration of SUB device should be considered in cats with SUB device obstruction and a positive urine culture.

Citing Articles

Letter regarding "Benign ureteral obstruction in cats: Outcome with medical management".

Aronson L, Schmiedt C, Bartges J, Monnet E, Hardie R J Vet Intern Med. 2023; 38(1):12-13.

PMID: 37945320 PMC: 10800177. DOI: 10.1111/jvim.16909.

Multicenter retrospective evaluation of transmural migration of subcutaneous ureteral bypass devices within the digestive tract in cats.

Veran E, Vachon C, Byron J, Howard J, Berent A, Weisse C J Vet Intern Med. 2022; 36(5):1677-1685.

PMID: 35976072 PMC: 9511080. DOI: 10.1111/jvim.16511.

References

Borchert C, Berent A, Weisse C . Subcutaneous ureteral bypass for treatment of bilateral ureteral obstruction in a cat with retroperitoneal paraganglioma. J Am Vet Med Assoc. 2018; 253(9):1169-1176. DOI: 10.2460/javma.253.9.1169. View

Johnson C, Culp W, Palm C, Zacuto A . Subcutaneous ureteral bypass device for treatment of iatrogenic ureteral ligation in a kitten. J Am Vet Med Assoc. 2015; 247(8):924-31. DOI: 10.2460/javma.247.8.924. View

Kulendra N, Borgeat K, Syme H, Dirrig H, Halfacree Z . Survival and complications in cats treated with subcutaneous ureteral bypass. J Small Anim Pract. 2020; 62(1):4-11. DOI: 10.1111/jsap.13226. View

Kyles A, Hardie E, Wooden B, Adin C, Stone E, Gregory C . Management and outcome of cats with ureteral calculi: 153 cases (1984-2002). J Am Vet Med Assoc. 2005; 226(6):937-44. DOI: 10.2460/javma.2005.226.937. View

Krishna V, Bharathkumar D . Intraluminal migration of gossypibioma. Int J Surg Case Rep. 2018; 47:61-63. PMC: 5994683. DOI: 10.1016/j.ijscr.2018.04.001. View

Fages J, Dunn M, Specchi S, Pey P . Ultrasound evaluation of the renal pelvis in cats with ureteral obstruction treated with a subcutaneous ureteral bypass: a retrospective study of 27 cases (2010-2015). J Feline Med Surg. 2017; 20(10):875-883. PMC: 11129236. DOI: 10.1177/1098612X17732900. View

Veran E, Vachon C, Byron J, Howard J, Berent A, Weisse C . Multicenter retrospective evaluation of transmural migration of subcutaneous ureteral bypass devices within the digestive tract in cats. J Vet Intern Med. 2022; 36(5):1677-1685. PMC: 9511080. DOI: 10.1111/jvim.16511. View

McQuitty R, Branter E . Treatment of fungal pyelonephritis and ureterolithiasis with a subcutaneous ureteral bypass system and systemic antifungal medication in a cat. Vet Med (Auckl). 2018; 9:73-78. PMC: 6267714. DOI: 10.2147/VMRR.S179112. View

Anson A, Carrillo J, Bayon A, Escobar M, Seva J, Agut A . IMAGING DIAGNOSIS-COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM. Vet Radiol Ultrasound. 2017; 59(3):E28-E31. DOI: 10.1111/vru.12473. View

10.

Clarke D . Feline ureteral obstructions Part 1: medical management. J Small Anim Pract. 2018; 59(6):324-333. DOI: 10.1111/jsap.12844. View

11.

Berent A, Weisse C, Bagley D, Lamb K . Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009-2015). J Am Vet Med Assoc. 2018; 253(10):1309-1327. DOI: 10.2460/javma.253.10.1309. View

12.

Sapora J, Hardie R, Evans N . Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat. JFMS Open Rep. 2019; 5(1):2055116919831856. PMC: 6415474. DOI: 10.1177/2055116919831856. View

13.

Clarke D . Feline ureteral obstructions Part 2: surgical management. J Small Anim Pract. 2018; 59(7):385-397. DOI: 10.1111/jsap.12861. View

14.

Kulendra E, Kulendra N, Halfacree Z . Management of bilateral ureteral trauma using ureteral stents and subsequent subcutaneous ureteral bypass devices in a cat. J Feline Med Surg. 2013; 16(6):536-40. PMC: 11112189. DOI: 10.1177/1098612X13509098. View

15.

Vrijsen E, Devriendt N, Mortier F, Stock E, Van Goethem B, de Rooster H . Complications and survival after subcutaneous ureteral bypass device placement in 24 cats: a retrospective study (2016-2019). J Feline Med Surg. 2020; 23(8):759-769. PMC: 10812192. DOI: 10.1177/1098612X20975374. View

16.

Livet V, Pillard P, Goy-Thollot I, Maleca D, Cabon Q, Remy D . Placement of subcutaneous ureteral bypasses without fluoroscopic guidance in cats with ureteral obstruction: 19 cases (2014-2016). J Feline Med Surg. 2016; 19(10):1030-1039. PMC: 11110986. DOI: 10.1177/1098612X16670572. View

17.

Kopecny L, Palm C, Drobatz K, Balsa I, Culp W . Risk factors for positive urine cultures in cats with subcutaneous ureteral bypass and ureteral stents (2010-2016). J Vet Intern Med. 2018; 33(1):178-183. PMC: 6335572. DOI: 10.1111/jvim.15343. View

18.

Ceci F, DAmore L, Annesi E, Bambi L, Grimaldi M, Gossetti F . Chronic anemia due to transmural e-PTFE anti-adhesive barrier mesh migration in the small bowel after open incisional hernia repair: A case report. Int J Surg Case Rep. 2018; 53:54-57. PMC: 6214886. DOI: 10.1016/j.ijscr.2018.10.012. View

19.

Dirrig H, Lamb C, Kulendra N, Halfacree Z . Diagnostic imaging observations in cats treated with the subcutaneous ureteral bypass system. J Small Anim Pract. 2019; 61(1):24-31. DOI: 10.1111/jsap.13071. View

20.

Fouhety A, Boursier J . Infection and extrusion of a subcutaneous access port in a cat: a long-term postoperative complication of a subcutaneous ureteral bypass device. JFMS Open Rep. 2020; 6(1):2055116920911765. PMC: 7158251. DOI: 10.1177/2055116920911765. View