Clinical Presentation and Outcome of Cats with Circumcaval Ureters Associated with a Ureteral Obstruction. (30th September 2014)

• Record Type: Journal Article
• Authors: Steinhaus, J.; Berent, A.C.; Weisse, C.; Eatroff, A.; Donovan, T.; Haddad, J.; Bagley, D.
• Is Part Of: Journal of veterinary internal medicine. Volume 29:Number 1(2015:Jan./Feb.)
• Page Start: 63
• Page End: 70
• Publication Date: 2014-09-30
• Subjects: Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.12465
• Languages: English
• ISSNs: 0891-6640

Abstract

<abstract abstract-type="main" id="jvim12465-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jvim12465-sec-0001" sec-type="section"> <title>Background</title> <p>Circumcaval ureters (CU) are a rare embryological malformation resulting in ventral displacement of the caudal vena cava, which crosses the ureter, potentially causing a ureteral stricture.</p> </sec> <sec id="jvim12465-sec-0002" sec-type="section"> <title>Objectives</title> <p>To evaluate cats with obstructed CU(s) and report the presenting signs, diagnostics, treatment(s), and outcomes. Cats with obstructed CU(s) were compared to ureterally obstructed cats without CU(s).</p> </sec> <sec id="jvim12465-sec-0003" sec-type="section"> <title>Animals</title> <p>193 cats; 22 circumcaval obstructed (Group 1); 106 non‐circumcaval obstructed (Group 2); 65 non‐obstructed necropsy cases (Group 3).</p> </sec> <sec id="jvim12465-sec-0004" sec-type="section"> <title>Methods</title> <p>Retrospective study, review of medical records for cats treated for benign ureteral obstructions from AMC and University of Pennsylvania between 2009 and 2013. Inclusion criteria: surgical treatment of benign ureteral obstruction, complete medical record including radiographic, ultrasonographic, biochemistry, and surgical findings.</p> </sec> <sec id="jvim12465-sec-0005" sec-type="section"> <title>Results</title> <p>Seventeen percent (22/128) of obstructed cats had a CU (80% right‐sided) compared to 14% (9/65) non‐obstructed necropsy cats (89% right‐sided). Clinical presentation, radiographic findings, and creatinine were not statistically different between Groups 1 and 2. Strictures were a statistically more common (40%) cause of ureteral obstruction in Group 1 compared to Group 2 (17%) (<italic>P</italic> = .01). The MST for Groups 1 and 2 after ureteral decompression was 923 and 762 days, respectively (<italic>P</italic> = .62), with the MST for death secondary to kidney disease in both groups being >1, 442 days. Re‐obstruction was the most common complication in Group 1 (24%) occurring more commonly in ureters of cats treated with a ureteral stent(s) (44%) compared to the subcutaneous ureteral bypass (SUB) device (8%) (<italic>P</italic> = .01).</p> </sec> <sec id="jvim12465-sec-0006" sec-type="section"> <title>Conclusions and Clinical Importance</title> <p>Ureteral obstructions in cats with a CU(s) have a similar outcome to those cats with a ureteral obstruction and normal ureteral anatomy. Long‐term prognosis is good for benign ureteral obstructions treated with a double pigtail stent or a SUB device. The SUB device re‐obstructed less commonly than the ureteral stent, especially when a ureteral stricture was present.</p> </sec> </abstract>