Subcutaneous ureteral bypass (SUB)™ device placement is an alternative to traditional ureteral surgery. However, outcomes have not been described for treatment of benign ureteral obstructions in dogs. The purpose was to evaluate pre-operative, peri-operative (< 7 days), short (7-30 days) and long-term (> 30 days) parameters in dogs treated with SUBs™ for benign ureteral obstructions. The hypothesis was SUBs™ were associated with favorable technical outcomes when compared with alternatives.
SUBs™ were placed using fluoroscopic- and surgical-assistance. Medical records were reviewed for pre-, intra-, and post-operative data.
Twelve SUBs™ were placed in nine dogs (3 bilateral). Causes of obstruction included: ureterolithiasis (9/12;75%), extraluminal compression (2/12;17%), and stricture (1/12;8%). Eleven of 12 ureters had a stent placed prior and needed a SUB™ for: recurrent stricture (4/11;36%), ureteritis (4/11;36%), or stent migration (3/11;27%). Placement was successful in all ureters.
The median creatinine pre-operative and 3 months post-operative was 2.1 mg/dL and 1.2 mg/dL, respectively. Seven dogs (7/9;78%) had a history of urinary tract infection(s ) prior to SUB™ placement.
Long-term complications included infection (5/9;55%) and mineralization (6/12;50%). Dogs that mineralized their device had a history of urolithasis. Historical pre-operative infections commonly had post-operative infections (5/7). There were no peri-operative or procedure-related deaths. No dog had worsening azotemia in the short-term. The median survival time was > 774 days, with 5/9 still alive.
Use of the SUB™ device in dogs is a safe and effective treatment option for benign ureteral obstructions and associated with a good prognosis. The high rate of mineralization and infections should be considered in the long-term.
Director of Interventional Endoscopy
The Animal Medical Center
Dr. Berent graduated from Cornell University College of Veterinary Medicine. She completed an internship at the University of Minnesota and a residency in internal medicine at the Veterinary Hospital of the University of Pennsylvania. After completing a fellowship in interventional radiology at the Veterinary Hospital of the University of Pennsylvania and a fellowship in Endourology at Thomas Jefferson University she served as an Adjunct Assistant Professor in Internal Medicine and Interventional Radiology/ Interventional Endoscopy at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. She now is the director of the interventional endoscopy service at the Animal Medical Center in NYC and particularly focus ureteral diseases, urinary incontinence and minimally invasive management of urinary stone disease. She also has an interest in hepatobiliary interventions, biliary stenting and other aspects of interventional radiology and endoscopy
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