Novel treatment alternatives for feline ureteral obstruction(s) include placement of a double pigtail ureteral stent and a subcutaneous ureteral bypass (SUB) device. This study evaluated parameters for the prediction of hospitalization times, peri-operative survival, renal recovery and long-term survival in cats with benign ureteral obstructions after successful decompression with either a ureteral stent or SUB device. The medical records of 41 cats treated for benign ureteral obstruction(s) were retrospectively reviewed. Preoperative historical, biochemical and imaging parameters, along with intra- and postoperative biochemical parameters and complications were evaluated for predictors of hospitalization length, survival to discharge, 3-, 6- and 9-month post-procedure creatinine, and overall survival time. All patients had successful decompression of their renal pelvis. Hospitalization time was positively associated with presenting creatinine, perioperative complications, post-procedure creatinine and potassium, but was negatively associated with post-procedure sodium. No parameters were associated with survival to discharge. A higher creatinine at discharge was positively associated with a higher creatinine at follow-up. A decreased overall survival was associated with a higher presenting blood urea nitrogen, higher creatinine at hospital discharge and in over-hydrated patients during hospitalization. Cats with International Renal Interest Society stage 1 and 2 kidney disease, versus stage 3 and 4, at 3 months and 6 months post-procedure, lived longer. Cats with ureteral obstruction(s) treated with a ureteral stent or SUB device had an overall good survival and no admitting parameter was associated with survival to discharge. No single parameter was associated with all outcomes in this study, making predicting patient survival and cost prior to ureteral decompression difficult.

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Results suggested that survival rates of cats with ARF were similar to survival rates in dogs and that residual renal damage persisted in approximately half of cats surviving the initial hospitalization.

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Hemodialysis (HD) has been used in the management of renal failure in dogs, but its feasibility has not been reported for uremic cats. Therefore, we investigated the technical possibility, efficacy, and complications of intermittent HD in cats with severe uremia. A total of 160 HD treatments were performed on 29 cats with acute renal failure (ARF) (n = 15). chronic renal failure (CRF) (n = 6), or acute on CRF (n = 8) between November 1993 and June 1996. Hemodialysis treatments were performed with transcutaneous dialysis catheters using a bicarbonate-based delivery system, sodium modeling, and volumetric-controlled ultrafiltration. Presenting serum chemistries (mean i SD) for all cats were creatinine, 16.4 i-7.5 mg/dL; blood urea nitrogen (BUN), 229 t 87 mg/dL; phosphate, 15.4 t 5.4 mg/dL; potassium, 6.0 t 1.6 mEq/L; and HCO; , 16.0 t 4.4 mEq/L. For intensive HD treatments, pre-HD versus post-HD creatinine changed from 10.3 i 4.4 t o 1.6 2 0.9 rng/dL and BUN from 105 i 33 t o 8 he therapeutic alternatives for acute renal failure (ARF) T or advanced chronic renal failure (CRF) in cats are limited.' Many cats with ARF remain unresponsive to attempts to promote diuresis or die as a result of the metabolic disturbances of uremia before repair of renal damage can occur. Therapy itself may contribute to life-threatening complications that cannot be resolved (eg, overhydration). For cats with end-stage CRF, dietary and conventional medical therapy often is poorly accepted or ineffective, resulting in poor quality of life and owner frustration. Hernodialysis (HD) is the most common form of renal replacement therapy for the majority of human patients with severe uremia. With HD, an artificial kidney alleviates azotemia and life-threatening acid-base, electrolyte, and metabolic disturbances of renal failure by removal of toxic solutes and excessive fluid from the body. The procedure requires reusable access to the vasculature, an effective extracorporeal flow of blood, an artificial kidney (heniodialyzer), and a delivery system to facilitate generation of dialysate and transfer of uremic solutes. Hemodialysis has been successfully employed in dogs with ARF and CRF, but the small size of cats has posed technical hurdles with vascular access, blood delivery, extracorporeal circulation, and hemodynamic stability that precluded its application in this species. The volume of pediatric blood lines and dialyzers suitable for use in dogs approximated the total blood volume of cats. Fluid removal by ultrafiltration was difficult to regulate and monitor accurately on older delivery systems and frequently induced hypovolemia and hypotension. Acetate-based dialysate formulations caused vasodilation and hemodynamic instability with the rapid delivery of acetate to dogs.' The combination of these technical factors led to predictable decreases in blood pressure in experimental and pet dogs treated with HD despite their larger size and made dialysis unsuitable for cats.' Technologic developments and sophistication of dialysis delivery tec...