Transmural migration of a subcutaneous ureteral bypass into the intestine in three cats

Abstract

mon complications include system occlusion, urinary tract infection and sterile cystitis. In this case series, we describe three cats with subcutaneous ureteral bypass devices placed where transmural migration of subcutaneous ureteral bypass catheters into the small intestine resulted in gastrointestinal signs, urinary infection and subcutaneous ureteral bypass occlusion. The system was changed in one case and removed in the other two. In all cases, an intestinal resection and anastomosis was performed. All cats had a good medium-term outcome, and urinary infection persisted in the case for which the subcutaneous ureteral bypass system was changed. Transmural migration of the device should be considered in cats with subcutaneous ureteral bypass presenting with persistent urinary tract infection, gastrointestinal signs or device obstruction, even if imaging studies such as ultrasound or contrast studies do not demonstrate any abnormalities.

Surgical repositioning with omentalisation of an exposed subcutaneous ureteral bypass shunting port in a cat

“… 3 , 5 , 6 Complications of SUB devices include blockage due to mineralisation, blood clot formation, urine leakage, infection, kinking of the tubing and transmural migration into the gastrointestinal tract. 3 , 7 , 8 Previously reported management of such complications have included SUB device exchange or removal, use of tissue plasminogen activator for obstruction from blood clots and tetra-EDTA solution for infections and mineralisation. 3 , 7 , 9 …”

“…3,5,6 Complications of SUB devices include blockage due to mineralisation, blood clot formation, urine leakage, infection, kinking of the tubing and transmural migration into the gastrointestinal tract. 3,7,8 Previously reported management of such complications have included SUB device exchange or removal, use of tissue plasminogen activator for obstruction from blood clots and tetra-EDTA solution for infections and mineralisation. 3,7,9 The aim of this case report was to describe a novel technique for the successful management of an exposed SUB shunting port, which involved topical treatment, repositioning and omentalisation of the device.…”