SUBs for Upper Urinary Tract Uroliths

Diagnosis and management of feline obstructive ureterolithiasis has markedly increased over the past 10 years. It is possible that this condition is an emerging disease, due to changes in diet and lifestyle of cats, but it is likely that increased awareness and improved diagnostic capabilities, has increased diagnosis.

Optimal management of patients with feline ureterolithiasis presents many challenges and is an area in which management options are evolving. The risks associated with surgery had led to reluctance to pursue surgical options, however publications from the University of California, Davis (Kyles et al., JAVMA 2005a, 2005b), demonstrated that survival rates for patients managed surgically were greater (91% versus 66% at 12 months post-diagnosis) for surgically than medically managed patients. Subsequent management has focussed upon intervention to relieve the obstruction and, depending upon experience, conventional surgery (Roberts et al, 2011) and ureteric stents (Nicoli et al, 2012; Manassero et al; Kulendra et al, 2014; Berent et al, 2014; DeRoy et al 2016) have provided surgical options for relief of ureteric obstruction.

The subcutaneous ureteric bypass system was developed as an alternative technique. The device is extraluminal and therefore, in theory, avoids any ureteral surgery or potential ureteritis or trigone irritation, may be placed more quickly and is at less risk of obstruction due to its larger size (Horowitz et al., 2013; Steinhaus 2015; Berent 2016; DeRoy et al, 2016; Livet et al., 2016). [...]