Kyles Andrew E, Hardie Elizabeth M, Wooden Brent G, Adin Christopher A, Stone Elizabeth A, Gregory Clare R, Mathews Kyle G, Cowgill Larry D, Vaden Shelly, Nyland Thomas G, Ling Gerald V
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2005 Mar 15;226(6):937-44. doi: 10.2460/javma.2005.226.937.
To determine outcome of medical and surgical treatment in cats with ureteral calculi.
Retrospective study.
153 cats.
Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information.
All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure.
Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function.
确定输尿管结石猫的内科和外科治疗结果。
回顾性研究。
153只猫。
查阅病历。联系猫主人及转诊兽医以获取随访信息。
所有猫在决定进行手术前均先接受内科治疗。内科治疗包括胃肠外给予液体和利尿剂以促进尿液生成及输尿管结石排出,以及对肾衰竭的支持治疗。输尿管近端的结石通常通过输尿管切开术取出,而输尿管远端的结石更可能通过部分输尿管切除术和输尿管膀胱吻合术取出。输尿管切开术可在不放置肾造瘘管用于术后尿液引流的情况下进行。术后并发症发生率和围手术期死亡率分别为31%和18%。最常见的术后并发症是术后漏尿和持续性输尿管梗阻。慢性肾衰竭在诊断时常见且治疗后仍持续存在,约半数猫的血清肌酐浓度仍高于参考上限。内科和外科治疗后的12个月生存率分别为66%和91%,有一些猫死于与泌尿系统疾病相关的原因,包括输尿管结石复发和慢性肾衰竭恶化。
结果表明,猫输尿管结石的内科和外科治疗与高发病率和死亡率相关。治疗可稳定肾功能,尽管许多存活的猫肾功能仍会持续受损。