Section of Internal Medicine, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Vet Intern Med. 2011 Mar-Apr;25(2):222-9. doi: 10.1111/j.1939-1676.2011.0679.x. Epub 2011 Feb 11.
Feline ureteral obstructions have emerged as a common problem. Ureteral strictures rarely are reported as a cause and the predisposing factors and clinical course of this condition have not been described.
Evaluate cases of feline ureteral strictures and characterize historical features, clinical signs, diagnostic imaging, surgical and endoscopic findings, histopathology, treatment modalities, and short- and long-term outcomes.
Ten cats diagnosed with ureteral strictures based on compatible findings from at least 2 of the following: ultrasonography, ureteropyelography, surgical exploration, or histopathology.
Retrospective study.
Median age, serum creatinine concentration, and size of the renal pelvis were 12 years, 3.7 mg/dL, and 11.75 mm, respectively. Six of 10 cats had hyperechoic periureteral tissue on ultrasound examination at the stricture site. Four cats had evidence of a circumcaval ureter at surgery. Eight cats had an intervention including ureteral stent placement (n = 6) and traditional surgery (n = 2). Seven of 8 cats had decreases in serum creatinine concentration and renal pelvic parameters preceding discharge and 6 had persistently improved results at their last examination. All patients survived to discharge. Median survival time was > 294 days (range, 14 to > 858 days) with 6/10 cats still alive.
Ureteral strictures may occur in cats secondary to ureteral surgery, inflammation, a circumcaval ureter, impacted ureterolithiasis, or for unknown causes. With appropriate and timely intervention, the prognosis for long-term survival is good. In addition to ureteral reimplantation or ureteronephrectomy, ureteral stenting or SC ureteral bypass may be considered as future therapeutic options.
猫的输尿管梗阻已成为一个常见问题。输尿管狭窄很少被报道为原因,其发病因素和临床病程尚未描述。
评估猫输尿管狭窄病例,描述其病史特征、临床症状、诊断影像学、手术和内镜检查结果、组织病理学、治疗方式以及短期和长期结果。
根据至少 2 种以下检查结果相符而诊断为输尿管狭窄的 10 只猫:超声检查、肾盂输尿管造影、手术探查或组织病理学检查。
回顾性研究。
中位年龄、血清肌酐浓度和肾盂大小分别为 12 岁、3.7 mg/dL 和 11.75 mm。10 只猫中有 6 只在超声检查狭窄部位时可见输尿管周围组织回声增强。4 只猫在手术时发现腔静脉旁输尿管。8 只猫进行了干预,包括输尿管支架置入术(6 只)和传统手术(2 只)。8 只猫中有 7 只在出院前血清肌酐浓度和肾盂参数降低,6 只猫在最后一次检查时结果持续改善。所有患者均存活至出院。中位生存时间>294 天(范围 14 至>858 天),10 只猫中有 6 只仍存活。
猫的输尿管狭窄可能继发于输尿管手术、炎症、腔静脉旁输尿管、嵌顿性输尿管结石或未知原因。通过适当和及时的干预,长期生存的预后良好。除了输尿管再植入或肾输尿管切除术外,输尿管支架或经皮输尿管旁路术也可作为未来的治疗选择。