Clarke D L
Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, 19104, USA.
J Small Anim Pract. 2018 Jul;59(7):385-397. doi: 10.1111/jsap.12861. Epub 2018 May 20.
Feline obstructive ureteral disease will likely remain a common and frustrating cause of critical illness in cats for the foreseeable future. Since many cats are uraemic and cardiovascularly unstable secondary to obstructive nephropathy, prompt recognition using clinical intuition, blood work and diagnostic imaging is essential to make a timely diagnosis and decision about timing for intervention, if indicated. Multiple surgical and interventional procedures exist for the management of feline ureteral obstructions but there is no ideal technique and all currently available procedures carry risk of infection, re-obstruction, urine leakage and the need for additional procedures in the future. Therefore, until clear, evidence-based guideline exist, the decision about which ureteral procedure to perform in cats should be guided by nature of the obstruction, location, concurrent urolithiasis, infection and surgeon preference. In all likelihood, ureteral surgery, stents and ureteral bypass devices will continue to remain viable options and the decision about which procedure to use will be made on a case-by-case basis.
在可预见的未来，猫阻塞性输尿管疾病可能仍是猫重症常见且令人困扰的病因。由于许多猫因阻塞性肾病继发尿毒症且心血管不稳定，运用临床直觉、血液检查和诊断成像进行快速识别对于及时诊断以及在必要时决定干预时机至关重要。目前有多种手术和介入方法用于治疗猫输尿管阻塞，但尚无理想技术，且所有现有方法均有感染、再阻塞、尿液渗漏风险以及未来需要额外手术的问题。因此，在明确的循证指南出现之前，猫输尿管手术方式的选择应依据阻塞的性质、位置、并发尿路结石、感染情况以及外科医生的偏好来决定。很有可能输尿管手术、支架置入和输尿管旁路装置仍将是可行的选择，具体采用哪种方法将根据具体病例决定。
