Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York.
Ryder Science, Inc. Medical Biofilm Research, Brentwood, Tennessee.
J Vet Intern Med. 2019 Sep;33(5):2124-2132. doi: 10.1111/jvim.15582. Epub 2019 Aug 6.
Subcutaneous ureteral bypass (SUB) device placement is an increasingly popular treatment option for decompression of ureteral obstruction in cats. Mineralization occlusion of the device occurs in a minority of cases but is the most common complication.
To evaluate a 2% tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of mineralization occlusion in cats with SUBs.
Six client-owned cats (8 obstructed devices).
Case series. Each cat was found to have device occlusion based on a combination of ultrasound examination, SUB irrigation, and failure to identify another cause of device obstruction. Each SUB was drained, irrigated using sterile saline, and infused with 1-2 mL of 2% tEDTA solution. Success was defined as normalization of flow during subsequent ultrasound visualization while irrigating. The volume and frequency of tEDTA instillations, time to achieve device patency, follow-up biochemical and ultrasound findings, and future reobstruction events were recorded.
Resolution of mineralization was documented in all 8 SUBs. Reobstruction events occurred in 2 cats, all of which resolved after additional tEDTA infusions, but 1 cat ultimately required device exchange at 356 days from the first tEDTA infusion. In 1 cat, a single infusion was prematurely discontinued because of persistent pelvic dilatation after 1.25 mL of tEDTA had been instilled. No complications were observed.
Tetrasodium EDTA infusions can be safely considered as a treatment option for mineralized SUB devices in cats. This solution was easily infused, well tolerated, and avoided the need for SUB device exchange in the majority of cats in which it was used.
皮下输尿管旁路 (SUB) 装置的放置是治疗猫输尿管梗阻减压的一种越来越受欢迎的治疗选择。少数情况下会发生装置的矿化闭塞，但这是最常见的并发症。
评估 2%四钠乙二胺四乙酸 (tEDTA) 溶液在治疗患有 SUB 的猫的矿化闭塞中的作用。
6 只患宠猫（8 个阻塞装置）。
病例系列研究。每只猫都被发现存在装置阻塞，这是基于超声检查、SUB 冲洗和未能确定装置阻塞的其他原因的综合结果。每个 SUB 都被引流，用无菌生理盐水冲洗，并注入 1-2 毫升 2% tEDTA 溶液。成功的定义是在随后的超声可视化冲洗过程中流量恢复正常。记录 tEDTA 滴注的体积和频率、达到装置通畅的时间、随访的生化和超声发现以及未来的再阻塞事件。
8 个 SUB 中的所有装置的矿化都得到了缓解。2 只猫发生了再阻塞事件，所有猫在接受额外的 tEDTA 滴注后都得到了解决，但其中 1 只猫在首次接受 tEDTA 滴注后 356 天最终需要更换装置。在 1 只猫中，由于在注入 1.25 毫升 tEDTA 后持续出现骨盆扩张，单次滴注被提前停止。没有观察到并发症。
四钠 EDTA 滴注可安全地作为治疗猫矿化 SUB 装置的选择。该溶液易于注入，耐受性良好，避免了在大多数接受该溶液治疗的猫中需要更换 SUB 装置。
