Department of Clinical Sciences, Centre Hospitalier Universitaire Vétérinaire (CHUV), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada.
Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada.
J Feline Med Surg. 2021 Oct;23(10):892-899. doi: 10.1177/1098612X20983980. Epub 2021 Jan 27.
The aim of the study was to describe renal pelvis (RP) and ureteral ultrasonographic measurements in a population of cats with confirmed benign ureteral obstruction (UO) by antegrade pyelography. The secondary objective was to further describe clinical findings associated with minimally dilated obstructed kidneys in an attempt to better understand its occurrence.
Retrospective case series of cats diagnosed with benign UO were confirmed by antegrade pyelography. Medical records were reviewed and signalment, diagnostic imaging results, serum creatinine (SCr) concentration and urine culture results were recorded. Each obstructed kidney was categorized into two groups: group 1 included all RP measurements ⩽4 mm and group 2 included all RP measurements >4 mm.
A total of 82 cats with 114 obstructed ureters met the inclusion criteria. Fifty (61%) cats had a unilateral UO and 32 (39%) had a bilateral UO. Thirty (26%) kidneys were included in group 1 while 84 (74%) were included in group 2. Nine (8%) kidneys had an RP dilation ⩽2 mm. Median RP and ureteral diameters were 6.6 mm (range 1.1-37.0 mm) and 3.2 mm (range 0.0-11.0 mm), respectively. RP size correlated positively with ureteral diameter in the study population ( <0.0001), but not in group 1 when analyzed separately ( = 0.47). UO was secondary to stones in 80 (70%) ureters. Seventeen (21%) cats had a positive urine culture. At admission, 79 (96%) cats were azotemic with a median preoperative SCr concentration of 444 µmol/l (range 108-1326 μmol/l). The mean (95% confidence interval [CI]) preoperative SCr concentration was significantly higher in group 1 (762 µmol/l [498-1165 μmol/l]) than in group 2 (409 µmol/l [333-502 μmol/l]). RP size in the two groups correlated negatively with preoperative SCr concentration ( = 0.0002).
Feline UO may be associated with minimal RP dilation and the severity of RP and ureteral dilation can be highly variable. Absence of significant RP dilation does not rule out UO in cats.
本研究旨在描述通过顺行肾盂造影术确诊为良性输尿管梗阻 (UO) 的猫的肾盂 (RP) 和输尿管超声测量值。次要目的是进一步描述与轻度扩张梗阻肾脏相关的临床发现，以更好地了解其发生情况。
回顾性病例系列研究纳入了通过顺行肾盂造影术确诊为良性 UO 的猫。回顾了病历，并记录了特征、诊断影像学结果、血清肌酐 (SCr) 浓度和尿液培养结果。每个梗阻的肾脏分为两组：组 1 包括所有 RP 测量值 ⩽4 mm，组 2 包括所有 RP 测量值 >4 mm。
共有 82 只猫的 114 条梗阻输尿管符合纳入标准。50 只 (61%) 猫单侧 UO，32 只 (39%) 双侧 UO。30 只 (26%) 肾脏纳入组 1，84 只 (74%) 肾脏纳入组 2。9 只 (8%) 肾脏的 RP 扩张 ⩽2 mm。RP 和输尿管直径的中位数分别为 6.6 mm (范围 1.1-37.0 mm) 和 3.2 mm (范围 0.0-11.0 mm)。研究人群中，RP 大小与输尿管直径呈正相关 ( <0.0001)，但单独分析组 1 时不相关 ( = 0.47)。UO 继发于 80 根 (70%) 输尿管结石。17 只 (21%) 猫的尿液培养呈阳性。入院时，79 只 (96%) 猫出现氮血症，术前 SCr 浓度中位数为 444 µmol/l (范围 108-1326 μmol/l)。组 1 的平均 (95% 置信区间 [CI]) 术前 SCr 浓度显著高于组 2 (762 µmol/l [498-1165 μmol/l]) (409 µmol/l [333-502 μmol/l])。两组的 RP 大小与术前 SCr 浓度呈负相关 ( = 0.0002)。
猫的 UO 可能与 RP 轻度扩张有关，RP 和输尿管扩张的严重程度可能高度可变。没有明显的 RP 扩张并不能排除猫的 UO。
