Hammond Tara N, King Ryan G, Danielson Kelson C
Department of Emergency/Critical Care, Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, USA.
Department of Radiology, Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, USA.
J Vet Emerg Crit Care (San Antonio). 2023 May-Jun;33(3):371-379. doi: 10.1111/vec.13288. Epub 2023 Mar 21.
To describe the successful management of pelvic urethral strictures in 3 young cats (1 after perineal urethrostomy, 1 after a third-time urethral obstruction, and 1 with prolonged lower urinary tract signs post-urethral obstruction) using balloon dilation and a short-term, indwelling urethral catheter.
A 9-month-old neutered male domestic longhair cat with a urethral obstruction and a suspected congenitally narrowed urethra was treated via perineal urethrostomy. The cat later developed acute kidney injury, multidrug-resistant urinary tract infections, and a pelvic urethral stricture. A second case, a 2.3-year-old neutered male domestic shorthair cat, developed a stricture of the pelvic urethra after multiple obstructions and catheterizations. A third case, a 1.2-year-old neutered male domestic shorthair cat, had persistent and prolonged lower urinary tract signs after treatment for a urinary obstruction. The cat also had an abnormally small urethral opening and was ultimately found to have a proximal urethral stricture. The strictures in all 3 cases were successfully treated with a combination of fluoroscopic-guided balloon dilation and short-term indwelling urethral catheterization while managing any present infection.
To the authors' knowledge, this is the first published case series of successful balloon dilations paired with the use of a short-term indwelling urethral catheter in cats that developed urethral strictures after catheterization due to urinary obstructions. This procedure appears safe and well tolerated and appears to offer a long-term, cost-effective solution to urethral strictures at the level of the pelvis.
描述3只年轻猫(1只在会阴尿道造口术后、1只在第三次尿道梗阻后、1只在尿道梗阻后出现长期下尿路症状)盆腔尿道狭窄的成功治疗方法,采用球囊扩张术和短期留置尿道导管。
一只9个月大已绝育的雄性家猫长毛猫,患有尿道梗阻且怀疑尿道先天性狭窄,接受了会阴尿道造口术治疗。这只猫后来出现急性肾损伤、多重耐药性尿路感染和盆腔尿道狭窄。第二例,一只2.3岁已绝育的雄性家猫短毛猫,在多次梗阻和插管后出现盆腔尿道狭窄。第三例,一只1.2岁已绝育的雄性家猫短毛猫,在治疗尿道梗阻后出现持续且长期的下尿路症状。这只猫的尿道开口异常小,最终发现有近端尿道狭窄。所有3例狭窄均通过透视引导下的球囊扩张术和短期留置尿道导管联合治疗,并同时处理任何现有的感染,获得成功。
据作者所知,这是首次发表的关于因尿路梗阻插管后发生尿道狭窄的猫成功进行球囊扩张术并使用短期留置尿道导管的病例系列。该手术似乎安全且耐受性良好,似乎为盆腔水平的尿道狭窄提供了一种长期、经济有效的解决方案。