Ozzie is a beautiful 12 year old Himalayan cat who was referred to Dr. Erinne Branter at ACCESS Specialty Animal Hospital, Los Angeles, after being hospitalized for several days at his primary veterinarian’s office with a right ureteral obstruction. Ureteral obstructions are blockages that prohibit urine to drain from the bladder and can be caused by blood clots, mucus, crystals, strictures, tumors, or in Ozzie’s case, stones. Blockages are no walk in the park for any patient—animal or human— but can be deadly to dogs and cats. Untreated, a blockage can cause death due to complete kidney shut down.
Typically, a stent (tube that links the kidney to the bladder) can be placed to help a patient’s body pass the urine and stones. Ozzie had a stent implanted previously, which worked well for him for some time. Unfortunately, some patients are simply prone to re-obstruction, and in Ozzie’s case this called for a different approach.
Dr. Branter, the head of our Interventional Radiology Department, consulted with Ozzie’s owners, and it was decided that a subcutaneous ureteral bypass, or SUB, would be placed to help Ozzie pass urine.
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The SUB works as a secondary ureter, having one end of a small catheter implanted into the kidney and leading to the port, which rests under the skin, and connects to the end of the catheter which leads to the bladder. The port makes it possible for a veterinarian to flush the catheters to obtain urine samples for testing; while the catheter acts as a filter for the urine, making it possible for the fluid to pass through successfully.
Dr. Branter performed the SUB placement alongside Dr. Kim Carey, an ACCESS surgeon. With two veterinary technicians to assist and another to monitor the anesthesia, Ozzie was in good hands. The sub was placed successfully and they also were able to extract fat cells to culture stem cells. Ozzie’s stem cells will be used to help his kidney function in the future. It is not uncommon for cats to stop eating while they are under stress from being out of their normal environment, so Ozzie also had an esophageal feeding tube, or e-tube, temporarily placed to help him during his recovery process. After recovering well from anesthesia, Ozzie stayed in our hospital for a few days to be monitored after his surgery. It’s safe to say that Ozzie stole all of our hearts here during his stay, and we are so happy to have been able to help him.
Ozzie’s case is not uncommon, though it may be hard for some owners to recognize the signs of an emergency with their cat. Symptoms of ureteral blockages may include change in appetite and general signs of lethargy, vomiting, or reduced appetite. These are not typical “urinary” signs as seen with bladder or urethral issues, but they should be evaluated by a doctor.
If you think your cat may be blocked, call your primary veterinarian immediately. Additionally, if your cat has elevated kidney values, please have him or her checked with an ultrasound of the kidneys. This is very important as you can significantly improve kidney function by addressing ureteral obstructions.
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