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Comparison of 3 Techniques for Ureteroneocystostomy in Cats

Authors

  • Margo L. Mehl DVM, Diplomate ACVS,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Andrew E. Kyles BVMS, PhD, Diplomate ACVS & ECVS,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Rachel Pollard DVM, Diplomate ACVR,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Joshua Jackson DVM, Diplomate ACVS,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Philip H. Kass DVM, PhD, Diplomate ACVPM,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Stephen M. Griffey DVM, PhD,

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • Clare R. Gregory DVM, Diplomate ACVS

    1. From the Veterinary Medical Teaching Hospital, the Departments of Surgical and Radiological Sciences, and Population Health and Reproduction, and the Comparative Pathology Laboratory, University of California—Davis, Davis, CA
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  • This study was supported by the George and Phyllis Miller Feline Health Fund, Center for Companion Animal Health, School of Veterinary Medicine, University of California, Davis.

  • Presented at the 12th Annual American College of Veterinary Surgeons Veterinary Symposium, San Diego, CA, October 17–20, 2002.

  • Dr. Joshua Jackson's current address is Veterinary Specialty Hospital, 6525 Calle del Nido, Rancho Sante Fe, CA 92067.

Address reprint requests to Dr. Margo L. Mehl, DVM, Diplomate ACVS, Department of Surgical and Radiological Sciences, University of California-Davis, One Shields Avenue, Davis, CA 95616. E-mail: mmehl@ucdavis.edu or Dr. Andrew Kyles at aekyles@ucdavis.edu.

Abstract

Objective— To compare 3 techniques for ureteroneocystostomy in cats.

Study Design— Experimental surgical study.

Animals— Fifteen adult cats.

Methods— Cats (15) had ureteroneocystostomy with ureteronephrectomy of the contralateral kidney: 5 cats had an intravesical mucosal apposition technique (modified Leadbetter-Politano; intravesical-MA group), 5 cats had extravesical ureteroneocystostomy (modified Lich Gregoir) using a simple continuous suture pattern (extravesical-SC group) and 5 cats had an extravesical technique using a simple interrupted suture pattern (extravesical-SI group). Renal function was evaluated by measuring serum creatinine concentration. Ultrasonographic assessment of the kidney and ureteroneocystostomy site was performed the day after surgery, twice weekly for 3 weeks and once weekly for the remainder of the study. Cats were euthanatized 50 days after surgery. The kidney and ureter removed at surgery, the remaining kidney, ureter, ureteroneocystostomy site, and bladder were examined histologically.

Results— Two extravesical-SC cats were euthanatized because of azotemia and uroabdomen, and 1 died acutely at day 4 for unknown reasons. In the intravesical-MA and extravesical-SI cats, the serum creatinine concentration increased after surgery, peaking at a mean (±SD) of 9.4±2.4 mg/dL and 4.9±3.3 mg/dL on day 3, and decreasing to 3.4±5.7 mg/dL and 1.5±0.4 mg/dL on day 7, respectively. The extravesical-SI technique was associated with consistently lower serum creatinine concentrations for the first week after surgery compared with the other techniques. The mean serum creatinine concentration was within the reference range in cats in the intravesical-MA and extravesical-SI groups by days 10 and 5, respectively. Renal pelvic dilatation occurred in all cats but resolved more rapidly in cats after extravesical techniques. There was no significant difference in serum creatinine concentrations or renal pelvic dilation between the intravesical-MA and extravesical-SI techniques. Bladder mass height at the anastomosis site was significantly larger and persisted for longer with intravesical-MA technique.

Conclusion— An extravesical-SI technique is seemingly the choice for ureteroneocystostomy in cats with undilated ureters. Renal pelvic dilation on ultrasound examination should be expected after ureteroneocystostomy in cats.

Clinical Relevance— An extravesical ureteroneocystostomy technique using a simple interrupted pattern for anastomosis should be considered in cats undergoing renal transplantation.

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