Urethral stenting in a cat with refractory obstructive feline lower urinary tract disease

Successful management of pelvic urethral strictures with balloon dilation in 3 cats

OBJECTIVE

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.

CASE SUMMARIES

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.

NEW OR UNIQUE INFORMATION PROVIDED

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.

Resolution of urethral obstruction using temporary urethral stents in two female cats

Case summary

The management of urethral obstructions is well documented in male cats but is less established for females. These cases describe two female cats that presented with non-dissolvable urocystoliths. Urocystoliths were removed by laser lithotripsy and basket retrieval. Following urolith removal, urethral obstruction occurred in both cats. Both cats were successfully managed using temporary urethral stents in lieu of indwelling urethral catheters permitting outpatient, spontaneous recovery of the urethra.

Relevance and novel information

Use of temporary urethral stents has not been described in cats. These novel stents are constructed from materials available in most veterinary facilities, placed without advanced imaging and reside entirely within the urethra and vestibule. Temporary stents are used to bypass urethral disease, facilitating outpatient recovery, and are easily removed when no longer needed. For these reasons, temporary stents are a cost-efficient alternative to permanent stents or indwelling urinary catheters attached to closed urine-collection systems.

Implantação de stent autoexpansível para tratamento de estenose uretral em cão: relato de caso

RESUMO O stent endovascular autoexpansível pode ser utilizado como forma de tratamento para estenose uretral em cães. O stent de nitinol é composto por uma liga de níquel e titânio que permite mudanças em suas estruturas sob a influência da temperatura corporal e tem excelente biocompatibilidade na uretra canina. Este estudo relata o caso de um cão, sem raça definida, 14 anos de idade, com histórico de disúria há duas semanas, diagnosticado com grande quantidade de cálculos e microcálculos na bexiga, no colo vesical e na uretra prostática, também cistite e hiperplasia prostática. Depois de tratamento para cistite, orquiectomia e cistotomia para retirada dos cálculos, porém sem melhora clínica após 30 dias de acompanhamento, com o paciente apresentando disúria, foi realizada uretrocistografia retrógrada, que evidenciou estenose da uretra prostática. Esse paciente foi encaminhado para procedimento de implantação de um stent de nitinol na uretra prostática. Imediatamente após o procedimento e até o presente momento, o paciente apresenta micção espontânea, sem qualquer sinal de disúria, sendo este o primeiro relato no Brasil do uso dessa técnica.

Use of a self-expanding metallic stent for the treatment of a urethral stricture in a young cat

A 4-month-old intact male domestic shorthair cat was evaluated for urinary outflow obstruction after several weeks of medical management for traumatic urethral rupture. Positive-contrast retrograde urethrography and anterograde cystoscopy performed 4 weeks after the initial urethral injury confirmed a stricture approximately 1cm distal to the bladder trigone at the site of the initial urethral tear. A self-expanding metallic urethral stent (SEMS) was placed under fluoroscopic guidance to relieve the urethral stricture and re-establish luminal patency. After stent placement, the cat was able to void urine normally with minimal urinary incontinence noted. This resolved several months post-stent placement. No known clinical complications persisted other than mild intermittent hematuria.