Chapter 22: Table of Contents
Stent vs. SUB
A recent study comparing ureteral stents and SUB in cats treated for ureteral obstruction revealed that cats treated with SUBs had less complications and longer survival times than those treated with stents. (Deroy et al. 2017) Surgical time was also longer for stents than for SUBs and so was mortality rates (18% vs 13%). (Deroy et al. 2017) Finally, stents were more likely to obstruct than SUBs and to require further surgical intervention (44% vs 9%). Mortality rates for stents (18%) and SUBs (13%) in a recent study were similar to previous reports and were mostly related to lack of improvement in renal function (Deroy et al. 2017). Persistent azotemia is a problem (>40-50% of cats and 25-50% of dogs) but most patients are somewhat improved post intervention. (Berent 2011) There is unfortunately no parameter that can be used to predict survival to discharge and actual response to intervention. (Horowitz et al. 2013) However, a higher creatinine at discharge was associated with a higher creatinine at follow-up. Since no one clinical parameter is associated with survival to discharge, predicting patient survival, cost and outcome is impossible prior to decompression. (Horowitz 2013). You have to try to know.
< Subcutaneous Ureteral Bypass (SUB)
References:
Berent AC. Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostics and therapeutic options. J Vet Em Crit Care 2011; 21:86-103.
Deroy C, Rossetti D, Ragetly G, et al. Comparison between double-pigtail ureteral stents and ureteral bypass devices for treatment of ureterolithiasis in cats. JAVMA 2017; 251:429-437.
Horowitz C, Berent A, Weisse C, et al. Predictors of outcome for cats with ureteral obstructions after interventional management using ureteral stents or a subcutaneous ureteral bypass device. J Feline Med Surg 2013; 15:1052-1062.