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UC Davis Veterinary Surgeons Utilize Artificial Ureter in Kitten


March 3, 2016

Googgie now has an artificial ureter after one of her natural ureters became permanently obstructed.

Googgie now has an artificial ureter after one of her natural ureters became permanently obstructed.

"Case of the Month" - March 2016

Googgie, a 17-week-old spayed female Sphynx, was brought to the UC Davis veterinary hospital following a three-day bout of inappetence, lethargy and vomiting. Originally seen by the Emergency and Critical Care Service, she was noted to have an enlarged, painful left kidney.

With ultrasound, it was discovered that an obstruction of the left ureter was preventing flow of urine to the bladder. It could not be determined through imaging what was causing the blockage, and surgery was needed to discover, then alleviate, the obstruction.

Specialists from the Soft Tissue Surgery Service were brought in to review Googgie’s case and work with the Anesthesiology Service to prepare her for surgery. After opening Googgie’s abdomen, surgeons were able to see the extent of the damage to her ureter. A traumatic stricture (scarred down area) was present around the ureter, preventing it from being open. There was a solution, however. Dr. Bill Culp and his team had success previously in dogs and cats with a relatively new procedure creating an artificial ureter using catheters, and they were hopeful it would succeed in a kitten as well.

Bypassing the natural ureter, Dr. Culp was able to create two distinct ends of a new ureter with tubing – one end coming from the kidney, one end leading into the bladder. The two pieces were connected with a titanium shunting port that was placed just under the skin for easy access for collecting urine samples from the system. Known as a subcutaneous ureteral bypass (SUB), the system has primarily been utilized in older animals. The longevity of the system for longer installation into young animals is unknown, and Googgie’s device will need to be monitored long term to ensure functionality.

Tests following the successful surgery showed normal kidney function. Had Googgie’s signs of an illness been delayed longer, she could have lost complete function of the affected kidney, potentially leading to medical issues later in life.

Googgie recovered from the procedure without complications. She appeared bright, and was eating and drinking several hours after surgery. The following morning, she continued to recover and maintained an excellent appetite. For the next few days, she remained under the watchful eyes of technicians and veterinarians who supported her with IV fluid therapy and pain medications while she recovered. A follow-up ultrasound revealed complete resolution of the swollen kidney, and showed the SUB system remained in an appropriate position.

After nearly a week, Googgie was discharged from the hospital to continue her recovery at home. Three-week and three-month recheck examinations continued to be positive. Her weight had doubled since her initial visit to the emergency room, and she is growing like a normal cat.

The placement of the SUB in Googgie is unique due to Googgie’s age. As conventional methods for correcting ureteral obstructions are often less than optimal, it is hopeful that implantation of this SUB system will hold promise as a viable alternative. Initial data regarding use of SUB systems indicate fewer long-term complications compared with traditional ureteral surgery.

While the surgeons did need to open Googgie’s abdominal cavity to perform the surgery, they were able to place the implant minimally invasively, and utilize interventional radiology to help guide the procedure. Minimally invasive procedures at UC Davis are dramatically changing the face of veterinary surgery with equipment and technology allowing for new procedures to be performed that were not available less than a generation ago.

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About the Veterinary Medical Teaching Hospital
The William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis—a unit of the #1 world ranked School of Veterinary Medicine—provides state-of-the-art clinical care while serving as the primary clinical teaching experience for DVM students and post graduate veterinarian residents. The VMTH treats more than 51,000 animals a year, ranging from cats and dogs to horses, cows and exotic species. To learn more about the VMTH, please go to www.vetmed.ucdavis.edu/vmth. Timely news updates can be received on its Facebook (www.facebook.com/ucdavisvetmed) and Twitter (www.twitter.com/ucdavisvetmed) pages.

Media Contact:
Rob Warren
VMTH Communications & Marketing Officer
rjwarren@ucdavis.edu
530-752-2363