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An 18-year-old Hanoverian Warmblood gelding was presented with a history of acute haematuria. On rectal examination, a severely dilated right ureter with a concrement was palpated. Transabdominal sonography raised the suspicion of right kidney enlargement and loss of normal architecture. An exploratory laparoscopy was performed to evaluate the diagnostic findings. The tentative plan was to perform a laparoscopic ureterolith removal and a hand-assisted right nephrectomy, as high ureterolith recurrence rates are reported without nephrectomy. Right hand-assisted laparoscopic nephrectomy was performed and confirmed nephrolithiasis. Since the ureteral stone could not be mobilised, it was left in situ. Post-operative pain management proved a major challenge in this case, and was initially insufficient in spite of a multi-modal approach. Applied pain management techniques as used in human donor nephrectomy require further investigation for potential future use in equine patients. The gelding resumed his activity as a leisure horse six weeks after surgery, but was euthanized three months after surgery due to an unrelated cause. Nephrectomy without ureterolith removal provided a successful solution for this case of severe kidney disease. [ABSTRACT FROM AUTHOR]

Case series summary: Two cases of placement of modified endoluminal ureteral stents are described, for revision of a subcutaneous ureteral bypass (SUB) and for primary treatment of obstructive ureterolithiasis. Modified endoluminal stents were inserted through the ureterotomy, anchored in the renal pelvis with a single pigtail and shortened to a length sufficient to span the proximal ureter and ureterotomy site. Relevance and novel information: The advantages of this approach as a surgical option for feline obstructive ureterolithiasis are demonstrated, including the avoidance of disruption, or bypass, of the ureterovesicular junction, minimisation of implanted foreign material and avoidance of intravesicular stent mass, maintenance of the physiological route of urine flow, including preservation of active distal ureteral function, and limitation of the potential complications of ureterotomy. The clinical efficacy of this adaptation of the previously published endoluminal stenting technique is demonstrated with its applicability de novo and in the revision of other stenting procedures. [ABSTRACT FROM AUTHOR]

ABSTRACT: Feline ureteral obstruction can have several causes; however, ureterolithiasis has been increasing in occurrence. The restriction of urinary flow induced by the obstruction has harmful consequences to the body and can lead to acute renal failure. Calcium oxalate ureterolithiasis is reported in older cats, aged mean 12 years old. A case of bilateral ureteral obstruction in a 7-month-old mixed breed cat is described in this report. Imaging tests such as abdominal ultrasonography, radiography and excretory urography were performed to determine the diagnosis. The surgical procedure of bilateral ureterotomy was then performed, which allowed the improvement of the urinary flow of both kidneys and the resolution of clinical signs caused by uremia. The quantitative analysis of both uroliths revealed the composition of 100% monohydrate calcium oxalate. Calcium oxalate stones can also cause ureteral obstruction in young cats; although, are less common in this age. When conservative treatment fails, surgical intervention becomes necessary for the rapid return of renal function. To author’s knowledge this is the first report of a ureterolithiasis caused by calcium oxalate in a young cat.

Despite advances in non-invasive and minimally invasive techniques, some proximal ureteral stones with impaction require open or laparoscopic surgery. No systematic reviews or meta-analyses have compared the efficacy and safety of open proximal ureterolithotomy and laparoscopic approaches. The aim of this study was to compare the efficacy and safety between open and laparoscopic proximal ureterolithotomy for ureteral stone management. Following the PRISMA guidelines, systematic searches were conducted in five databases (PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest) to identify articles comparing those two surgical approaches. Operative time, blood loss, pain score, hospital stay, recovery time, and complications were collected and compared. Heterogeneity-based meta-analysis with random-effects or fixed-effects models were conducted. Two randomized controlled trials and four observational cohort studies with 386 participants met the criteria. Open surgery had significantly less time than laparoscopic ureterolithotomy (mean difference (MD): 26.63 minutes, 95%CI: 14.32, 38.94; p <0.0001). Intraoperative blood loss (MD: -1.27 ml; 95%CI: -6.64, 4.09; p =0.64) and overall complications (OR: 0.68; 95%CI: 0.41, 1.15; p =0.16) were not significantly different between two approaches. Laparoscopic ureterolithotomy reduced visual analogue scale (VAS) pain scores (MD: -2.53; 95%CI: -3.47, -2.03; p <0.00001), hospital stays (MD: -2.40 days; 95%CI: -3.42 to -1.38 days; p =0.03), and recovery time (MD: -9.67 days; 95%CI: -10.81 to -8.53 days; p <0.00001). In conclusion, open proximal ureterolithotomy had less time, but laparoscopic surgery reduced postoperative pain, hospital stay, and recovery time. Both methods had comparable intraoperative bleeding and complications., Competing Interests: No conflict of interest was declared by the authors., (© 2024 by the authors.)

A 15-year-old, 113 kg intact male Sumatran tiger ( Panthera tigris sumatrae) was evaluated for weight loss, polydipsia, and intermittent hematuria. The tiger was immobilized for diagnostic testing including blood work, urinalysis, and abdominal ultrasound. Laboratory testing demonstrated macro- and microhematuria, azotemia, and an increased urine protein:creatinine ratio. Abdominal ultrasound revealed bilateral ureterolithiasis as well as hydronephrosis and ureteral dilation. Ultrasonography performed 5 months later revealed worsening of the right-sided hydronephrosis and hydroureter and a decrease in the severity of dilation on the left side presumably from passage of the left-sided ureteral calculi. Nephroureteral decompression via the placement of a stent was elected. A pigtail ureteral catheter (8.2 French diameter) was placed in the right ureter via an antegrade percutaneous approach utilizing ultrasound and fluoroscopic-guidance. Following stent placement, macrohematuria resolved although microhematuria was noted in opportunistic urine samples. Five months after stent placement, the azotemia had mildly progressed, the urine protein:creatinine ratio was improved, the right hydronephrosis and hydroureter had completely resolved, and the ureteral stent remained in the appropriate position. The tiger had clinically improved with a substantial increase in appetite, weight, and activity level. Ureteral stenting allowed for nephroureteral decompression in the captive large felid of this report, and no complications were encountered. Ureteral stenting provided a minimally invasive method of managing ureteral obstruction in this patient and could be considered in future cases due to the clinical improvement and low morbidity. Zoo Biol. 34:193-197, 2015. © 2015 Wiley Periodicals Inc. [ABSTRACT FROM AUTHOR]

Background: Uroliths in ureters are seldom seen in cats and, according to our knowledge, there are no reports of ureterolithiasis in this specie in our country. The radiography and ultrasound should be used in combination to improve the sensitivity to 90% in detecting ureteral calculi in cats. The aim of this study is to report a case of ureterolithiasis in a cat, emphasizing the importance of appropriate use of diagnostic imaging to identify the cause of nephropathy, enabling the return of the renal function. Case: A 7-year-old female cat, was referred to the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul with history of weight loss for two months and previous diagnosis of chronic kidney insufficiency. In blood work, it was found total calcium and creatinine increase. At x-ray evaluation, it was found two radiopaques structures on the right kidney, consistent with uroliths and the presence of a small radiopaque structure in the region of the left ureter. Ultrasound exam indicated two hyperechoic structures in the right renal pelvis, forming acoustic shadowing suggestive of lithiasis. The left kidney showed partial loss of renal parenchyma by distention of the pelvis for anechogenic homogeneous content compatible with hydronephrosis. It was also observed dilated left ureter in its proximal third. After three days, the animal was subjected to ureterotomy. After midline incision of the ventral abdomen, the location of ureteral calculi was identified by inspection and palpation of the ureter. The ureter was carefully lifted into paralumbar space. Subsequently, the region where the calculi was located was gently dissected of periureteral fat and oppened through a small longitudinal incision on the calculi. This was removed using a fine forceps. Subsequently, the calculi was submitted for analyze at Minnesota Urolith Center, University of Minnesota, USA, confirming its constitution of 100% calcium oxalate. Five days after surgery, the patient had normal levels of creatinine. Eighteen days after surgery the patient did another abdominal ultrasound and there was no dilatation of the left renal pelvis and proximal ureter. Discussion: Hypercalcemia is a risk factor for formation of calcium oxalate uroliths. Therefore, their presence should be investigated in azotemic and/ or hypercalcemic animals, as shown in this study. Due to the radiopacity of calcium oxalate uroliths, they usually are seen on abdominal radiography. However, due to the reduced size of the ureter and the overlapping of adjacent structures, sometimes the ureterolithis are not visualized on radiographs, resulting in low sensitivity. In contrast, ultrasound was found to have a very high sensitivity in detecting ureteral obstruction, due to the early onset of hydronephrosis and renal pelvic dilatation in most animals. Thus, due to the complementarity of the two techniques mentioned above, the x-ray and abdominal ultrasound should be used in combination so there is 90% of sensitivity in the diagnosis of ureteral lithiasis in cats. Although chronic kidney disease is a common condition in cats, there are several other causes of azotemia. Many of these are reversible and the full return of renal function depends on many occasions on the fast and correct diagnosis of the cause that leads to impairment of the kidneys. Thus, the complementarity between the imaging methods should be employed in order to identify the cause of nephropathy. [ABSTRACT FROM AUTHOR]

Ureteral obstructions in dogs and cats have been recognized as a common cause of acute uremia. The diagnosis and management of this disorder is challenging, often necessitating special diagnostic and treatment modalities as well as special surgical skills. Recently, with the development of interventional radiology in veterinary medicine, minimal invasive treatment options emerged for dogs and cats with ureteral obstruction. This review provides medical and surgical guidelines for the diagnosis and management of dogs and cats with ureteral obstruction, and introduces new therapeutic options such as interventional radiology and endoscopy. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To review the clinical features of stone disease in dogs and cats for a non-veterinary audience. Methods: Relevant peer-reviewed scientific reports were reviewed. Results: Lower urinary tract stones are more common in dogs and cats than they are in humans. In addition to struvite stones, calcium oxalate, urate and cystine stones are all commonly found in the bladder and the urethra. The genetic basis for stone disease in some breeds of dog has been elucidated. The small size of cats creates technical challenges when managing ureterolithiasis. Conclusions: Naturally occurring stone disease in companion animals is a valuable area for further study. The structure of the canine genome might facilitate the identification of novel disease loci in breeds of dog predisposed to stone formation. [Copyright &y& Elsevier]

Treated 50 cases of renal colic with electroacupuncture and compared the results with those in two control groups. Total effective rate in the treatment group, control group I and control group II was 98.0%, 90.0% and 92.0% respectively. [ABSTRACT FROM AUTHOR]