Background: Placement of a subcutaneous ureteral bypass (SUB) device is an effective method to relieve all causes of ureteral obstruction in cats. Complications involving migration within the gastrointestinal tract have been seldomly described.
Objectives: To characterize transmural migration of SUB devices within the digestive tract in cats.
Animals: Eleven migrated SUB catheters identified in 8 cats between 2017 and 2021.
Methods: Retrospective review of medical records of cats with a SUB device in which migration into the gastrointestinal tract was identified.
Results: The median time from SUB device placement to implant migration was 928 days (201-2298 days). Seven cats had obstruction of the SUB device and a positive urine culture at diagnosis. The migration was identified by ultrasound in 6/11, pre-operative contrast radiography in 2/2, and only at time of surgery in 3 SUB devices. All cats underwent surgical correction. Four nephrostomy and 7 cystotomy catheters migrated. Migration occurred into the duodenum (3/11), jejunum (7/11), and colon (1/11). SUB devices were removed in 7 cats and replaced in 2 cats, with 1 cat diagnosed with 2 migration events. Gastrointestinal resection and anastomosis were performed in 7/8 cats and an enterotomy in 2 cats. Six cats survived to discharge. The median follow-up time after migration diagnosis was 365 days (range, 0-1114 days) and 2 cats are still alive.
Conclusions and clinical importance: Although a rare complication, migration of SUB device should be considered in cats with SUB device obstruction and a positive urine culture.
Keywords: cats; digestive migration; subcutaneous ureteral bypass; ureteral obstruction.
© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.