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Use of subcutaneous ureteral bypass systems as a bridge to definitive ureteral repair in a cat with bilateral ureteral ligation secondary to complicated ovariohysterectomy
  1. Andrew James Carey Beer,
  2. Vicky J Lipscomb,
  3. Lynda Rutherford and
  4. Karla Chui Luan Lee
  1. Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
  1. Correspondence to Dr Karla Chui Luan Lee; klee{at}


A kitten presented with acute kidney injury, bilateral hydronephrosis and proximal hydroureter, three days following bilateral ureteral ligation, during a complicated ovariohysterectomy procedure. Clinical signs were anorexia, lethargy, weakness, hypothermia, nausea, pain and anuria, associated with marked azotaemia, hyperkalaemia and metabolic acidosis. Insufficient response to medical management alone led to emergency surgical placement of bilateral subcutaneous ureteral bypass (SUB) systems, resulting in dramatic improvement in azotaemia and acidosis and resolution of hyperkalaemia. Elective bilateral neoureterocystostomy was performed the next day. The cat was clinically well for three months until the left SUB cystostomy catheter migrated out of the bladder resulting in uroabdomen. At this time, fluoroscopy demonstrated normal ureteral function bilaterally, so both SUBs were removed. Following recovery from surgery the cat has remained clinically normal. This report highlights the possibility of temporary SUB placement as a bridge to definitive ureteral repair in cases of accidental ureteral ligation.

  • acute kidney injury
  • ureteral ligation
  • ureteral injury
  • subcutaneous ureteral bypass
  • neoureterocystostomy
  • emergency medicine
  • ovariohysterectomy
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  • Contributors VJL, LR: primary case management, manuscript review. AJCB: manuscript preparation and review. KCLL: primary case management, manuscript preparation and review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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