Background: Subcutaneous ureteral bypass (SUB) is the gold standard for feline ureteric obstruction management, but SUB explantation is little documented. Hypothesis/
Objectives: Describe reasons for SUB explantation, clinical outcomes and owner experiences. Animals: Twenty-one cats that underwent SUB explantation.
Methods: Retrospective case-series. Data from 21 cats that underwent SUB explantation between 10/15-08/23 analysed. Twenty owners contacted for follow-up.
Results: SUB placement was mostly associated with ureterolithiasis (16/21). Explantation was performed a median of 1.8y(range 0.2-4.1) later, most commonly for positive urine culture(15/21) followed by SUB obstruction(8/21), sterile cystitis(4/21), suspected SUB failure(2/21), and one transmural migration to the gastrointestinal tract (two further cats had transmural migration noted intra-operatively). Contrast studies documented that 26/31 ureters had regained patency. Seventeen cats had all implants removed (9 unilateral, 8 bilateral). Two underwent unilateral explantation and ureteronephrectomy. One underwent unilateral explantation despite bilateral SUBs and bilateral ureteral patency, and one underwent unilateral explantation and contralateral replacement. Median follow-up was 596 days(3–2310). Four cats had ureteral reobstruction (one had a partial obstruction at explantation). Ten cats did not reobstruct and the remainder were undetermined. Seven cats died, at a median time of 614 days(405 – 2200). Four deaths were related to renal disease (two reobstructions). Questionnaire response was 45%(9/20), and 8/9 owners would consider explantation if in the same position in future. Conclusions and Clinical Importance: For SUB cats with complications, explantation appears a viable option. Most ureters re-gained patency before explantation with reobstruction only documented in 4/21. Most responding owners were satisfied with the outcome.
