OBJECTIVE: To determine the outcome of minimally invasive ureteral stent placement for dogs with malignant ureteral obstructions. DESIGN-Retrospective case series. ANIMALS: 12 dogs (15 ureters) with ureteral obstruction secondary to a trigonal urothelial carcinoma. PROCEDURES: In all patients, indwelling, double-pigtail ureteral stents were placed by means of percutaneous antegrade needle and guide wire access under ultrasound and fluoroscopic guidance. RESULTS: Stents were successfully placed in all patients. In 11 of 12 patients, percutaneous antegrade access was accomplished. One patient required access via laparotomy because percutaneous access could not be achieved. The median survival time from the date of diagnosis was 285 days (range, 10 to 1,571 days), with a median survival time of 57 days (range, 7 to 337 days) from the date of stent placement. Three complications occurred in 1 patient. Seven patients required concurrent urethral stent placement for relief of urethral obstruction. All animals were discharged from the hospital (median hospitalization time after stent placement, 18 hours [range, 4 hours to 7 days]) with an indwelling, double-pigtail ureteral stent (3 bilateral and 9 unilateral) in place. All stents evaluated 0.25 to 11 months after placement were considered patent. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that ureteral stent placement was safe, effective, and well tolerated in patients with malignant ureteral obstructions. Stents could be reliably placed in a minimally invasive manner and remain patent long-term. Ureteral stent placement should be considered as early as possible in patients with neoplasia, prior to the development of permanent renal damage.
OBJECTIVE: To determine the outcome of minimally invasive ureteral stent placement for dogs with malignant ureteral obstructions. DESIGN-Retrospective case series. ANIMALS: 12 dogs (15 ureters) with ureteral obstruction secondary to a trigonal urothelial carcinoma. PROCEDURES: In all patients, indwelling, double-pigtail ureteral stents were placed by means of percutaneous antegrade needle and guide wire access under ultrasound and fluoroscopic guidance. RESULTS: Stents were successfully placed in all patients. In 11 of 12 patients, percutaneous antegrade access was accomplished. One patient required access via laparotomy because percutaneous access could not be achieved. The median survival time from the date of diagnosis was 285 days (range, 10 to 1,571 days), with a median survival time of 57 days (range, 7 to 337 days) from the date of stent placement. Three complications occurred in 1 patient. Seven patients required concurrent urethral stent placement for relief of urethral obstruction. All animals were discharged from the hospital (median hospitalization time after stent placement, 18 hours [range, 4 hours to 7 days]) with an indwelling, double-pigtail ureteral stent (3 bilateral and 9 unilateral) in place. All stents evaluated 0.25 to 11 months after placement were considered patent. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that ureteral stent placement was safe, effective, and well tolerated in patients with malignant ureteral obstructions. Stents could be reliably placed in a minimally invasive manner and remain patent long-term. Ureteral stent placement should be considered as early as possible in patients with neoplasia, prior to the development of permanent renal damage.
Authors: Maureen A Griffin; William T N Culp; Michelle A Giuffrida; Peter Ellis; Joanne Tuohy; James A Perry; Allison Gedney; Cassie N Lux; Milan Milovancev; Mandy L Wallace; Jonathan Hash; Kyle Mathews; Julius M Liptak; Laura E Selmic; Ameet Singh; Carrie A Palm; Ingrid M Balsa; Philipp D Mayhew; Michele A Steffey; Robert B Rebhun; Jenna H Burton; Michael S Kent Journal: J Vet Intern Med Date: 2019-11-13 Impact factor: 3.333