Ureteral Obstruction

Allison Zwingenberger

University of California, Davis

Publication Date: 2012-01-04

History

6 year old male neutered domestic short hair cat who began growling, becoming restless, and not acting himself. He had vomited several times.

Question

1. What is the special study that has been performed?

   a	Double contrast cystogram The air near the bladder is actually in the colon.
   b	Positive contrast cystogram Although there is a urinary catheter in place, contrast has been administered by another route.
   c	Excretory urogram Correct. Contrast was injected intravenously, and due to reduced renal function and ureteral distension, appears dilute.

Findings

Initial projections reveal a intravenous catheter within the right medial saphenous vein terminating within the caudal vena cava. Bilaterally the kidneys are mildly enlarged. Contrast material was administered intravenously. The renal pelves are mildly distended. The proximal ureters are mildly distended but taper. No obstructive process is identified.

DDX

Bilateral proximal ureteral dilation. Differentials include pyelonephritis or a previous obstructive process that has now passed.

Diagnosis

Although no definitive cause for the ureteral and/or urethral obstruction was identified, the enlarged renal pelves and ureters as well as the enlarged urinary bladder were suggestive. Renal values improved over the next several days, and the cat was able to urinate once the urinary catheter was removed. Final diagnosis of feline idiopathic cystitis.