Subcutaneous Ureteral Bypass Catheter

Understanding ureteral obstructions in cats

In healthy cats, urine is produced in the kidneys, passes through the renal pelvis and flows down the ureter to the bladder. Ureteral obstructions occur when a blockage in the ureter prevents this flow, which can severely damage the kidneys.

The most common cause is kidney stones, accounting for 80% of obstructions, while other causes include blood clots, infections, scarring (ureteral strictures), and rarely, ureteral cancer. Ureteral obstructions can be partial or complete and may affect one or both kidneys, with complete obstructions leading to fatal kidney failure within 48-72 hours if left untreated.

Symptoms & diagnosis

Symptoms vary depending on the severity of the obstruction. Cats with partial obstructions or normal function in the other kidney may show few signs, while more severe cases can cause vomiting, lethargy, weight loss and difficulty urinating.

Stones can also increase the risk of chronic urinary tract infections. Diagnosing ureteral obstructions typically involves an ultrasound to identify changes like enlarged kidneys, dilated ureters and visible stones. X-rays or CT scans may also be used to confirm the diagnosis.

Treatment

Many ureteral obstructions ultimately require surgery. While medical management using intravenous fluids, muscle relaxants and anti-inflammatories can be attempted, it’s only effective in 7.7-15% of cases. If untreated, kidney function continues to deteriorate, leading to permanent damage. Many cats either aren’t candidates or don’t respond to medical treatment, making surgery necessary.

Surgical stone removal is challenging due to the small feline ureter size. Scar tissue commonly forms within the ureter that causes another obstruction after surgery is completed. The preferred treatment is Subcutaneous Ureteral Bypass (SUB), which bypasses the obstruction by directing urine from the kidney to the bladder via a catheter.

This advanced procedure is typically not available at regular veterinary clinics, so your cat will need to come to our specialised facility for the surgery and ongoing care.

SUBs are permanent prosthetic ureters placed into the kidney using fluoroscopy. We have used these devices to save the lives of many cats since they have become available.

The catheter is inserted into the renal pelvis, which is enlarged due to the obstruction, and connected to a metal port under the skin. A second catheter connects the port to the bladder, allowing urine to bypass the obstructed ureter and flow normally from the kidney to the bladder.

One study of 134 cats showed a 94% survival rate to discharge, though complications like catheter blockage, leakage, or kinking occurred in some cases. Long-term outcomes depend on kidney function three months post-surgery.

Regular veterinary care is essential for cats with SUBs to prevent blockages or infections, requiring routine flushing every few months. This life-saving procedure has proven highly successful, and our team has had positive experiences using it.

Patient Stories

Our commitment to feline health is best seen in the stories of the cats we’ve had the privilege of treating. These journeys highlight the dedication, expertise and compassion that drive us.

Each patient faced unique challenges, and it was our honour to offer high-quality care and help them regain strength and happiness. We value the deep bonds with cats and their owners, knowing the difference we make in their lives.

See All Stories

The road to recovery for Kuro

Kuro is a calm and dignified older cat who faced a challenging case of hyperthyroidism and early kidney changes.

Kikki’s transformation after I-131

Kikki is a gentle and resilient cat who came to CSS with a long-standing case of hyperthyroidism and significant heart changes.

Bubba beats hyperthyroidism

Bubba is a charming ginger and white cat who came to us after his owner noticed he was hunting more, eating voraciously and losing weight, all subtle signs of hyperthyroidism.

Expert care and a tailored plan saved Ed from pancreatitis

Pancreatitis is an inflammatory condition that disrupts digestion and often goes unnoticed until a cat becomes seriously ill. That was the case for Ed, whose vague symptoms progressed into a life-threatening emergency. Thankfully, with expert care from Cat Specialist Services, she made a full recovery.

Tango Triumphs Over FIP

At 5 months old, Tango was diagnosed with Feline Infectious Peritonitis (FIP). Once considered a fatal disease, the introduction of new treatments has significantly boosted the survival rate.

Contacting Us

Pet Owners
If you would like to talk about treatment for your cat, call us on 1300 228 377 or fill in the form.
In an emergency, please contact your local vet.

Vets and Nurses
To refer a patient or book a telehealth consultation please call us on 1300 228 377, book through the portal or fill in the form. For advice calls, please see the guidelines here.

1300 228 377

1-15 Lexington Rd,
Underwood, QLD, AU, 4119

Monday-Friday: 8 am-6 pm
Saturday/Sunday - Closed