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Sunday, January 9, 2011

In Print - Stephen Mehler, DVM, DACVS

J Am Vet Med Assoc. 2009 Jan 15;234(2):236-9.

Use of a balloon-expandable metallic stent to relieve malignant urethral obstruction in a cat.

Newman RG, Mehler SJ, Kitchell BE, Beal MW.

Abstract

CASE DESCRIPTION: A 19-year-old neutered male domestic shorthair cat was evaluated because of signs of urinary tract obstruction.

CLINICAL FINDINGS: Physical examination findings were consistent with urethral obstruction, and a mass could be palpated in the region of the bladder neck. Abdominal ultrasonography and thoracic radiography revealed a mass in the trigone of the urinary bladder and a solitary mass in the left caudal lung lobe. Cytologic examination of the urine sediment, samples obtained by means of traumatic urethral catheterization, and fine-needle aspirates of the bladder mass did not result in a diagnosis.

TREATMENT AND OUTCOME: A balloon-expandable metallic stent was placed in the proximal portion of the urethra to relieve the malignant obstruction. After stent placement, the cat had signs of urinary incontinence and detrusor atony, both of which resolved with medical treatment. The cat was euthanized 1 month after stent placement because of progressive azotemia. Histologic examination of necropsy samples revealed grade III urothelial carcinoma and papillary pulmonary adenocarcinoma.

CLINICAL RELEVANCE: Findings suggested that stent placement may be a viable palliative treatment in cats with malignant urinary obstruction.

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