x-ray of feline midsection

Tiger Lily’s owners describe her as the sweetest cat they have ever known; and they have had dozens of cats over the years. “If you are sick, she will stay with you, and try to nurse you, and make you feel better,” says her mom. “So when she got sick, I told her, ‘I am going to take care of you now’.”

Kidney disease is very common in older domestic cats. It can cause high blood pressure, heart problems, and many other health issues, including ureter and kidney stones. When Tiger Lily developed kidney disease several years ago, her veterinarian put her on a special diet and advised unlimited access to plenty of fresh water. However, Tiger Lily still had to be hospitalized several times for IV fluid therapy. Each time, that did the trick and her appetite and energy level improved.

As the disease progressed, IV fluids were not enough and her veterinarian referred her to the OSU Veterinary Teaching Hospital (VTH), where a CT scan revealed multiple stones in her ureter and kidneys. Also visible in the scan was swelling of her right kidney, which suggested her right ureter, the tiny tube that takes urine from the kidney to the bladder, was blocked. The solution was surgery.

In the past, Tiger Lily would have had two options:  Insertion of a tube, called a stent, placed inside the length of the ureter, or surgical removal of the stones. The first option was not a good choice for Tiger Lily because she is prone to stones and infections, and the second option can create scarring which leads to further obstruction of the ureter.

Fortunately, Dr. Katy Townsend, a soft tissue surgeon at the VTH, is skilled in a relatively new procedure called a Subcutaneous Ureteral  Bypass system. For this surgery, Dr. Townsend essentially created a new ‘ureter’ for Tiger Lily using a specialized synthetic tubing to connect the kidney to the bladder and bypass the obstructed ureter. The system is connected to a tiny port which allows it to be periodically flushed (see illustrations) which helps avoid infection and the formation of stones.

The surgery was a success and Tiger Lily is back to her old self. Although kidney disease is irreversible, with proper diet, regular veterinary check-ups, and treatment of related issues like hypertension and urninary tract infections, she can live many more happy years.

Soft-tissue Surgeon, Dr. Katy Townsend, used a Subcutaneous Ureteral Bypass to save Tiger Lily.