Implante de sistema de derivação urinária subcutâneo (bypass) em felino com ureterolitíase – relato de caso

Abstract

Over the years, feline medicine has been growing and becoming increasingly important for maintaining the quality of life and well-being of the species. Among the diseases that affect felines, urolithiasis represents great importance, given the high rates of animals affected by the disease. Ureterolithiasis in cats refers to the presence of stones in the ureters. These stones can cause partial or complete obstruction of urinary flow, resulting in clinical signs, the main ones being dysuria, blood in urine, anorexy, emesis and abdominal pain. These clinical signs may vary according to the location and size of the stones, as well as the severity of the obstruction. The diagnosis is usually made on the basis of a complete anamnesis, urinalysis, imaging tests such as ultrasound and radiography, and laboratory tests. Treatment of ureterolithiasis can vary depending on the size and location of the stones, as well as the general condition of the patient. In cases of complete obstruction, immediate intervention may be necessary to prevent kidney damage and restore urinary flow. Currently, clinical/conservative treatment is available, which aims at dissolving the stone, increasing urine output, analgesia of the patient, anti-inflammatory drugs and reestablishment of hydration. However, it is known that most of the stones present in the ureter in felines are composed of calcium oxalate, whose composition is not amenable to drug dissolution. Therefore, surgical treatment is opted for in feline ureterolithiasis. The implantation of a urinary shunt system is a technique for correction in situations of ureteral obstruction, being more used in cats. The present report was proposed with the objective of presenting the surgical intervention of a clinical case of a feline patient affected with unilateral ureterolithiasis, with the presence of hydronephrosis and involvement of the contralateral kidney, being opted by the responsible team the application of the technique of implantation of the subcutaneous urinary shunt system. The objective was to describe the surgical technique necessary for proper implantation of the system, in order to ensure an efficient route of return of urinary flow.