Burst wave lithotripsy for the treatment of obstructive ureteroliths in cats.

Burst wave lithotripsy shows promise as a minimally invasive treatment for feline ureteral obstruction, though multiple sessions are often needed.

Ureteral obstruction is a significant cause of morbidity and mortality in cats, with current non-surgical interventions being limited. This single-arm clinical trial evaluated the safety and efficacy of a veterinary burst wave lithotripsy (BWL) device for treating obstructive ureteroliths in 11 client-owned cats (10 unilateral, 1 bilateral), totaling 12 treated ureters containing 17 ureteroliths. BWL was performed under general anesthesia in sessions not exceeding 90 minutes, utilizing ultrasound guidance. A total of 20 treatments were administered across the 12 ureters, with 5 ureters receiving one treatment, 6 receiving two, and 1 receiving three. Apparent fragmentation was achieved in 11 of 12 treated ureters. Among the 10 ureters with follow-up imaging available, 8 demonstrated ureterolith passage with concurrent reduction in ureteral dilatation. Cats achieving ureterolith passage showed a median serum creatinine reduction of 29% at 1–3 weeks post-treatment. One serious adverse event occurred—worsening obstruction due to residual fragments—which was successfully resolved with retreatment. No other serious adverse events were reported. The authors conclude that BWL is a promising minimally invasive alternative for managing feline obstructive ureterolithiasis, though multiple treatment sessions are frequently required. Larger controlled studies are needed to further define optimal treatment protocols, patient selection criteria, and long-term outcomes.

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