Subcutaneous ureteral bypass explantation in 21 cats (2015-2023): outcomes and owner perceptions.

SUB explantation is a viable option for managing device-related complications, with acceptable outcomes and high owner satisfaction.

This retrospective case series evaluated outcomes and owner perceptions following subcutaneous ureteral bypass (SUB) explantation in 21 cats (31 SUBs) over an 8-year period (2015–2023). Explantation was performed at a median of 1.8 years post-placement, most commonly due to positive urine culture (PUC; 15/21 cats), SUB obstruction (8/21), sterile cystitis (4/21), and suspected SUB failure (2/21). The majority of ureters (26/31) demonstrated documented patency at explantation. Surgical approaches included complete implant removal in 17 cats, unilateral explantation with ipsilateral ureteronephrectomy in 2 cats, and unilateral explantation in 2 cats with bilateral SUBs. Median follow-up post-explantation was 596 days. Ureteral re-obstruction occurred in 4 cats, with 2 of these deaths being renal-related. Among cats explanted for PUC, 9/15 achieved a negative postoperative urine culture, though 3/15 retained clinical signs associated with infection. Owner satisfaction was high, with 8 of 9 survey respondents indicating they would pursue explantation again under similar circumstances. Mortality data showed 7 cats died at a median of 614 days post-explantation, with 11 lost to follow-up and 3 remaining alive at time of reporting. The study supports SUB explantation as a viable and generally effective management strategy for cats experiencing device-related complications, though clinicians should counsel owners regarding risks of persistent infection and ureteral re-obstruction.

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