Non-surgical relief for urethral obstruction in dogs and cats
Like people, dogs and cats produce urine in their kidneys, store it in their bladder, and void it through their urethra. If passage of urine out the urethra is obstructed, a dog or cat could die within a day or two due to rising potassium levels that interfere with heart function. Obstruction can also result in very painful bladder distension or even bladder rupture. Bladder stones and other diseases may cause a temporary urethral obstruction that can often be successfully relieved via medical or surgical means. Tumors (arising primarily from the urethra or prostate), trauma and associated scar tissue, and other diseases can cause a permanent obstruction for which there was not any great solution…until now.
Patients with urethral obstruction are generally happy, healthy, and otherwise normal when the obstruction is relieved. Some patients can achieve temporary relief via a urinary catheter, but this is both a short term and a messy patch on a long-term issue. Radical surgical techniques have been developed to re-route the urinary tract, but not without significant changes to the pet and owners’ lives, with the potential for major complications. Now, however, we can place a stent to hold open the urethra and allow the pet to continue with a good or potentially even normal quality of life.
The length of the obstruction and the normal urethral diameter can be evaluated via contrast cystourethrogram (a “dye” study that clearly defines the urethra and bladder on x-rays) and/or cystourethroscopy (endoscopic camera evaluation of the bladder and urethral internal anatomy). An appropriately sized Vet Stent-UrethaTM (by Infiniti Medical), can be placed generally within 24-48 hours, ideally via fluoroscopic (like a video/moving x-ray) or digital x-ray guidance. Once the stent is placed, the patient is no longer obstructed and can usually go home within 24 hours. The stent is completely internal, so the pet cannot get to it, and the owners do not have to deal with external catheters, urine collection bags, etc. The stent is held in place by gentle radial tension, and is unlikely to dislodge, migrate, etc. The stent is non-reactive, permanent, and well-tolerated by the body’s tissues.
While one may expect that the length of the disease and the percentage of urethra stented would determine the pets’ level of continence, actually 90% of patients with a urethral stent are completely continent or mildly incontinent (leaking immediately before or after urination, but not in between) even with almost the entire urethra stented. Many owners are willing to tolerate mild incontinence if it occurs, as opposed to euthanizing a beloved pet that is otherwise normal aside from the obstruction. Neither the stent itself, nor its placement, is painful, and most owners report their pet to be pretty much normal.
For non-cancerous disease, a Vet Stent-Urethra can be a permanent solution to an otherwise life-ending problem. If the underlying disease process is cancer, this may eventually spread beyond the stent or to a distant site within 6-12 months depending on the extent of the disease. Patients with transitional cell carcinoma (the most common type of urethral tumor in dogs and cats) receiving a simple, non-steroid anti-inflammatory drug, Piroxicam, sometimes experience well beyond a year of good quality life as long as they do not become obstructed. A year may not seem like a long time, but it is a significant portion of the lifespan of a dog or cat. Additionally, this is quality life, without invasive or radical surgery. There is likely a higher risk of urinary tract infection with extensive stenting as the barrier to bacteria reaching the bladder is more open.
Please schedule an appointment with our board-certified surgeon, Dr. Jeff Christiansen at the clinic of your choice, to evaluate your pet and to discuss urethral stenting to improve your pet's or patient's length and quality of life.
If you have additional questions, please feel free to e-mail Dr. Christiansen directly.
For further information on urethral stents, please see the Vetstent urethra section of the Infiniti Medical website.