Therapeutic use of tetrasodium ethylenediaminetetraacetic acid solution for treatment of subcutaneous ureteral bypass device mineralization in cats.
kidney
renal calculi
renal/urinary tract
ureteral calculi
ureteral obstruction
ureteral surgery
ureters
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
01
02
2019
accepted:
15
07
2019
pubmed:
7
8
2019
medline:
6
2
2020
entrez:
7
8
2019
Statut:
ppublish
Résumé
Subcutaneous ureteral bypass (SUB) device placement is an increasingly popular treatment option for decompression of ureteral obstruction in cats. Mineralization occlusion of the device occurs in a minority of cases but is the most common complication. To evaluate a 2% tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of mineralization occlusion in cats with SUBs. Six client-owned cats (8 obstructed devices). Case series. Each cat was found to have device occlusion based on a combination of ultrasound examination, SUB irrigation, and failure to identify another cause of device obstruction. Each SUB was drained, irrigated using sterile saline, and infused with 1-2 mL of 2% tEDTA solution. Success was defined as normalization of flow during subsequent ultrasound visualization while irrigating. The volume and frequency of tEDTA instillations, time to achieve device patency, follow-up biochemical and ultrasound findings, and future reobstruction events were recorded. Resolution of mineralization was documented in all 8 SUBs. Reobstruction events occurred in 2 cats, all of which resolved after additional tEDTA infusions, but 1 cat ultimately required device exchange at 356 days from the first tEDTA infusion. In 1 cat, a single infusion was prematurely discontinued because of persistent pelvic dilatation after 1.25 mL of tEDTA had been instilled. No complications were observed. Tetrasodium EDTA infusions can be safely considered as a treatment option for mineralized SUB devices in cats. This solution was easily infused, well tolerated, and avoided the need for SUB device exchange in the majority of cats in which it was used.
Sections du résumé
BACKGROUND
BACKGROUND
Subcutaneous ureteral bypass (SUB) device placement is an increasingly popular treatment option for decompression of ureteral obstruction in cats. Mineralization occlusion of the device occurs in a minority of cases but is the most common complication.
OBJECTIVE
OBJECTIVE
To evaluate a 2% tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of mineralization occlusion in cats with SUBs.
ANIMALS
METHODS
Six client-owned cats (8 obstructed devices).
METHODS
METHODS
Case series. Each cat was found to have device occlusion based on a combination of ultrasound examination, SUB irrigation, and failure to identify another cause of device obstruction. Each SUB was drained, irrigated using sterile saline, and infused with 1-2 mL of 2% tEDTA solution. Success was defined as normalization of flow during subsequent ultrasound visualization while irrigating. The volume and frequency of tEDTA instillations, time to achieve device patency, follow-up biochemical and ultrasound findings, and future reobstruction events were recorded.
RESULTS
RESULTS
Resolution of mineralization was documented in all 8 SUBs. Reobstruction events occurred in 2 cats, all of which resolved after additional tEDTA infusions, but 1 cat ultimately required device exchange at 356 days from the first tEDTA infusion. In 1 cat, a single infusion was prematurely discontinued because of persistent pelvic dilatation after 1.25 mL of tEDTA had been instilled. No complications were observed.
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Tetrasodium EDTA infusions can be safely considered as a treatment option for mineralized SUB devices in cats. This solution was easily infused, well tolerated, and avoided the need for SUB device exchange in the majority of cats in which it was used.
Identifiants
pubmed: 31386229
doi: 10.1111/jvim.15582
pmc: PMC6766516
doi:
Substances chimiques
Calcium Chelating Agents
0
Edetic Acid
9G34HU7RV0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2124-2132Informations de copyright
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Références
Sci Rep. 2017 May 11;7(1):1798
pubmed: 28496123
Antimicrob Agents Chemother. 2007 Jan;51(1):78-83
pubmed: 17074799
J Am Vet Med Assoc. 2005 Mar 15;226(6):937-44
pubmed: 15786997
Adv Wound Care (New Rochelle). 2015 Jul 1;4(7):415-421
pubmed: 26155384
Adv Exp Med Biol. 2018;1057:101-110
pubmed: 29280095
Int J Environ Res Public Health. 2010 Jul;7(7):2745-88
pubmed: 20717537
J Urol. 1989 Nov;142(5):1359-60
pubmed: 2509736
J Urol. 1986 Mar;135(3):608-11
pubmed: 3003404
Expert Rev Cardiovasc Ther. 2016 Aug;14(8):927-38
pubmed: 27149141
Am J Kidney Dis. 2015 Dec;66(6):1015-23
pubmed: 26141306
J Urol. 1966 Apr;95(4):469-75
pubmed: 4956497
J Vet Intern Med. 2016 Sep;30(5):1564-1574
pubmed: 27611724
J Vet Intern Med. 2015 Jan;29(1):63-70
pubmed: 25270055
J Vet Intern Med. 2019 Sep;33(5):2124-2132
pubmed: 31386229
J Am Vet Med Assoc. 2018 Nov 15;253(10):1309-1327
pubmed: 30398425
Urol Res. 1991;19(4):265-8
pubmed: 1926663
Emerg Infect Dis. 2002 Sep;8(9):881-90
pubmed: 12194761
Int J Toxicol. 2002;21 Suppl 2:95-142
pubmed: 12396676
J Feline Med Surg. 2013 Dec;15(12):1052-62
pubmed: 23723387
Urol Int. 2014;92(3):349-55
pubmed: 24246673
J Urol. 1987 Mar;137(3):530-3
pubmed: 3102759
J Am Vet Med Assoc. 2014 Mar 1;244(5):559-76
pubmed: 24548231