Multicenter retrospective evaluation of transmural migration of subcutaneous ureteral bypass devices within the digestive tract in cats

Abstract Background Placement of a subcutaneous ureteral bypass (SUB) device is an effective method to relieve all causes of ureteral obstruction in cats. Complications involving migration within the gastrointestinal tract have been seldomly described. Objectives To characterize transmural migration of SUB devices within the digestive tract in cats. Animals Eleven migrated SUB catheters identified in 8 cats between 2017 and 2021. Methods Retrospective review of medical records of cats with a SUB device in which migration into the gastrointestinal tract was identified. Results The median time from SUB device placement to implant migration was 928 days (201‐2298 days). Seven cats had obstruction of the SUB device and a positive urine culture at diagnosis. The migration was identified by ultrasound in 6/11, pre‐operative contrast radiography in 2/2, and only at time of surgery in 3 SUB devices. All cats underwent surgical correction. Four nephrostomy and 7 cystotomy catheters migrated. Migration occurred into the duodenum (3/11), jejunum (7/11), and colon (1/11). SUB devices were removed in 7 cats and replaced in 2 cats, with 1 cat diagnosed with 2 migration events. Gastrointestinal resection and anastomosis were performed in 7/8 cats and an enterotomy in 2 cats. Six cats survived to discharge. The median follow‐up time after migration diagnosis was 365 days (range, 0‐1114 days) and 2 cats are still alive. Conclusions and Clinical Importance Although a rare complication, migration of SUB device should be considered in cats with SUB device obstruction and a positive urine culture.