Background: Ureteroliths are a major source of morbidity and mortality in cats. In human trials, burst wave lithotripsy (BWL) is safe and efficacious for extracorporeal treatment of ureteroliths. Hypothesis/
Objectives: The objective of this study was to obtain pilot data on the safety and efficacy of BWL for treatment of obstructive ureteroliths in cats.Animals:Three cats with obstructing ureteroliths.
Methods: Phase 1 clinical trial. BWL was performed under general anesthesia using ultrasound guidance. Adverse events were recorded and characterized by severity and relationship to BWL. Technical success was defined as resolution of obstruction, urolith passage, or apparent fragmentation.
Results: One cat had bilateral obstructions, and two had unilateral obstructions. In total, four ureters and seven ureteroliths were treated with BWL. Two cats required a second treatment due to persistent (1) or worsening (1) obstruction; the worsening of obstruction was classified as a major adverse event possibly related to BWL. Following BWL, fragmentation was apparent in six of seven ureteroliths, of which three passed into the bladder prior to discharge. All cats had a reduction in serum creatinine (pre-treatment concentrations of 1.6, 2.0, and 2.4 mg/dL and post-treatment concentrations of 1.5, 1.7, and 1.3 mg/dL, respectively). All cats survived to discharge. Conclusions and clinical importance:Based on preliminary data, BWL shows promise as a minimally invasive therapy for obstructing ureteroliths in cats. In cats with multiple ureteroliths, more than one treatment might be necessary. Additional cases and follow up are warranted to determine how BWL outcomes compare to current treatment modalities.
