🔍 What Is Ureterolithiasis?

Ureterolithiasis occurs when stones (uroliths) form in a cat’s ureter—the narrow tube connecting the kidney to the bladder—leading to obstruction of urine flow. These stones often originate in the kidney and migrate down the urinary tract :contentReference[oaicite:3]{index=3}.

1. Causes & Stone Composition

• Most feline ureteroliths are **calcium oxalate** (~98%)—they cannot be dissolved medically :contentReference[oaicite:4]{index=4}.
• Less common stones include struvite and cystine :contentReference[oaicite:5]{index=5}.
• Predisposing factors: breed, diet, urinary pH, UTIs, genetics :contentReference[oaicite:6]{index=6}.

2. Who Is Affected?

• Adult to senior cats are most commonly affected.
• No clear breed or sex bias—any cat with predisposition may be affected.
• Concurrent kidney disease or anatomical narrowing increases risk.

3. Clinical Signs

• Often unnoticeable early on.
• Signs of ureteral blockage: pain, vomiting, anorexia, lethargy, dehydration :contentReference[oaicite:7]{index=7}.
• Kidney damage, hydronephrosis, azotemia may develop :contentReference[oaicite:8]{index=8}.
• Frequent urination or straining may occur with lower tract disease :contentReference[oaicite:9]{index=9}.

4. Diagnosis & Staging

1. Physical exam & labs: CBC/chem/UA show kidney stress, azotemia, hematuria.
2. Abdominal ultrasound: detects hydronephrosis, dilated ureter, and stones :contentReference[oaicite:10]{index=10}.
3. Radiographs: may detect radiopaque stones, though poor sensitivity :contentReference[oaicite:11]{index=11}.
4. CT (non‑contrast +/- contrast): gold‑standard imaging for precise stone location and preoperative planning :contentReference[oaicite:12]{index=12}.

5. Treatment Options

a. Ureteral Stenting

• Endoscopic placement of a **double pigtail stent** through the ureter to bypass the stone :contentReference[oaicite:13]{index=13}.
• Allows urine flow while preserving kidney function. Requires anesthesia and monitoring.

b. SUB (Subcutaneous Ureteral Bypass)

• Permanent bypass device: catheter connects renal pelvis to bladder via subcutaneous port :contentReference[oaicite:14]{index=14}.

c. Surgical Ureterotomy or Nephrectomy

• Surgical removal of stones when stenting/SUB not feasible.
• Nephrectomy considered if kidney irreversibly damaged.

d. Medical Management

• Only for very small stones that can pass spontaneously.
• Includes fluids, pain meds, diuretics, and monitoring :contentReference[oaicite:15]{index=15}.

6. Prognosis & Outcomes

• Without treatment, obstruction → permanent renal damage or hydronephrosis :contentReference[oaicite:16]{index=16}.
• Stenting/SUB reduces azotemia and preserves kidney function; periodic flushing may be required.
• Surgical removal has variable outcomes; nephrectomy carries good prognosis in unilateral disease.
• Long‑term care may include managing CKD and preventing infection.

7. Prevention & Long‑Term Monitoring

• Encourage hydration: wet food, water fountains.
• Use prescription diets when indicated based on stone type.
• Monitor urine pH and mineral excretion.
• Every 3–6 months: bloodwork, urinalysis, and ultrasound imaging to track kidney and device status.

8. Ask A Vet Remote Monitoring 🐾📲

• 📸 Upload ultrasound images or vet reports for specialist review.
• 🔔 Medication reminders: analgesics, antibiotics, flushing protocols.
• 🧭 Track appetite, urination frequency, vomiting, activity.
• 📊 Alerts if signs worsen: anuria, pain, increased azotemia.
• 👥 Virtual consults help coordinate imaging, device maintenance, and planning further interventions.

9. FAQs

Can ureter stones be dissolved?

No—calcium oxalate stones do not dissolve medically and require mechanical relief :contentReference[oaicite:17]{index=17}.

Will my cat need surgeries over time?

SUB or stent may need periodic maintenance or replacement—especially SUB port flushing.

What if my cat has CKD too?

Ureteral relief can stabilize kidney values; long‑term CKD care remains essential.

Is CT really necessary?

CT provides precise mapping for device placement—especially useful if ultrasound is inconclusive :contentReference[oaicite:18]{index=18}.

10. Take‑Home Tips ✅

• Detect early: ultrasound or bloodwork when kidney values rise or cats show pain/vomiting.
• Act quickly: obstruction requires timely stenting, SUB, or surgery.
• Support function: hydration, CKD management, infection prevention.
• Monitor regularly: via imaging and labs, with Ask A Vet supervising remotely.

Conclusion

Ureterolithiasis in cats is serious but treatable. With advanced options like ureteral stents or SUB devices, many cats maintain kidney function and quality of life. Recovery includes ongoing monitoring, imaging, and preventive strategies. Ask A Vet enhances care with remote medication management, symptom tracking, and expert follow‑ups in 2025 and beyond 🐾📲.

If your cat shows signs like vomiting, pain, decreased appetite, or rising kidney values—seek veterinary evaluation promptly and initiate Ask A Vet monitoring for optimized care and reassurance.