{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:45:26Z","timestamp":1783658726550,"version":"3.55.0"},"reference-count":15,"publisher":"American Veterinary Medical Association (AVMA)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"sc_a1\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The Subcutaneous Ureteral Bypass (SUB) 3.0 device was designed to treat ureteral obstructions to circumvent kinking found with prior versions where the nephrostomy and cystostomy catheters traversed the body wall. The authors hypothesized that new adaptations would reduce procedure times and kinking without negatively impacting other short-term complication rates.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The medical records of cats with SUBs for benign ureteral obstructions flushed routinely with tetrasodium EDTA were reviewed. Cats with a SUB 2.0 (group 1), SUB 3.0 (group 2), and unilateral SUB 2.0\/unilateral SUB 3.0 (group 3) were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a3\">\n<jats:title>Results<\/jats:title>\n<jats:p>80 cats (121 renal units [71 SUB 2.0, 50 SUB 3.0]) were included. Most ureteral obstructions were caused by ureterolithiasis \u00b1 stricture (89 of 121 [74%]), stricture alone (17 of 121 [14%]), or pyonephrosis (8 of 121 [7%]). Survival rates to 90 days were 75%, 85%, and 94% in groups 1, 2, and 3, respectively. Median procedure times for unilateral 2.0, bilateral 2.0, unilateral 3.0, bilateral 3.0, and bilateral 2.0\/3.0 were 75, 120, 55, 73.5, and 102.5 minutes, respectively. Kinks were reported in 11 of 71 SUB 2.0s (15.5%) and 0 of 50 SUB 3.0s (0%), blood clot occlusion was reported in 10 of 71 SUB 2.0s (14%) and 2 of 50 SUB 3.0s (4%), and obstruction from mineralization was documented in 1 SUB 3.0 (2%). One cat in group 1, and one in group 2 developed \u2265 1 infection during this follow-up period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a4\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The results support that the SUB 3.0 is associated with fewer short-term complications and shorter surgical times than the SUB 2.0 over a 90-day follow-up period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a5\">\n<jats:title>Clinical Relevance<\/jats:title>\n<jats:p>The SUB 3.0 requires shorter anesthetic times and results in less kinking than previous versions. Follow-up studies to assess long-term complications, like chronic infections or mineralization, are underway.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.24.09.0255","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T16:46:12Z","timestamp":1741365972000},"source":"Crossref","is-referenced-by-count":1,"title":["The Subcutaneous Ureteral Bypass 3.0 device shows improved short-term outcomes compared to the 2.0 device for treatment of benign ureteral obstructions in cats"],"prefix":"10.2460","volume":"86","author":[{"given":"Steven R.","family":"Magidenko","sequence":"first","affiliation":[{"name":"Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson C.","family":"Berent","sequence":"additional","affiliation":[{"name":"Department of Interventional Endoscopy\/Interventional Radiology, The Animal Medical Center, New York City, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chick","family":"Weisse","sequence":"additional","affiliation":[{"name":"Department of Interventional Endoscopy\/Interventional Radiology, The Animal Medical Center, New York City, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mejia","sequence":"additional","affiliation":[{"name":"Department of Interventional Endoscopy\/Interventional Radiology, The Animal Medical Center, New York City, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Lamb","sequence":"additional","affiliation":[{"name":"Lamb Statistical Consulting, West Saint Paul, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"10","key":"B1","series-title":"J Am Vet Med Assoc","first-page":"1309","article-title":"Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009\u20132015)","volume":"253","author":"Berent AC","year":"2018","unstructured":"Berent AC, Weisse CW, Bagley DH, Lamb K. Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009\u20132015). J Am Vet Med Assoc. 2018;253(10):1309\u20131327. doi:10.2460\/javma.253.10.1309"},{"issue":"1","key":"B2","series-title":"J Small Anim Pract","first-page":"4","article-title":"Survival and complications in cats treated with subcutaneous ureteral bypass","volume":"62","author":"Kulendra NJ","year":"2021","unstructured":"Kulendra NJ, Borgeat K, Syme H, Dirrig H, Halfacree Z. Survival and complications in cats treated with subcutaneous ureteral bypass. 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Subcutaneous ureteral bypass device placement in 81 cats with benign ureteral obstruction (2013\u20132018). J Vet Intern Med. 2021;35(6):2778\u20132786. doi:10.1111\/jvim.16280"},{"issue":"6","key":"B5","series-title":"J Am Vet Med Assoc","first-page":"744","article-title":"Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats","volume":"252","author":"Cray M","year":"2018","unstructured":"Cray M, Berent AC, Weisse CW, Bagley D. Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats. J Am Vet Med Assoc. 2018;252(6):744\u2013753. doi:10.2460\/javma.252.6.744"},{"issue":"5","key":"B6","series-title":"J Vet Intern Med","first-page":"2124","article-title":"Therapeutic use of tetrasodium ethylenediaminetetraacetic acid solution for treatment of subcutaneous ureteral bypass device mineralization in cats","volume":"33","author":"Chik C","year":"2019","unstructured":"Chik C, Berent AC, Weisse CW, Ryder M. Therapeutic use of tetrasodium ethylenediaminetetraacetic acid solution for treatment of subcutaneous ureteral bypass device mineralization in cats. J Vet Intern Med. 2019;33(5):2124\u20132132. doi:10.1111\/jvim.15582"},{"issue":"2","key":"B7","series-title":"J Vet Intern Med","first-page":"222","article-title":"Feline ureteral strictures: 10 cases (2007-2009)","volume":"25","author":"Zaid MS","year":"2011","unstructured":"Zaid MS, Berent AC, Weisse C, Caceres A. Feline ureteral strictures: 10 cases (2007-2009). J Vet Intern Med. 2011;25(2):222\u2013229. doi:10.1111\/j.1939-1676.2011.0679.x"},{"issue":"7","key":"B8","series-title":"J Small Anim Pract","first-page":"385","article-title":"Feline ureteral obstructions part 2: surgical management","volume":"59","author":"Clarke DL","year":"2018","unstructured":"Clarke DL. Feline ureteral obstructions part 2: surgical management. J Small Anim Pract. 2018;59(7):385\u2013397. doi:10.1111\/jsap.12861"},{"issue":"11","key":"B9","series-title":"J Am Vet Med Assoc","first-page":"1576","article-title":"Antegrade pyelography for suspected ureteral obstruction in cats: 11 cases (1995-2001)","volume":"222","author":"Adin CA","year":"2003","unstructured":"Adin CA, Herrgesell EJ, Nyland TG, et al. Antegrade pyelography for suspected ureteral obstruction in cats: 11 cases (1995-2001). J Am Vet Med Assoc. 2003;222(11):1576\u20131581. doi:10.2460\/javma.2003.222.1576"},{"issue":"6","key":"B10","series-title":"J Am Vet Med Assoc","first-page":"932","article-title":"Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984\u20132002)","volume":"226","author":"Kyles A","year":"2005","unstructured":"Kyles A, Hardie EM, Wooden BG, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984\u20132002). J Am Vet Med Assoc. 2005;226(6):932\u2013936. doi:10.2460\/javma.2005.226.932"},{"key":"B11","series-title":"Front Microbiol","first-page":"1187","article-title":"Comparison of the in vitro activity of five antimicrobial drugs against Staphylococcus pseudintermedius and Staphylococcus aureus biofilms","volume":"7","author":"Ferran AA","year":"2016","unstructured":"Ferran AA, JingJing L, Toutain PL, Bousquet-Melou A. Comparison of the in vitro activity of five antimicrobial drugs against Staphylococcus pseudintermedius and Staphylococcus aureus biofilms. 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Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices. J Feline Med Surg. 2022;24(10):e330\u2013e337. doi:10.1177\/1098612X221107795"},{"key":"B14","author":"Berent AC","year":"2025","unstructured":"Berent AC, Weisse C, Milligan M, Mejia J, Woods S, Lamb K. Long-term outcomes after prophylactic infusion of 2% tetrasodium ethylenediaminetetraacetic acid in 95 subcutaneous ureteral bypass devices in 66 cats with benign ureteral obstructions. JVIM 2025, in press."},{"key":"B15","series-title":"Adv Exp Med Biol","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/5584_2017_134","article-title":"The efficacy of tetrasodium EDTA on biofilms","volume":"1057","author":"Percival SL","year":"2018","unstructured":"Percival SL, Salisbury AM. The efficacy of tetrasodium EDTA on biofilms. 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