Diversion of urine via a cystostomy tube is occasionally performed on small animals temporarily before the start of definitive treatment in situations such as trauma, surgery, urethral inflammation, or obstruction by calculi. Indications for longer-term use of a cystostomy tube include neurogenic bladder dysfunction and extra- or intraluminal obstruction of the lower urinary tract caused by neoplasia, trauma, or scar tissue. However, the long length (22 cm to 55 cm) of the latex mushroom-tipped catheters or Foley catheters typically used in veterinary medicine make them cumbersome to stabilize without sutures or bandages. In this study, a silicone low-profile gastrostomy port (LPGP) valve system was adapted for use as a low-profile cystostomy tube (LPCT) for 4 client-owned dogs with neoplasia and a cat with bladder dysfunction. The article describes the surgery and placement of the LPGP system in detail as well as the evacuation of urine via an extension tube kit every 6 to 8 hours at home by the pet owner.
Minimal complications were consistent with those reported for tube cystostomies. No bandaging was required, the 1- to 3-cm LPCT did not inhibit patient mobility, and the evacuation tube was easy to use and keep clean. Four of the 5 pet owners said they would be comfortable using the LPCT again.
COMMENTARY: Cystostomy tubes are indicated when urethral occlusion precludes normal urine passage and in atonic bladder; however, they can be cumbersome, difficult for pet owners to work with on a long-term basis, and messy. This paper introduces a low-profile cystostomy tube for long-term use that pet owners found quite easy to use.
Clinical use of low-profile cystostomy tubes in four dogs and a cat. Stiffler KS, Stevenson MA, Cornell KK, Glerum LE, Smith JD, et al. JAVMA 223:325-329, 2003.