Successful resolution of acute postrenal azotemia from iatrogenic bilateral ureteric ligation in a cat managed with peritoneal dialysis

This report describes a neutered 1-year-old female Scottish Fold cat exhibiting oliguria, lethargy, and severe depression following ovariohysterectomy (OVH). Laboratory tests showed severe metabolic acidosis, hyperkalemia, and azotemia. Ultrasonography revealed hydronephrosis, hydroureter on both sides, and stenosis near the urinary bladder. Abdominal exploration revealed that both ureters were ligated. Iatrogenic bilateral ureteral ligation was diagnosed based on the abdominal exploration results. Peritoneal dialysis (PD) was performed immediately upon recovery from anesthesia. After three consecutive days of PD, azotemia and anuria resolved by the sixth day post-operation, and the patient was discharged the following day. After 7 months of follow-up, the patient exhibited no clinical signs or abnormal laboratory parameters indicative of azotemia. This report demonstrates that PD is a safe, effective, and easily performed procedure for resolving postrenal azotemia resulting from iatrogenic bilateral ureteral ligation in cats, which can be initiated once the patient has recovered from surgery. Furthermore, this report also describes the patient management protocol, PD drain placement method, and peritoneal dialysis protocol, all of which can be implemented in clinical practice.