Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

Objectives To report the technique and outcome of a cat treated with a total cystectomy and bilateral cutaneous ureterostomy. Animals A 16-year-old male castrated domestic shorthair cat. Study design Case report. Case presentation A cat was referred after a 2-week history of pollakiuria and hematuria. Transitional cell carcinoma (TCC) was suspected based on ultrasonographic, cytologic, and contrast computed tomographic (CT) findings. A total cystectomy was combined with a modified cutaneous ureterostomy: the ureter, incised like a fish-mouth aperture, was anastomosed to the skin after the creation of a rectangular-shaped defect. Complete excision of a TCC was confirmed histologically. Results Ureteral stents were removed 7 days (left) and 28 days (right) postoperatively. The cat's incontinence was managed with an absorbent diaper surrounding the ureteral stomata. The right ureter became obstructed 14 months after surgery, and the cat died at home approximately 16 months after surgery. In spite of the urinary incontinence, the owner was satisfied with the surgery and evaluated the cat's quality of life as satisfactory. Conclusions The total cystectomy and cutaneous ureterostomy described here allowed urinary excretion and resulted in long-term survival of a cat with bladder TCC.