An active wheelchair bound 7-year-old male neutered paraplegic Hound presented for management of a chronic upper motor neuron bladder that failed medical management. A cystostomy Foley catheter was placed surgically at the apex of the bladder but caused multiple urinary tract infections and had several dislodgments secondary to constant rubbing against the harness/frame of the wheelchair. The Foley catheter was replaced 4 months later by a low-profile gastrostomy tube inserted in the same stoma; however, the intraluminal part aspirating against the bladder wall prevented effective draining. PleuralPort placement in the bladder with a subcutaneous port was performed to permit controlled bladder drainage and minimize infection risk. The fenestrated silicone catheter was fed through a small incision on the left abdominal and bladder wall. The bladder was circumferentially pexied to the abdominal wall at the catheter insertion. The PleuralPort placed on the left caudal thorax was dislodged after 10 days due to interference with the wheelchair. The dislodgement caused migration of the fenestrated part of the tubing into the subcutaneous tissue with urine leakage demonstrated by contrast fluoroscopy. The subcutaneous seroma was debrided, flushed and a closed-suction drain placed; Pseudomonas aeruginosa was cultured. The PleuralPort was exchanged using the same cystostomy site, catheter better secured at the abdominal wall exit and subcutaneous port placed dorsally in the flank, cranial to the left ilium and remote to the wheelchair. Bladder drainage has been successful at home and no complication has been noted since the surgical revision 5 months ago.
