A 1.5-year-old male neutered domestic short haired cat was presented to his primary care veterinarian for vomiting and anorexia. He was febrile (104F) and azotemic with a creatinine of 4mg/dL. He was hospitalized for 4 days and treated with intravenous fluids and an antibiotic. An abdominal ultrasound revealed an enlarged right kidney and serial blood work revealed a progressive azotemia. The cat was sent to a referral hospital where ultrasound examination further revealed the presence of ureteroliths with right hydroureter and hydronephrosis. The right ureteral obstruction did not resolve with further medical management with intravenous fluids, an analgesic, diuretic and antibiotic so he was transferred to Cornell for surgical treatment. A Subcutaneous Ureteral Bypass (SUB) was placed to bypass the occluded right ureter allowing urine to flow from the kidney to the bladder. The following day, his azotemia and hydronephrosis were improved so the patient was discharged to the care of his owners.