Cooper ES, Owens TJ, Chew DJ et al: A protocol for managing urethral obstruction in male cats without urethral catheterization, J Am Vet Med Assoc 237:1261, 2010.
Urethral obstruction (UO) is a fairly common medical condition in male cats that typically requires emergency treatment. The standard treatment for UO involves medical stabilization of cardiovascular and metabolic derangements, correction of electrolyte abnormalities with IV fluid administration, and relief of the obstruction by urethral catheterization. Standard treatment for UO may require a number of days in the hospital at considerable expense. The investigators performed a clinical trial involving 15 male cats with UO where standard treatment had been declined by owners due to cost concerns. They speculated that pharmacological manipulation of stress, urethral tone, and discomfort could help alleviate some of the functional components of the obstructive process (urethral spasm and edema) and the patients might not need urinary catheterization. Excluding the most severely affected patients, 15 cats were enrolled in the study and were administered acepromazine, buprenorphine, and medetomidine. Decompressive cystocentesis was performed up to three times daily and fluid therapy was administered as needed. The cats were placed in a quiet, dark environment to minimize stress. Criteria for successful treatment were spontaneous urination within 72 hours and discharge from the hospital. Treatment was considered successful in 11 of the 15 cats. While this protocol cannot be recommended as an alternative to conventional management at this time, it could serve as an alternative to euthanasia when financial constraints prevent more extensive treatment. [VT]