Animal Health Solutions

25 Q3 2020 | Animal Health Solutions Table 1 Material to release UO and for the urethral catheterization procedure in the cat. Asepsis and antisepsis • Shaver • Disinfectant solution (chlorhexidine) • Sterile gloves Urethral catheters • Flexible, 3.5 Fr x 10, 14 or 18 cm – Polytetrafluoroethylene (Teflon) – Polyethylene with or without barium • Semi-rigid – polypropylene UO release • Water-based sterile lubricating gel • Olive-tip catheter (Minnesota catheter) – 21 G x 1/2, 1, or 1 1/2" • 3-, 5- and 10 mL syringes • Venoclysis extensions Other • Needle holder and scissors • Nylon suture (2–0 or 3–0) • Sterile urine collection bag Video 1 Sacrococcygeal epidural in a cat with UO with assistance by neurostimulator device. Video 2 Penis massage in a cat with blocked urethra. With this maneuver it was possible remove a urethral plug lodged in the penile urethra. Figure 6 Material to release UO, and urethral catheterization procedure in the cat. BIBLIOGRAPHY 1. Del-Angel-Caraza J, Delgadillo-Quezada L, Vázquez- Manzanilla CA, y col. Abordaje diagnóstico del gato con enfermedad del tracto urinario. RE-MEVET Julio- Septiembre 2017;1(3):7-13. http://remevet.com Ultimo acce-so: 13 de Julio de 2019. 2. George C, Grauer G. Feline Urethral Obstruction: Diagnosis & Manage-ment. Today´s Veterinary Practice; July/August 2016:36-46. https://todays- veterinarypractice.com/wp-content/uploads/ sites/4/2016/06/TVP_2016-0708_FelineUrethreal.pdf Ultimo acceso: 13 de Julio de 2019. 3. Cooper E, Owens T, Chew D, y col. A protocol for managing urethral obs-truction in male cats without urethral catheterization. J Am Vet Med Assoc 2010; 237:1261–6. 4. Hall J, Hall K, Powell L, y col. Outcome of male cats managed for urethral obstruction with decompressive cystocentesis and urinary catheterization: 47 cats (2009-2012). J Vet Emerg Crit Care2014; 25:256-62. 5. Beal, M. Interventional Management of Urethral Obstructions. Vet Clin North Am Small Anim Pract 2018; 48:863–74. 6. Pachtinger G., Urinary catheter placement for feline urethral obstruction. Clinican´s Brief July 2014: 69-74. https://files.brief.vet/migration/arti-cle/19061/urinary- catheter-placement-for-feline-obstruction-19061- article.pdf Ultimo acceso: 13 de Julio de 2019. 7. Seitz M., Burkitt-Creedon J., Drobatz K.Evaluation for association between indwelling urethal catheter placement and risk of recurrent urethral obstruc-tion in cats. J Am Vet Med Assoc 2018; 252:1509–20. 8. Aguiñaga-Negrete E, Bernal-Torres AC, Perini- Perera S, y col. Cistocente-sis en perros y gatos: Procedimiento y consideraciones. REMEVET Mar-zo- Abril 2019;3(12):6-9. http://remevet.com Ultimo acceso: 13 de Julio de 2019. 9. Corgozinho KB, Souza HJM, Pereira AN, y col. Catheter-induced urethral trauma in cats with urethral obstruction. J Feline Med Surg 2007; 9:481–6. 10. Gaskell CJ. The lower urinary tract. In: Chandler EA, Gaskell CJ, Gaskell RM (eds). Feline Medicine and Therapeutics, 3rd ed. Ames: Blackwell Pu-blishing 2004:316–8. 11. Drobatz KJ. Urethral obstruction in cats, In: Bonagura JD, Twedt DC (eds). Kirk's Current Veterinary Therapy XIV. St. Louis: WB Saunders Co; 2009:951–3. 12. Porters N, Bosmans T, Debille M, y col. Sedative and antinociceptive effects of dexmedetomidine and buprenorphine after oral transmucosal or intramus- cular administration in cats. Vet Anaest Analg 2014; 41:90-6. 13. Robertson SA, Goloski SM, Pascoe P, y col. AAFP Feline anesthesia guide-lines. J Fel Med Surg 2018; 20:602-34. 14. Skarda RT, Tranquilli WJ. Local and regional anesthetic and analgesic tech-niques: horses. In: Tranquilli WJ, Thurmon JC, Grimm KA (eds). Lumb & Jones Veterinary Anesthesia and Analgesia, 4th edn. Ames: Blackwell Publi-shing 2007:620–2. 15. O'Hearn AK, Wright BD. Coccygeal epidural with local anesthetic for ca-theterization and pain management in the treatment of feline urethral obs- truction. J Vet Emerg Crit Care 2011; 21:50–2. 16. Osborne CA, Lulich JP, Polzin DJ. Feline urethral obstruction. In: Bartges J, Polzin DJ (eds). Nephrology and urology of small animals. Wiley-Blackwell 2011:367-74. 17. Meige F, Sarrau S, Autefage A. Management of traumatic urethal ruptura in 11 cats using primary alignment with a urethral catheter. Vet Comp Orthop Traumatol 2008; 21:76–84. 18. Dorsey T, Monaghan K, Respess M, Labato M, y col. Effect of urinary blad-der lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats. Small Animals. J Am Vet Med Assoc 2019; 254:483–6. 19. Hugonnard M, Chalvet-Monfray K, DernisJ, y col. Occurrence of bacteriu-ria in 18 catheterised cats with obstructive lower urinary tract disease: a pilot study. J Fel Med Surg 2013; 15:843-8. 20. Rieser T. Urinary Tract Emergencies. Vet Clin North Am Small Anim Pract 2005; 35:359-73. by which it is possible to extract the urethral plug or sand, especially if they are near the external urethral orifice (Video 2); this maneuver should be avoided when there are evident uroliths blocking the urethra. A gentle bladder compression should be tried, to induce urination with very little resistance; aggressive compression should be avoided if there is any difficulty in emptying. In many cases, these maneuvers clear the UO and make it unnecessary to place a urethral catheter; however, hospitalization of the patient for medical observation and management is advisable, with 8, 12, or 24 hours of dexmedetomidine (0.0025–0.02 mg/ kg c/8 hours VO) and buprenorphine (0.01–0.02 mg/kg c/8 hours VO); with acepromazine(2.5 mg total c/8 hours VO) in cases of very nervous cats (modified from Coopers et al., 2010). It is worth mentioning that some animals may present a greater sedative effect, so the dose should be adjusted. When the patient manages to urinate without difficulty during the first 24 hours, it can be discharged. When it is not possible to relieve the UO with penile massage it is necessary to place a urethral catheter. Types of urethral catheter The urethral catheterization procedure consists of two maneuvers: first, release the UO; and the second, to place the urethral catheter. Each process requires different material (Table 1) (Figure 6). Look for Part Two of this article in the Q4 Animal Health Solutions.

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