Animal Health Solutions

49 Q4 2020 | Animal Health Solutions Figure 11 Patient with urethral catheterization. Top: Urethral catheter fixation system. Note how the clamping plate with holes attaches to the skin of the prepuce with four simple stitches. Down: Closed collection system connected to the urethral catheter. Figure 12 The collection bag should be placed below the patient to allow urine to be evacuated by gravity; the use of the Elizabethan collar will prevent the patient from removing the catheter or the collection systemrecurrence. 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. It is important to mention that some cats with UO may have post- obstructive diuresis on the days following the release of the UO, so urinary density and production should be monitored. This problem is usually gradually corrected with fluid control therapy in the first 36 hours. It is recommended to continue with oral pharmacological management with dexmedetomidine and buprenorphine and, if necessary, acepromazine, adjusting the dose according to the patient's needs, in addition to feeding with a feline therapeutic urinary diet. The use of antibiotics as prevention, together with the placement of aseptic catheters is controversial. Some authors have reported that significant bacteriuria is associated with the placement of urinary catheters, such as of Escherichia coli and Staphylococcus spp. because these bacteria can ascend into the bladder during catheter placement or when permanently in place in the urethra. 19 So, it is therefore considered prudent to use them in a prophylactic way, avoiding the complications of bacterial cystitis. Once the patient is stable, without abdominal pain and the urine has better characteristics, the urethral catheter must be removed, observing the micturition characteristics for 24 hours. If the patient has no trouble urinating, it may be discharged. This article considers only the general management of UO in the cat; each patient will present complications of different severity, such as acute kidney injury, hyperkaliemia, metabolic acidosis, etc., which should be managed with detailed analysis of each case. 10,20 Remember that UO in a cat is the result of an FLUTD and that with diagnosis and proper medical management of the disease recidivism of the problem can be prevented.

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