Urethral Obstruction Flashcards
(30 cards)
How common is urethral obstruction?
It’s common and a potential life-threatening emergency condition in male cats because they have a larger urethra
What’s the percentage of urethral obstructions across North America?
2-13%
What’s the management on urethral obstruction?
- Initial stabilization
- Relief of obstruction (urinary catheter)
- Post-obstructive care
What are the clinical signs of urethral obstruction?
- Inability/pain to urinate
- Abdominal pain
- Accumulation of endogenous waste products
- Electrolyte derangements
- Metabolic acidosis (Low pH)
- Vomiting
- Dehydration
- Cardiac arrhythmias
- Death
What’s the cause (etiology) of urethral obstruction?
- Idiopathic condition
- Urolithiasis (stones) (related to diet)
- Urethral plugs (accumulation of crystals, debris, and inflammatory cells) (it’s the white on penis)
What’s the causes of feline idiopathic/interstitial cystitis?
- Stress-associated condition
- Environmental changes (diet, new homes, new pets)
Tell me the characteristics regarding the B-receptors and gamma receptors in the sympathetic system.
- B-receptors in the bladder allow the detrusor muscle to relax and fill
- Gamma receptors in the bladder and neck, and urethra cause constraction
Tell me the responsibility of the sympathetic system.
Responsible for storage phase in urination
What are some predisposing factors?
Cats with FUO had higher body weight and were younger
What are some diagnostics for urethral obstruction?
- Bloodwork
- Abdominal Radiographs
- Urinalysis
- Urine Culture
- Need to look for underlying causes of bacteriuria
When diagnosing urethral obstruction with bloodwork, what do you look for?
- Azotemia (elevated BUN and creatinine)
- Hyperkalemia (elevated potassium levels)
- Metabolic acidosis (decreased blood pH)
Rate from highest to lowest importance in ER concerns: shock, pain, renal function, and cardiac function
- Shock
- Cardiac function
- Pain
- Renal function
What does fluid therapy aim to do?
Aimed to rapidly correct hydration deficits and ongoing losses (post-obstructive diuresis)
What should hypovolemic and hypotensive cats receive?
Should receive shock doses of IV fluids (10-15 ml/kg, then reassess)
What’s a good IV used for fluid therapy?
Lactated … NOT sodium chloride or the other one
What’s the normal heart rate in a cat?
About 200 bpm
Why should you monitor fluid therapy?
Post-obstructive diuresis is common and occurs in 46% (13/28) of cats within 6 hours in one study
What’s the heart rate like in hyperkalemia
The higher the heart rate, the worse it’s getting
What percentage of cats developed scant effusion several hours later after cystocentesis?
16%
What are some drugs used to treat hyperkalemia?
- Insulin and 50% dextrose
- 50% dextrose alone
- Terbutaline
- Sodium bicarbonate
- 10% calcium gluconate
What’s the general knowledge about cystocentesis?
- Acepromazine + Buprenorphine
- Decompressive cystocentesis every 8 hours
- Low stress environment
- 73% survival to discharge
- Uroabdomen 3 cats and hemoabdomen 1 cat
- up 10 times cystocentesis was performed in some patients
What’s the general knowledge of urinary catheterization?
- Sedation or general anesthesia is required
- Using non-traumatic techniques to prevent urethral ruptura
- Maintaining an aseptic technique
- Difficult catheterizations may require expertise
What are the different types of catheters?
1) Polypropylene (Tomcat)
2) Polyvinyl (Redrubber)
3) Polytetrafluorothylene (Slippery Sam)
4) Polyurethane
*Nat, all of these are listed in order of the picture**
How long do I leave the urinary catheter? What are some objective measures I should use? Subjective measures?
- Average: 24-48 hours
- Objective Measures: Azotemia has resolved, post-obstructive diuresis is controlled, and patient is stable
- Subjective Measures: Degree of hematuria
