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How I Treat…The Cat With a Blocked Bladder
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Pathogenesis of obstruction
Urethral obstruction (UO) is a potentially life-threatening manifestation of feline lower urinary tract disease. The male cat has a long and narrow urethra (compared to the female), and is much more likely to develop an obstruction. It has long been held that the presence of a physical obstruction, such as a calculus or urethral plug (or much less commonly stricture or neoplasia), is responsible for occluding the lumen of the urethra in these cases, but there is evidence to suggest that mechanical obstruction secondary to urethral spasm and edema may play an equally important role (1,2). These conditions are thought to be brought about by underlying feline idiopathic cystitis (FIC). The pathogenesis of FIC is still unclear but it appears to be a sterile inflammatory process, as attempts to consistently isolate a bacterial or viral cause have been unsuccessful. [...]
Key Points
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Feline urethral obstruction may occur secondary to physical obstruction (stones, mucous plug) as well as functional obstruction (inflammation, urethral spasm, edema).
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Heavy sedation, lubricated flush, and appropriate technique are essential to ensure the risk of urethral trauma is minimized.
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Severe hyperkalemia is considered to be the most life-threatening aspect of obstruction.
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Awareness and monitoring for post- obstructive diuresis is important to maintain appropriate fluid balance.
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Analgesia and urethral relaxants are important components of therapy both during hospitalization and after discharge.
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