Occurrence and clinical management of urethral obstruction in male cats under primary veterinary care in the United Kingdom in 2016

Abstract

Background Urethral obstruction (UO) has a negative effect on welfare of cats. Objectives This study aimed to determine incidence, case management, and outcomes of UO in cats in primary‐care practice in the United Kingdom. Animals All male cats under veterinary care within the VetCompass database in 2016. Methods A retrospective cohort study was performed. The electronic records of all male cats with a clinical note during the study period were searched for UO cases and were manually reviewed for inclusion. Additional demographic and clinical information were extracted on cases. Results From the study cohort of 237 825 male cats, there were 1293 incident cases. The estimated UO incidence risk during 2016 was 0.54 (95% CI: 0.51‐0.57). Demographic and clinical data were available for 1108 cases. Antibiotics were administered to 641/1108 (57.9%) cases. Overall repeat catheterization rate was 253/854 (29.6%). Repeat catheterization at 48 hours was less frequent in patients with indwelling catheters (10.1%) vs those that had a catheter placed and then immediately removed (14.8%; P = .04). Death during a UO episode was 329/1108 (29.6%), and 285/329 (88.0%) deaths involved euthanasia. Conclusions and Clinical Importance Antibiotics were commonly prescribed in cats for treatment of UO despite minimal evidence in the clinical records of bacterial cystitis. Repeat catheterization was common and case fatality rate during a UO episode was high. Repeat catheterization within 48 hours of elective removal of a urethral catheter was less common in cats that had previously had indwelling catheters. The majority of cats requiring repeat catheterization survived until the end of the study.

Pseudomembranous cystitis in cats with presumed or confirmed mineralization: A retrospective study of 26 cases (2016‐2021)

“…3 Bacterial infection was not commonly identified in our cat population (5/21; 24%), which is similar to the rate of bacterial UTI reported in FIC. 20,[32][33][34] It is considered unlikely that C. urealyticum infection was missed in our samples because all bacterial cultures were held for at least 48 hours, the minimal incubation time required for C. urealyticum growth, and most (86%) cultures were performed before antibiotic treatment. 9,31,35 However, not all cultures were held for 72 hours, therefore C. urealyticum infection cannot be conclusively ruled out.…”

“…[16][17][18] Male cats affected by FIC with episodes of urethral obstruction (UO) have a 60% likelihood of FIC relapse and a 36% likelihood of reobstruction, placing this feline population at increased risk of repeated urogenital interventions. [18][19][20] Considering that PMC has only been described in cats with UO at increased risk of repeated urological interventions, that mineralization has been only sporadically mentioned and that PMC has been associated with bacterial infection in human and veterinary patients, 1,2,4,18,19,21 further evaluation of the clinical characteristics of affected cats is needed.…”

“…Feline idiopathic cystitis (FIC) is a common disease in the feline population characterized by neurogenic bladder inflammation 16‐18 . Male cats affected by FIC with episodes of urethral obstruction (UO) have a 60% likelihood of FIC relapse and a 36% likelihood of re‐obstruction, placing this feline population at increased risk of repeated urogenital interventions 18‐20 …”

Resolution of urethral obstruction using temporary urethral stents in two female cats

“…Urethral obstruction (UO) is a common result of lower urinary tract disease in cats. 1 , 2 Neutered male cats with urethral plugs, uroliths or idiopathic disease are predisposed to UO. 1 – 5 There is minimal information regarding female cats with UOs, including cases following laser lithotripsy and basket retrieval of uroliths.…”

“… 1 , 2 Neutered male cats with urethral plugs, uroliths or idiopathic disease are predisposed to UO. 1 – 5 There is minimal information regarding female cats with UOs, including cases following laser lithotripsy and basket retrieval of uroliths. The following report describes two cases of UO following minimally invasive urolith removal that were successfully managed with a novel temporary urethral stent.…”