fluid rates adjusted accordingly. The urinary bladder is
gently flushed with sterile saline via the urinary catheter
as needed to aid in clearing debris. Radiographs are
performed to verify proper catheter placement and to
rule out urolithiasis. A venous blood gas or chemistry
are performed for assessment of any metabolic disturbances and repeated as needed until values have stabilized. Oral prazosin and buprenorphine are started;
NSAIDs are considered on occasion. A urine culture
collected via cystocentesis is sometimes submitted
once the urinary catheter has been removed. Extensive
client education is provided at the time of discharge
regarding diet, water intake, availability, environment
changes and husbandry.
Needless to say this condition can be quite costly, and
has an uncertain future with potential for recurrence of
obstruction as well as failure of medical management.
In an effort to help these cats and their families, CSAH
has recently introduced an all-inclusive package for
stable obstructed felines. This will give us the ability to
provide optimum care and continue medical management; even if re-obstruction occurs in the initial 24-72
hours. The package includes labwork, imaging, anesthesia and/or sedation, hospitalization, medications,
nursing care and as many re-catherizations as needed
for up to 4 days. Obstructed cats that are in critical condition and experiencing life-threatening metabolic
disturbances will likely require much more intensive
care and stabilization, and therefore will not be eligible
for the all-inclusive fee package.
Our goal is to give more families the opportunity to
treat their cats, not worry about an escalating bill
during initial hospitalization, and possibly even have
the means to consider surgical treatment (perineal
urethrostomy) if medical management fails. We are
optimistic that the introduction of this package will
reduce the need for euthanasia of young and otherwise
healthy cats due to financial constraints and short-term
complications in our hospital. Meanwhile we will
continue following the literature and remain open to
new ideas and treatment options as studies continue to
shed light on this frustrating condition.
If you would like more information or have any questions please don’t hesitate to contact our Emergency
and Critical Care team.
-Eisenberg BW, Waldrop JE, Allen SE, Brisson JO, Aloisio
KM, Horton NJ. Evaluation of risk factors associated with
recurrent obstruction in cats treated medically for urethral
obstruction. J Am Vet Med Assoc. 2013; 243:1140-6.
-Hetrick PF, Davidow EB. Initial treatment factors associated
with feline urethral obstruction recurrence rate: 192 cases
(2004-2010). J Am Vet Med Assoc. 2013; 243:512-519. ■
By: Amy Harrison, DVM, Coral Springs Animal Hospital
Primary Care Clinician
Neutraceuticals,
herbs, and botanicals
are considered to be
novel
ingredients.
These products are
legally neither food,
food additives, nor
drugs (as recognized
by the FDA). Therefore, there is no premarket approval process and neither safety, efficacy or manufacturing is assured.
Many pet owners use these products and consider
them to be safe because they are “natural.” However,
adverse reactions have occurred due to either the active ingredient, contaminants, or therapeutic failure,
especially if traditional therapy is overlooked or not
pursued with the belief that the novel ingredient will be
sufficient. Also, dosing of such novel ingredients is often empirical and rarely based on scientific studies.
Consumer Laboratory (www.ConsumerLabs.com) is a
for-profit laboratory that offers a seal of “validation” for
dietary supplements sold in the USA that are appropriately labeled. The public can access selected information from the ConsumerLab website for $36.00/year.
Criteria for passing and failing and reasons for failure
for specific ingredients can be accessed, as well as a list
of proprietary products that have passed.
This information is from a lecture by Dawn Boothe,
DVM, PhD, DACVIM, DACVCP - Nutriceuticals: Balancing Fact and Fiction at the Gulf Atlantic Veterinary Conference in October 2013