HOW TO REMOVE URETHRAL OBSTRUCTION IN CATS Urology 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 system 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). recurrence of obstructions or shorten the permanence of the catheter or hospitalization duration (18). In our experience, hematuria is controlled in 24–48 hours without further intervention. 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. Catheter placement allows urethral permeability to be maintained and urine production and characteristics to be monitored; it can be maintained for 36–48 hours until metabolic alterations and urine cellularity have improved (6,7). It is important to mention that some cats with UO may have postobstructive 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. 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. It is recommended to continue with oral pharmacological management with dexmedetomidine and buprenorphine and, REMEVET 7
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