Felis ISSN 2398-2950

Urethra: obstruction

Contributor(s): Andrew Gardiner, Melissa Wallace

Introduction

  • Causes: urolithiasis, urethral plugs, trauma, neoplasia, extra-urethral mass, idiopathic inflammation, iatrogenic intervention.
  • Signs: straining (stranguria)   Urination: cat straining to urinate  and difficulty associated with urination/variable flow.
  • Diagnosis: clinical signs and physical examination.
  • Treatment: priority is to correct metabolic abnormalities and stabilize animal prior to definitive management.
  • Prognosis: depends on cause and extent of renal damage.
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Pathogenesis

Etiology

Specific

  • Urolithiasis: structure of male urethra.

Pathophysiology

  • Feline urethral obstruction is (unlike canine) often complete and is an urgent situation.
  • Most obstructions occur at the distal penile urethra or the membranous urethra.
  • Obstruction of normal flow of urine leads to:
    • Dilation of kidney calyces and collecting ducts: reduced renal blood flow and glomerular filtration rate.
    • Impaired excretion: azotemia Azotemia, hyperkalemia Hyperkalemia, metabolic acidosis Acid base imbalance.
    • Increased pressure: renal ischemia with or without superimposed infection; permanent kidney damage (severity depends on degree, duration and level of obstruction with or without presence of infection.).
  • Hyperkalemia may   →   cardiac arrythmias   →   death.

Timecourse

  • Bladder distention will reach critical proportions within hours of a complete blockage.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Gerber B, Eichenberger S & Reusch C E (2008) Guarded long-term prognosis in male cats with urethral obstruction. J Fel Med Surg 10 (1), 16-23 PubMed.
  • Lee J A & Drobatz K J (2003) Characterization of the clinical characteristics, electrolytes, acid-base, and renal parameters in male cats with urethral obstruction. J Vet Emerg Crit Care 13 (4), 227-33 VetMedResource.
  •  Foster S F, Hunt G B & Malik R (1999) Congenital urethral anomaly in a kitten. J Feline Med Surg (1), 61-64 PubMed.


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