A 7-year-old 346-kg Rocky Mountain Horse stallion was admitted for evaluation of a suspected mandibular fracture. The owner reported the patient suffered facial trauma during a thunderstorm 2 days prior to presentation. The referring veterinarian prescribed flunixin meglumine (1.1 mg/kg, IV, q 12 h) 1 day prior to admission.
On physical examination, the horse had a dropped jaw that was deviated leftward. The mouth could not be closed manually, and the horse resisted manipulation of the jaw. Moderate swelling was noticed over the right masseter muscles and temporomandibular joint (TMJ) region. There was marked periorbital swelling, exophthalmia, and severe
A 10-year-old 5.3-kg (11.7-lb) neutered male Chihuahua was referred for evaluation of a mediastinal mass and pleural effusion identified on thoracic radiographs obtained by the referring veterinarian. Clinical signs included a nonproductive cough of 3 days' duration, respiratory difficulty, and restlessness the night prior to hospital admission.
Physical examination findings included obesity (body condition score, 8/9), tachypnea (44 breaths/min; reference range, 18 to 35 breaths/min), and tachycardia (228 beats/min; reference range, 70 to 120 beats/min) with an irregularly irregular cardiac rhythm. The dog's body temperature was within reference range (37.6°C [99.7°F]; reference range, 37.2° to 39.2°C [99.0° to 102.5°F]).
OBJECTIVE To test for an association between indwelling urethral catheter placement in cats with urethral obstruction (UO) and the short-term (30-day) risk of recurrent urethral obstruction (RUO).
DESIGN Prospective cohort study.
ANIMALS 107 client-owned male cats with UO.
PROCEDURES Owners were offered standard care for their cats, including hospitalization, placement of an indwelling urethral catheter, IV fluid therapy, and other supportive treatments (inpatient group). One-time catheterization and outpatient care were offered (outpatient group) if standard care was declined. Data regarding signalment, measures of metabolic compromise and urinalysis findings at enrollment, catheterization-related variables, and supportive treatments of interest were collected. Risk of RUO ≤ 30 days after urethral catheter removal was determined for the outpatient vs inpatient group by OR and 95% confidence interval calculation. Other variables were compared between cats that did and did not develop RUO with Fisher exact and trend tests.
RESULTS 91 cats completed the study; 19 (5/46 [11%] inpatients and 14/45 [31%] outpatients) developed RUO. Risk of RUO was significantly greater for cats of the outpatient group (OR, 3.7; 95% confidence interval, 1.2 to 11.4). Among inpatients, increasingly abnormal urine color at the time of catheter removal was significantly associated with RUO. No other significant associations were identified.
CONCLUSIONS AND CLINICAL RELEVANCE Hospitalization and indwelling catheterization significantly reduced the risk for RUO ≤ 30 days after treatment for the population studied. Results suggested that removal of an indwelling catheter before urine appears grossly normal may be associated with development of RUO. One-time catheterization with outpatient care was inferior to the standard care protocol but was successful in many cats and may be a reasonable alternative when clients cannot pursue standard care.