Feline lower urinary tract disease is a complex set of clinical signs that most commonly occurs in indoor male cats.1–3 Cats with FLUTD often have stranguria, pollakiuria, periuria (inappropriate urination), hematuria, lethargy, vomiting, signs of abdominal pain, and vocalization. Urethral obstruction is a complication of FLUTD that can lead to postrenal azotemia and severe metabolic abnormalities.4–6 Hyperkalemia is the most life-threatening derangement, resulting in altered cardiac conduction and bradyarrhythmias. Urolithiasis, urethral plugs, crystalluria, urinary tract infection, and interstitial cystitis have been identified as possible inciting causes for urethral obstruction.1–3,7,8 Medical treatment for urethral obstruction may include IV administration of fluids, relief of the obstruction, and placement of an indwelling urinary catheter. The cost and duration of hospitalization for cats with urethral obstruction typically depend on the severity of illness, clinician preference, and availability of 24-hour care. The prognosis for survival to discharge is excellent,4,9,10 but recurrent urethral obstruction is a frustration for owners that can lead to euthanasia rather than continued medical or surgical treatment.
The associated risk factors and prognosis for recurrent urethral obstruction were recently evaluated retrospectively at a university hospital.9 Recurrent urethral obstruction was identified in 22% of cats within 6 months and 24% within 2 years. Another study10 identified recurrent obstruction in 36% of cats, most within 2 weeks after discharge.
The purpose of the study reported here was to evaluate signalment and laboratory abnormalities as risk factors for recurrent obstruction in cats treated medically because of urethral obstruction. Additionally, we sought to identify associations between specific treatment decisions and discharge recommendations to owners and the risk of recurrent urethral obstruction within 30 days after hospital discharge. Recurrent urethral obstruction was defined as a nonexpressible bladder or nonproductive stranguria documented by a veterinarian within the designated time period.
Feline lower urinary tract disease
Urine specific gravity
Stat profile critical care Xpress analyzer, NOVA Biomedical, Waltham, Mass.
2% chlorhexidine gluconate, Vétoquinol USA Inc, Fort Worth, Tex.
Sovereign Tom Cat Catheter 3.5F, 5.5 inches (14 cm), Tyco Healthcare Group LP, Mansfield, Mass.
Osborne Feline Urethral Catheter, 22 g (1 inch), KVP International Inc, Irwindale, Calif.
Feeding Tube and Urethral Catheter, 3.5F (1.2 mm), 41 cm or 5F (1.7 mm) 41 cm, Tyco Healthcare Group LP, Mansfield, Mass.
IDEXX Reference Laboratories, North Grafton, Mass.
Buster transparent dog collar 12.5 cm, Kruuse, Langeskov, Denmark.
Copies of the survey are available from the corresponding author on request.
R Development Core Team (2011). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria.
Prazosin, 0.5-mg capsules, Meds4Vets, Sandy, Utah.
Phenoxybenzamine, 2.5-mg capsules, Kaye's Pharmacy, Baltimore, Md.
Buprenorphine hydrochloride, Reckitt Benckiser Healthcare Ltd, Richmond, Va.
Amoxi-drops, Pfizer Animal Health, New York, NY.
Clavamox suspension, Pfizer Animal Health, New York, NY.
1. Buffington CA, Westropp JL, Chew DJ, et al. Risk factors associated with clinical signs of lower urinary tract disease in indoor-housed cats. J Am Vet Med Assoc 2006; 228: 722–725.
2. Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats. J Am Vet Med Assoc 2001; 218: 1429–1435.
3. Sævik BK, Trangerud C, Ottesen N, et al. Causes of lower urinary tract disease in Norwegian cats. J Feline Med Surg 2011; 13: 410–417.
4. Lee JA, Drobatz KJ. Characterization of the clinical characteristics, electrolytes, acid-base, and renal parameters in male cats with urethral obstruction. J Vet Emerg Crit Care 2003; 13: 227–233.
5. Drobatz KJ, Hughes D. Concentration of ionized calcium in plasma from cats with urethral obstruction. J Am Vet Med Assoc 1997; 211: 1392–1395.
6. Lee JA, Drobatz KJ. Historical and physical parameters as predictors of severe hyperkalemia in male cats with urethral obstruction. J Vet Emerg Crit Care 2006; 16: 103–111.
8. Gerber B, Boretti FS, Kley S, et al. Evaluation of clinical signs and causes of lower urinary tract disease in European cats. J Small Anim Pract 2005; 46: 571–577.
9. Segev G, Livne H, Ranen E, et al. Urethral obstruction in cats: predisposing factors, clinical, clinicopathological characteristics, and prognosis. J Feline Med Surg 2011; 13: 101–108.
10. Gerber B, Eichenberger S, Reusch CE. Guarded long-term prognosis of male cats with urethral obstruction. J Feline Med Surg 2008; 10: 16–23.
12. Francis BJ, Wells RJ, Rao S, et al. Retrospective study to characterize post-obstructive diuresis in cats with urethral obstruction. J Feline Med Surg 2010; 12: 606–608.
13. Brady CA, Otto CM, Van Winkle TJ, et al. Severe sepsis in cats: 29 cases (1986–1998). J Am Vet Med Assoc 2000; 217: 531–535.
14. Markwell PJ, Buffington CA, Smith BHE. The effect of diet on lower urinary tract diseases in cats. J Nutr 1998; 128:2753S–2757S.
15. Forrester SD, Kruger JM, Allen TA. Feline lower urinary tract diseases. In: Hand MS, Thatcher CD, Remillard RL, et al, eds. Small animal clinical nutrition. 5th ed. Topeka, Kan: Mark Morris Institute, 2010; 925–976.
16. Buffington CA, Westropp JL, Chew DJ, et al. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. J Feline Med Surg 2006; 8: 261–268.
17. Jones BR, Sanson RL, Morris RS. Elucidating the risk factors of feline lower urinary tract disease. N Z Vet J 1997; 45: 100–108.
18. Stella JL, Lord LK, Buffington CA. Sickness behaviors in response to unusual external events in healthy cats and cats with feline interstitial cystitis. J Am Vet Med Assoc 2011; 238: 67–73.
19. Markwell PJ, Buffington CA, Chew DJ, et al. Clinical evaluation of commercially available urinary acidification diets in the management of idiopathic cystitis in cats. J Am Vet Med Assoc 1999; 214: 361–365.