Sunday, May 10, 2015

1191. Dr Susan Little's talk on urethral obstruction, FIC in cats

May 10, 2015. The talk at M Hotel, on Sunday, a Mother's Day was limited to 50 pax and was full house. Dr Susan Little is co-owner of 2 cat clinics and an author of cat books, amongst other veterinary achievements
 
Here are some of her opinions.
 
1.  URETHRAL OBSTRUCTION
1.1 Stablise the cat by decompressing the bladder in some cases, before catherisation. Do cystocentesis. Insert 25-G needle at 45 degrees towards the neck of the bladder. Not at 90 degrees or into the apex of bladder as bladder shrinks away freom the needle when urine is collected.
1.2. Use 3-way stop valve to draw urine and collect it for urine analysis

1.3 Massage penile tip for some time  -around 10 minutes to express out the urethral plug and so avoid the need to catetherise. This does happen in some hh of her cases.

1.4. She uses warmed saline with sterile lubricant to flush the bladder. Apparently the lubricant is effective in cleaering the mucosa?
1.5 A commercial firm sells the appropriate cat cathether. An orange one which is softer for indwelling. The one with the stylet (costs more) but can be used for both purposes - flushing and indwelling. Has a butterfly for suturing to penile skin.
1.6. Pain relief is important. Suggested opiod and NSAID.
Medocab for cats (Boelinger?) is great as it is tasteless and given in the cat's food. She uses it.  Her opinion is that tolfedine is old school and not as good as meloxicam.  

1.7  ACP 2.5 mg/cat oral as anti-spasomodic and anti-anxiety is said to be effective.
1.8. Duration of indwelling catheter depends on lab analysis of urine and blood electrolytes.
1.9. Recurring cases. She did not mention perineal urethrostomy in her lecture.
1.10. Damage to pelvic urethra from catherisation rupture case - dye seen pooling in pelvic area on X-ray shown.
1.11. Blood test. Monitor for K+





2. FIC
 
2.1  Only 5% are due to bacterial infections. 60-70% idiopathic. Therefore she does not prescribe antibiotics.
2.2 Most cases are self-limiting according to her, whether treatment is given or not.
2.3 Litter boxes insufficient. Should be 4 boxes for 3 cats instead of lesser.
2.4  Pain relief is important. Opiod. Her favourite is given.

 
NASAL TUBE FEEDING OF CATS
She said it is easy in her practice with the nurse holding the cat. But given sedation if necessary.
Can email to her if you have queries.

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