Management of Urinary Tract Emergencies in Small Animals

Balakrishnan, Anusha; Drobatz, Kenneth J.

doi:10.1016/j.cvsm.2013.03.013

Cited by 26 publications

(21 citation statements)

References 44 publications

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“…Medical management of urethral obstruction includes individualised supportive therapy based on correction of electrolyte and hydration imbalances, analgesia and resolution of the urinary obstruction by the placement of an indwelling catheter. [13][14][15] It has been reported that decompressive cystocentesis, when performed in conjunction with placement of a urinary catheter, does not result in clinically significant uroperitoneum and enables uncontaminated samples to be obtained for urological cultures. 15 However, although other treatments have been suggested as useful to avoid recurrence in cats with obstructed FLUTD, 19 prospective randomised trials are needed to substantiate these conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment and management of FLUTD should be individualised, because of the multiple aetiologies, high rate of comorbidities, multifactorial contributors and individual responses . Nonetheless, it is not possible to predict which cats suffering from FLUTD will relapse …”

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confidence: 99%

“…2,[6][7][8] Treatment and management of FLUTD should be individualised, because of the multiple aetiologies, high rate of comorbidities, multifactorial contributors and individual responses. 1,13 Nonetheless, it is not possible to predict which cats suffering from FLUTD will relapse. 14,15 Cats may have an uncommon condition described as a complicated obstructive FLUTD presentation, with fibrinous exudate, blood clots, necrotic debris and wall thickening with hyperechoic strips of the bladder that can be easily detected with abdominal ultrasound (AUS).…”

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Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction

et al. 2017

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Case report The present case series describes the clinical course and outcome of three cats diagnosed with pseudomembranous cystitis. This is an uncommon presentation of lower urinary tract obstruction but can be easily be identified by ultrasonography, revealing severe bladder wall thickening and thin hyperechoic luminal strips. The condition can be secondary to severe bacterial urinary tract infection. All cats were successfully treated with medical management only, mainly based on antimicrobials and individualised supportive therapy.Conclusion Further evaluation of this condition is necessary in order to determine potential underlying aetiologies, pathophysiological mechanisms and the most appropriate standardised treatment.

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Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction

et al. 2017

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“…Urethral obstruction (UO) is a common urinary tract emergency in male cats, typically characterized by stranguria, hematuria, pollakiuria, vocalization, excessive grooming of the perianal area, vomiting, and lethargy . Urolithiasis, interstitial cystitis, and urethral plugs have been identified as possible causes for UO . Typical medical treatment for this condition includes IV fluid administration, relief of the obstruction by urethral catheterization, and post‐obstructive care.…”

Section: Introductionmentioning

confidence: 99%

Association of abdominal effusion with a single decompressive cystocentesis prior to catheterization in male cats with urethral obstruction

Gerken

Butler²,

Chew

2019

J Vet Emergen Crit Care

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Objective:To evaluate the occurrence of abdominal effusion and its association with decompressive cystocentesis in male cats with urethral obstruction.Design: Prospective observational clinical study.Animals: Forty-five male neutered, client-owned cats with naturally occurring urethral obstruction. Procedures: Laboratory testing and point-of-care ultrasonography were performed. Presence of abdominal effusion was evaluated using the Focused Assessment with Sonography for Trauma (FAST) technique at presentation. Decompressive cystocentesis was then performed prior to catheterization by a standardized technique. Repeat FAST examination was performed 15 minutes after cystocentesis and the following day to further assess for the presence of abdominal effusion. Results: A mean volume of 92.3 ± 35.2 mL of urine was removed from each cat via cystocentesis prior to catheterization. At presentation, 15 of 45 (33%) had abdominal effusion (13/15 with scant effusion, 2/15 with mild), with an additional 7 cats developing scant effusion 15 minutes post-cystocentesis. By the following day, 4 cats still had scant effusion present. No significant complications secondary to cystocentesis were reported. No association was found between severity of azotemia, or volume removed by cystocentesis, and the presence of effusion at presentation or after decompressive cystocentesis was performed. Conclusions and Clinical Relevance:A single decompressive cystocentesis prior to catheterization did not lead to development of clinically significant abdominal effusion or other discernable complications and appears to be a safe procedure in this population of patients. Abdominal effusion may be found at presentation in cats with urethral obstruction. The significance of this effusion remains to be determined. K E Y W O R D Sabdominal effusion, decompressive cystocentesis, male cats, UO, urethral obstruction Abbreviations: FAST, focused assessment with sonography for trauma;

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“…In 5 analyzed samples, it was possible to detect the presence of uroperitoneum (8.3%), caused by ruptures in the urinary tract due to traumas or urinary obstructions [2]. The presence of urine in the abdominal cavity promotes the dilution of the liquid in the cavity, which is classified as pure transudate immediately after the rupture, due to the decrease in protein concentration and cellularity.…”

Section: Discussionmentioning

confidence: 99%

Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count

Nunes

Duda

Matheus

et al. 2018

Acta Scientiae. Vet.

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Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (p = 0.95%).Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification. When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF). The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them.

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Management of Urinary Tract Emergencies in Small Animals

Cited by 26 publications

References 44 publications

Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction

Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction

Association of abdominal effusion with a single decompressive cystocentesis prior to catheterization in male cats with urethral obstruction

Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count

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