Perineal urethrostomy by emergency/critical care clinicians as an early treatment option in cats presenting to the emergency room for urethral obstruction

The purpose of this study is to determine the success rate of “unblock and go” approach to UO, and if that fails, to determine outcome after early PU surgery performed by a non-board-certified surgeon. Cats can be referred directly for unblock and go or can be referred for PU if unblock and go done elsewhere fails within 6 months of discharge.

Cats presenting with urinary obstruction will be unblocked with placement of a temporary urinary catheter and will be sent home same day with medications. They will have point of care bloodwork drawn, a lateral abdominal radiograph taken, and urinalysis submitted.

Cats presenting with another urinary obstruction within 6 months of previous presentation will undergo perineal urethrostomy surgery to widen the urethra and will be sent home same day with medications. They will have point of care bloodwork drawn.

Follow up via phone or email will be conducted at 2 weeks, 1 month, and 3 months post discharge.

Inclusion Criteria

• Male cats with urethral obstruction
• Cats who would otherwise have been euthanized due to financial limitations OR could only opt for unblock and go.
• Owners must agree to follow-up with updates via email or phone

Exclusion Criteria

• Elevated potassium level greater than 5.9
• Elevated creatinine level greater than 5.0
• Moribund presentation
• Cardiovascular disease/compromise

Client Benefits

1. If unblock and go is performed at Tufts, owners pay for exam fee, bloodwork, and urinalysis but do not pay for the procedure, lateral radiograph, or medications to go home. The study does NOT cover costs of procedure done elsewhere.
2. If PU pursued, owners pay for exam fee and bloodwork but not for the procedure or medications to go home. If cystotomy is necessary due to the presence of uroliths, this will be performed as well. This procedure is only done at Tufts and the study does NOT cover costs of procedure done elsewhere.

Sample or Data Requirements

• Owner must agree to follow up via phone or email at 2 weeks, 1 month, and 3 months post discharge.
• If unblocking performed somewhere else, must fill out info sheet that will be circulated to surrounding hospitals.