How can we treat the cases of urine retention in cats except passing the urinary catheter?
First we would want to determine the cause of the urine retention, as there are many possible causes. Urethral obstruction in male cats due to urethral irritation/spasm, uroliths, or plugs would be the most common scenario. I recommend that these patients have a thorough physical evaluation, especially hydration status, cardiac status, etc. Serum chemistries and electrolytes are extremely useful to determine status before any interventions. At a minimum, I recommend PCV, TP, electrolytes, ionized calcium, blood glucose, and BUN. Radiographs should also be performed to determine if uroliths are present, their location, and number. Get the full urethra on the film.
If a urethral problem is suspected, there is a published protocol for treatment without catheterization:
Cooper ES, Owens TJ, Chew DJ and Buffington CA. A protocol for managing urethral obstruction in male cats without urethral catheterization. J Am Vet Med Assoc. 2010; 237: 1261-6.
In that paper, 15 male cats WITHOUT urinaly calculi or severe metabolic derangements were treated with acepromazine, buprenorphine, and medetomidine as well as decompressive cystocentesis and subcutaneous fluids as needed. The cats were placed in a quiet, dark environment to minimize stress. The approach was successful in 11 of the cats (they urinated on their own and were discharged from the hospital within 72 hours). In the remaining 4 cats, 3 developed uroabdomen and one developed hemoabdomen. So clearly, appropriate patient selection is critical for this approach and it is not without risks. The authors recommended this protocol as an alternative to euthanasia when financial constraints prevented more extensive treatment.
Best wishes
Susan
