In-hospital medical management of feline urethral obstruction: A review of recent clinical research

Evidence-based medical practice requires that clinical research be conducted to help guide veterinary recommendations. Unfortunately, clinical research on the treatment of feline urethral obstruction (UO) is limited. Over the past decade, a body of clinically relevant scientific literature related to the in-hospital management of feline UO has been published. This review of the literature from December 2007 to February 2019 encompasses management options, stabilization, anesthetic considerations, unblocking procedures, urinary bladder lavage, intravesical treatments, post-obstructive diuresis, urinary catheter management, catheter-associated bacterial complications, and oral medications. Studies are briefly summarized with respect to their main findings and limitations. Common recurring limitations observed include small sample sizes leading to insufficient power and potential type II errors, lack of standardized treatment protocols, and assessment of multiple inter-related confounding variables. The authors' intent is for this article to inform practitioners and inspire future clinical research initiatives which address these limitations, possibly with large-scale multicenter studies, standardized treatment protocols, and multivariate regression modeling.