Is there consensus on feline urethral obstruction treatment?

Feline lower urinary tract disease (FLUTD) describes a collection of conditions that can affect the bladder or urethra in cats and may be described as either obstructive (Figure 1) or non obstructive depending on the clinical symptoms presented. The annual incidence of FLUTD in British cats is believed to be around 1% (Gunn-Moore, 2003), with obstruction of the penile urethra accounting for 18–58% of these cases (Williams, 2009). Clinical signs of this condition include stranguria, dribbling of small amounts of urine, lethargy, inappetance and vomiting (Ford and Mazzaferro, 2006). A thorough knowledge of the treatment of urethral obstruction is therefore essential in order to care for each individual patient appropriately, however, some controversy surrounding treatment does exist. Two differing viewpoints have emerged over the years concerning treatment with the first being represented by Lekcharoensuk et al (2002) who found that medical management, mainly change in diet, was successful in treating this condition, reducing the need for surgical intervention. The second point of view disagrees somewhat with this position; Gerber et al (2008) conclude that although perineal urethrostomy does not entirely eliminate the risk of re-obstruction, the incidence of re-obstruction is reduced in cats who undergo urethrostomy compared with those cats who do not. The fact that such controversy exists concerning this issue is a healthy sign that more rigorous examination and studies are still occurring within the clinical and research communities.