006. Management of FUS
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This article is from the Medical Information FAQ, posted to rec.pets.cats newsgroup. Maintained by Cindy Tittle Moore with numerous contributions by others.
006. Management of FUS
Obstruction of the male cat is a medical emergency. The obstruction must be relieved immediately.
Failure to produce a good stream of urine after relief of obstruction is indicative of urethral stricture and/or stones or matrex plugs. Failure of bladder to empty after relief of obstruction suggests bladder paralysis (usually temporary unless present prior to obstruction). In either event, a urinary catheter must be placed to allow continual urination.
Treatment of uremic poisoning requires IV fluid therapy with monitoring of blood levels of waste products until uremia is no longer present.
Permanent urethral damage with stricture, inability to dislodge a urethral obstruction, or inability to prevent recurring obstructions are all indications for perineal urethrostomy (amputation of the penis and narrow portion of the urethra to create a female-sized opening for urination). This procedure is usually effective in preventing reobstruction of the male cat, but this procedure should be a last resort
If FUS is indicated without obstruction, 75 to 80% of FUS cats without obstruction may be sucessfully managed by diet alone if urine reveals typical crystals and red blood cells. Unobstructed male cats or non-uremic obstructed males who have a good urine stream and bladder function after relief of an early obstruction may be managed as above initially. Cats who are symptom-free after 7 to 10 days of dietary management and who have normal follow-up urines at 21 days, may be maintained indefinitely with dietary management only.
DL-Methionine is often prescribed for cats with FUS. Most commonly, FUS-specific diets contain this acidifier. Antibiotics may be used. Distilled water for FUS-prone cats is often recommended as well.
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