Effect of intermittent bladder flushing on recurrence rate in feline urethral obstruction: 72 cases.

Objective
To evaluate the effect of intermittent bladder flushing on recurrent urethral obstruction (rUO) at 7 d and 30 d after discharge and the risk of bacteriuria as a result of indwelling urethral catheterization.


Animals
There were 72 cats with suspected obstructive feline idiopathic cystitis admitted to the hospital.


Procedures
Cats were randomly assigned to either intermittent bladder flushing (n = 34) or no-flush (control) groups (n = 38). Bladder flushing was performed with 5 mL/kg of sterile 0.9% saline, q8h during indwelling urinary catheterization. Urine was tested for bacteriuria by a point-of-care test at the time of urinary catheterization and via cystocentesis following catheter removal before discharge. Risk of rUO by groups and its association with other variables were evaluated.


Results
The age (median: 3.0 years) in the flush group was younger (P = 0.01), and the length of hospitalization (> 24 hours) was longer (P < 0.01) than that of the control group. Overall rUO was 6.6% on Day 7 and 21.8% on Day 30 after discharge, but there was no significant difference between groups. A shorter duration of catheterization (< 24 hours) was associated with higher risk of rUO (odds ratio: 6.0). The incidence of catheter-related bacteriuria was 14.5% and was not significantly different between groups (13.8% and 15.2% in the flush and control, respectively).


Conclusion and clinical relevance
Intermittent bladder flushing during hospitalization appears safe but did not decrease the incidence of rUO. The incidence of bacteriuria following catheterization was not affected by intermittent bladder flushing.