DOI
https://doi.org/10.18849/ve.v8i4.638Abstract
PICO Question
In male cats presenting with urethral obstruction, does administration of prazosin compared with no administration of prazosin reduce the incidence of recurrent urethral obstruction within the first month of initial presentation?
Clinical bottom line
Category of research
Treatment.
Number and type of study designs reviewed
A total of three studies were included in this appraisal. Two of which were prospective double-blind clinical studies and one retrospective study.
Strength of evidence
Weak.
Outcomes reported
Both double-blind studies found no significant difference between prazosin administration and the development of recurrent urethral obstruction (rUO) when compared with a placebo. Both studies, however, did report that cats had a shorter urinary catheterisation time with prazosin administration. The retrospective study found no association between prazosin administration and the risk of rUO and found that after 14 days post discharge, significantly more 73/302 (24%) cats that received prazosin had experienced rUO compared to 11/86 (13%) of cats that did not. One study found side effects to the administration of prazosin which may be detrimental to the overall recovery.
Conclusion
Administration of prazosin does not reduce the risk of rUO within 30 days of presentation. However, the strength of evidence is weak and would benefit from further clinical studies.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Conway, D.S., Rozanski, E.A. & Wayne, A.S. (2022). Prazosin administration increased the rate of recurrent urethral obstruction in cats: 388 cases. Journal of the American Veterinary Medical Association. 260(S2), 1–6. DOI: https://doi.org/10.2460/javma.21.10.0469
Corgozinho, K.B., de Souza, H.J.M., Pereira, A.N., Belchior, C., da Silva, M.A., Martins, M.C.L. & Damico, C.B. (2007). Catheter-induced urethral trauma in cats with urethral obstruction. Journal of Feline Medicine & Surgery. 9(6), 481–6. DOI: https://doi.org/10.1016/j.jfms.2007.09.002
Hanson, K.R., Rudloff, E., Yuan, L., Mochel, J.P. & Linklater, A.K. (2021). Effect of prazosin on feline recurrent urethral obstruction. Journal of Feline Medicine & Surgery. 23(12), 1176–1182. DOI: https://doi.org/10.1177/1098612x211001283
Hetrick, P.F. & Davidow, E.B. (2013). Initial treatment factors associated with feline urethral obstruction recurrence rate: 192 cases (2004–2010). Journal of the American Veterinary Medical Association. 243(4), 512–519. DOI: https://doi.org/10.2460/javma.243.4.512
Kyles, A.E., Hardie, E.M., Wooden, B.G., Adin, C.A., Stone, E.A., Gregory, C.R., Mathews, K.G., Cowgill, L.D., Vaden, S., Nyland, T.G. & Ling, G.V. (2005). Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984–2002). Journal of the American Veterinary Medical Association. 226(6), 932–936. DOI: https://doi.org/10.2460/javma.2005.226.932
Reineke, E.L., Thomas, B.A., Syring, R.S., Savini, J. & Drobatz, K.J. (2017). The effect of prazosin on outcome in feline urethral obstruction. Journal of Veterinary Emergency and Critical Care. 27(4), 387–396. DOI: https://doi.org/10.1111/vec.12611
Straeter-Knowlen, I.M., Marks, S.L., Rishniw, M., Speth, R.C., Wirth, W. & Knowlen, G.C. (1995). Urethral pressure response to smooth and skeletal muscle relaxants in anesthetized, adult male cats with naturally acquired urethral obstruction. American Journal of Veterinary Research. 56(7), 919–923.
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Copyright (c) 2023 Rebecca Hearne
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