Is dantrolene still used for FLUTD cat?

RE: Dantrolene for FLUTD cat

Beats — Tue, 30 Jul 2024 21:38:18 GMT

you don't need deceptively straight-forward line drawings and terminologically-correct-but-incomprehensible descriptions in a textbook these days... you need youtube

Charles Kuntz has excellent freely available high quality surgical videos, with commentary, of the procedure at vetdojo on youtube and probably now at vetalign also on youtube. He deserves an honorary FRCVS for that resource.

It's the necessary aftercare until it has healed, and inevitable inconvenience of the timing of that next blockage, that puts me off offering this as a budget procedure personally.

RE: Dantrolene for FLUTD cat

Virginia Campbell — Tue, 30 Jul 2024 20:38:18 GMT

Thanks for all replies.

In answer to why no perineal urethrostomy- cost. (I typed a longer explanation, then deleted it. In times past I would've said here look if he blocks again, if you want I'll have a lash at a perineal urethrostomy for a few buttons as long as you understand that I have offered and you have declined the option of referral to somebody who doesn't need a textbook peopped open in front of them. Those times are gone).

RE: Dantrolene for FLUTD cat

Anthony Dennison — Fri, 19 Jul 2024 15:25:13 GMT

[quote userid="8991" url="~/f/clinical-questions/30989/dantrolene-for-flutd-cat/245066#245066"]Cumulatively with other studies the best we can say is that there appears to be no difference in rate of re-blocking with P use, not that it increases the risk of reblocking. The Conway study is probably guilty of type 1 error. [/quote]

So in terms of contextualised care, is it worth the cost of it?

Suppose you could say the same about clopidogrel in cats with FATE, or is the evidence stronger there?

RE: Dantrolene for FLUTD cat

David Mills — Wed, 10 Jul 2024 14:38:47 GMT

[quote userid="9440" url="~/f/clinical-questions/30989/dantrolene-for-flutd-cat/245061#245061"]I thought hypovase had been evaluated and is now considered unhelpful?[/quote]

https://veterinaryevidence.org/index.php/ve/article/view/638

There was a recent retrospective study (Conway et al 2022) that suggested prazosin increased risk of reobstruction within 14d which generated a bit of noise but the headline is undermined by the data. It was a retrospective study with a variety of treatments given alongside P, the non-P group was significantly younger, where there was a difficult unblocking/grittiness when unblocking the effect disappeared. The non-P group was also 86, the P group 302, and an undocumented number of cats were lost to follow up. There was no power calculation.

Cumulatively with other studies the best we can say is that there appears to be no difference in rate of re-blocking with P use, not that it increases the risk of reblocking. The Conway study is probably guilty of type 1 error.

The relative complexity of UO especially management post-discharge (and compliance) make any studies into the condition difficult to say the least.

P may do something, it may not, theoretically as it does nothing for the distal urethra (no smooth muscle) its effectiveness may be limited. Dantrolene has more theoretical advantage in relaxing the distal urethra.

[quote userid="3169" url="~/f/clinical-questions/30989/dantrolene-for-flutd-cat/245064#245064"]Why not perineal urethrostomy? Can do in general practice[/quote]

I agree with this. Very straightforward procedure. It also removes the distal urethra meaning P is more likely to have an effect too.

RE: Dantrolene for FLUTD cat

Michael Woodhouse — Tue, 09 Jul 2024 21:04:52 GMT

[quote userid="2186" url="~/f/clinical-questions/30989/dantrolene-for-flutd-cat"]if he blocks again he'll be euthed[/quote]

Why not perineal urethrostomy? Can do in general practice

Personally I'd give a course of antibiotics and see if it makes a difference.

RE: Dantrolene for FLUTD cat

janine redman — Tue, 09 Jul 2024 18:48:41 GMT

Oral buprenorphine most helpful , though have used dantrolene in dogs

RE: Dantrolene for FLUTD cat

janine redman — Tue, 09 Jul 2024 18:47:45 GMT

I thought hypovase had been evaluated and is now considered unhelpful?