DiCiccio Victoria K, McClosky Megan E
Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
JFMS Open Rep. 2022 Aug 9;8(2):20551169221112065. doi: 10.1177/20551169221112065. eCollection 2022 Jul-Dec.
A 2-year-old neutered male domestic shorthair cat presented for a history of several weeks of infrequent urination and hyporexia progressing to anorexia. The cat had been normal prior to being placed on fluoxetine to treat inter-cat aggression, after which it began to display weight loss, hyporexia and abnormal urination habits. The cat had been seen by various veterinary hospitals previously and treated for suspected feline lower urinary tract disease. When the patient still had urinary retention despite perineal urethrostomy surgery, it was presented for ongoing care. Contrast urethrogram showed a mild questionable proximal ureteral narrowing, but other diagnostics were unremarkable. The patient was trialed on various medications, including alpha-antagonists, cholinergics, non-steroidal anti-inflammatory drugs and different analgesics with no improvement, but would reproducibly urinate only following administration of midazolam intravenously. Ultimately, the cat began urinating normally following the discontinuation of fluoxetine. The cat was urinating normally upon discharge, and when it presented for another complaint several months later, its weight, appetite and urination habits were normal.
Fluoxetine is a commonly utilized medication in behavioral medicine. Despite its common use and reports of urinary retention secondary to this medication in humans, this potential side effect is not reported in various veterinary pharmacologic textbooks or the veterinary literature. To our knowledge, this is the first report in veterinary medicine to describe urinary retention suspected to be secondary to prolonged administration of fluoxetine at an excessive dose.
一只2岁已绝育的雄性家猫前来就诊，有数周尿频不常见且食欲减退并逐渐发展为厌食的病史。这只猫在开始服用氟西汀治疗猫间攻击行为之前一切正常，之后便开始出现体重减轻、食欲减退和排尿习惯异常。此前它曾在多家兽医医院就诊，并因疑似猫下泌尿道疾病接受治疗。尽管进行了会阴尿道造口术，但该猫仍存在尿潴留，遂前来接受持续治疗。尿道造影显示近端输尿管轻度可疑狭窄，但其他诊断结果无异常。该患者试用了多种药物，包括α拮抗剂、胆碱能药物、非甾体抗炎药和不同的镇痛药，但均无改善，不过仅在静脉注射咪达唑仑后可反复排尿。最终，停用氟西汀后这只猫开始正常排尿。出院时这只猫排尿正常，几个月后因另一种病症前来就诊时，其体重、食欲和排尿习惯均正常。
氟西汀是行为医学中常用的药物。尽管其使用普遍，且在人类中有关于此药物导致尿潴留的报道，但各种兽医药理学教科书或兽医文献中均未提及这种潜在的副作用。据我们所知，这是兽医学中首次报道疑似因过量长期服用氟西汀导致尿潴留的病例。
