April 11, 2013 9.30 am review of hospitalised case
Toa Payoh Vets
"The day before, he was OK and came to me for food," the angry man in his late 50s, carrying his 3-year old grand-daughter in his left hand said to me on this morning of April 11, 2013. "Now, he can barely stand up. He passed "
Due to the sudden onset and the very low rectal temp of 33.9 deg C, I suspected trauma. "Did somebody kick the cat or did the neighbours poisoned him?" I palpated a full bladder about the size of an orange. The penile tip was bloody. I asked Dr Daniel to review the case.
"My neighbours feed him and don't do that. He has been around for the last 3 years going out to the 2nd storey but never to the 6th storey.
"An HDB official had visited him recently. The cleaner had complained that his cat had pooped on the 6th storey corridor. I suspect it is the cleaner!"
In the afternoon, Dr Daniel catheterised and unblocked the bladder. Lots of pinkish red urine. "Urinary tract infection" he said to me. "The cause is likely to be due to traumatic injury to the kidneys or bladder as the cat is very depressed. It is of sudden onset and unlikely to be UTI". Dr Daniel works in the afternoon and therefore he did not meet the owners when the cat came in at 10am.
Evidence-based medicine is practised. Urine sample sent to the lab.
Urine red, turbid. pH=8.0 (5-8), SG 1.015 (1.005-1.03). Protein 2+ (Negative), Blood 4+, WBC 252, RBC >2250, Bacteria Occasional. Crystals nil.
From these results and based on history of a suspected cleaner and sudden onset lethargy and inability to stand up, I would say there is kidney trauma as the Protein 2+ should be negative. UTI would be a secondary finding.
In the evening, the family came. The cat was still depressed and did not meow. The grandpa said that the friend of the cleaner had asked for his forgiveness. He had lodged a complaint against the cleaner with the town council manager. "I will record his confession when I meet him. He abused cats and this recording would be reported to the police. He should be sacked."
APRIL 11, 2013 9.45 AM
I reviewed the case. Bright. Not eating. T= 38.4C. Bladder orange-sized. Still peeing blood. Kidney trauma suspected based on urine analysis of Protein 2+.
The cat would be going home this afternoon and would need to be indoors for the next 10 days if not forever. The cat was not neutered and was fed dry food. FLUTD is usually not of sudden onset and does not give rise to hypothermia. So, this was a case of renal and bladder traumatic injuries.