Thursday, February 28, 2013

1403. SOP - Urethral obstruction in a male cat

Written: Feb 28, 2013  10.49 am reviewing this case to compare to the cat with bladder stones operated.

Feb 28, 2013

Urethral obstruction in cats may be quite common. A lady phoned me near midnight about her cat's difficulty in urination 2 days ago but she did not want to go to the emergency clinic I referred her to. So, I presumed this 13-year-old male neutered black and white cat to be the owner who came on Feb 28, 2013 as he cat could not pass urine and had blood in the urine passed.

"No, I did not phone you," the lady in her late 40s said to me as I palpated a bladder the 50% the size of a Thai mango.

"How long had he been having this problem?" I asked.
"Two days."
"Did he vomit?" I wanted to ascertain the kidney involvement as owners seldom volunteer this info.
"He vomited 3 times yesterday."
"He must be eating dry cat food since young," I predicted.
"Yes," she said. I feed dry IAMS and ikan bilis since he was young."
"He seldom drinks water," I said.
"You are correct."

This was a gentle old cat. He did not like me massaging his penile area to loosen the urethral plug and hissed.

Standard Operating Procedure (SOP). Emergency treatment usually

1. Sedate the cat. Collect blood and urine if possible. Blood collected. No urine
2. I Injected SC baytril and tolfedine. I used xylazine 0.1 and ketamine 0.4 ml IM. Sufficient.
3. Collect urine via catheter. This was not possible as the urethra was severely blocked at the bend of the penile area.
4. Put saline into syringe and flush into catheter to unblock. This was successful. Do not force catheter inwards as this tramatise the urethra as I had seen a vet doing it. Sedate first.
5. Urine flows out. Collect for urine analysis.
6. Irrigate bladder with saline and suck out any sand and blood
7. Stitch 3 areas catheter with absorbable to anchor catheter for 2 days. Blood still flows out on Day 2 (today).
8. Hospitalised overnight and goes home next day.

Urea 59 (7-11)
Creatinine 1003  (7-160)
Platelets 93  (300-800). Cat's mucous membranes were pale. Nose looked pale as compared to normal cat.

pH 6.5  SG 1.012 (not reliable as saline was used to unblock obstruction)
Blood 4+, Bacteria 3+, no crystals
(No crystals does not mean no bladder stone. Palpation of bladder on Day 2 - no hard stones). No urethral obstruction as catheter is in place.

X-RAYS not done to reduce cost for this first occurrence. Will do if recur.

Change slowly to canned food. Urine analysis 1 month later. K/D for 10 days. Seldom gets followed up as most owners don't comply.    

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