Saturday, April 20, 2013

1378. The FLUTD cat returned with a blocked bladder again.

With heartlanders, the least cost veterinary medicine is practised. For one and a half months after the cat fainted from a blocked bladder, the white grey cat now had difficulty peeing for the last 5 days. Dr Daniel handled the case and he decided to catherise the urethra to unblock the bladder. There was great difficulty in catherisation. The cat had no complaints but she would stop feeding the 10 cans of C/D diet and feed other canned food since the C/D was expensive.

"Clear" urine  leaked onto the table. "He was licking his penis," the owner said. I turned the cat upside down and noted that his penile tip was bright red. Clear urine dribbled onto the examination table.

I taught my new veterinary assistant Nai how to use the urine dipstick to check the urine for pH, SG, blood, protein, white cells and others. Nai is a young veterinarian graduated from Myanmar. He is new to this job and has lots to learn. It takes great patience to train a rookie from the internet generation. He would mumble in Myanmarese whenever I told him off for not doing a good job after I had taught him how it should be done. Many young people has a different mindset nowadays. They would do a task their own way and so needed to be supervised closely as a recordingsystem and process must be adhered to if the practice wants consistently a high standard of care.  

One day I told him that he should quit as there are others who can speak good English. They have the advantage of being able to handle phone queries and client discharge. If he wanted to stay, he should not grumble as nobody wants to employ or  train him if he has this attitude. "This is not your father's office," I said to him. Other practices would have sacked him.

Recently he understood that he had to change his mindset. Working in an established Singapore small animal practice like mine gave him the opportunity to see various cases and challenging surgeries as compared to working in a Yangon practice where it is difficult to handle complex cases due to financial constraints of the average pet owner. A cat spayed in Yangon costs S$20 which is at least 5 times cheaper than in Singapore.  In 2 years, he would have gained much veterinary knowledge and would open his own clinic in Yangon. Presently there are around 100 small animal veterinary practices in Yangon from one of my sources. Singapore has more than 50.

Back to this cat. There was a need to cut medical costs as the owner was worried. In theory, this cat should be sedated and catherised as in the earlier incident.

To save costs, I gave injections to reduce pain and infection followed by oral antibiotics and 10 cans of C/D.  The owner had complained that the C/D was costly as compared to the commercial canned foods.

It is like comparing apples to oranges. The C/D is specially formulated to prevent FLUTD (Feline Lower Urinary Tract Disease). .

The owner swore she had not fed the cat any dry food. But only canned food. But her other two cats were eating dry food. "Can you guarantee that this cat has not eaten any dry food?" I asked. She was not sure. Failure to comply with medical instructions lead to a recurrence of FLUTD.

This cat could have bladder stones but no X-rays were done to save money. If there is a 3rd recurrence, X-rays would have to be done.

Contrast this case to the other cat with bladder stone removed by me in an earlier report of these 2 cats. No news from the other cat at all. No problem. No news is good news.          
See case at:

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