1180. ** A FLUTD cat recovers from acute kidney failure

Friday Mar 27, 2015
2nd in-patient period at Toa Payoh Vets
Male, not neutered cat, 1.5 years old
Owner wants him to stay another 2 days. He went home after 2 days in-patient during the first visit.

History
Bladder obstruction some 2 weeks ago. The first vet had unblocked the bladder and sent the cat home after 5 days in-patient.
Yet the cat was still passing blood in the urine and had inflamed prepuce. He was not eating and was dehydrated.

The owner consulted me as a 2nd opinion on Mar 17, 2015.

I had palpated much enlarged painful kidneys (X-rays in another video). Therefore, the urethral obstruction blocking the flow of urine, putting back pressure enlarging the kidneys 3-6X and also causing bacterial infection and kidney failure (blood test results of high blood urea nitrogen and creatinine, leucocytosis and neutrophilia from the first vet).

After the first vet sent the cat home, the cat would not eat and it was difficult to give medication orally. Anorexia, tongue and lip ulcers are signs of uraemia as the cat had acute kidney failure. The cat was dehydrated and hypothermia (below 38C). Lethargy. No hope of survival?
This was acute kidney failure due to bacterial infections of the kidneys.

The first vet's clavulox antibiotics and treatment did not eliminate the bacteria. I got a bacterial culture and antibiotic sensitivity test of the urine. The bacteria was resistant to clavulox.


The video shows the cat after 2 days of treatmet at the 2nd in-patient treatment at Toa Payoh Vets

After antibiotics of Baytril, SC fluids of 200 ml for the next 2 days, the kidneys reduced in size (by palpation).The cat was not happy when the kidneys were palpated as there was still nephritis (see video).

 

 

CONCLUSION
The enlarged kidneys would be due to the back pressure of the urine from the obstructed bladder. The owner did not know that the cat had difficulty in urination as he shares a common toilet floor with the other 3 cats. The first vet relieved the obstruction and had treated him as an in-patient for 5 days.

This was a gentle cat and so did not claw the vets during fluid therapy. As the family could not accept pork in the prescripition diet, the Royal Canin Renal diet was reported not to contain pork. This was fed to this cat since he went home after the 2nd in-patient treatment.


FOLLOW UP
April 23, 2015
SMS
The owner was contactable by SMS. The cat is back to normal, eating only the Royal Canin Renal food. Normal temperature. So, it is good outcome. This cat is a favourite of the father as this cat meows as if talking to a person whenever he is spoken to. Unlike the other 3 neutered cats in the apartment. 

So, he is much loved by the father who told me that he did not want to neuter him as he would become dumb like the other 3 cats.

There is a learning lesson here. Many young Singaporeans do not greet or say good morning to the parents or superior officers. Be communicative and you will be most appreciated by the hand that feeds you or mentors you.