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. 

Blood test values

 Normal Feline & Canine Blood Chemistry Values
Blood, Temperature , Urine and Other Values for Your Dog and Cat  by Ron Hines

http://www.2ndchance.info/normaldogandcatbloodvalues.htm

1178. A cat drinks toilet water

April 22, 2015

"Your cat has a very low platelet count and liver disorder," I showed the blood test report to the very busy bearded husband who shook my hand as he arrived at 7.25pm to take back his cat.

I know he is very busy. He works in the car parking software field which demands all his waking hours of his life as the various car parks seems to have much bugs, needing his help to resolve the problems. "Your cat has been toxic. He also has pale gums but is now pinker. Did he drink toilet water?"

I had given the cat at least 200 ml of electrolytes, amino acids and antibiotics and the cat meowed when he saw the owner.

"Some cats love to drink from the water splashed or drippinig onto the bathroom floor," I said. The man reflected and thought that this cat could have lapped toilet water.

"I have 6 cats," he said. "The other 5 have no problems."
"It all depends on how much poison the cat drinks and for how long. Why do you have 6 cats? I thought you have only one?"
"The female becomes pregnant and it is against my religion to get an abortion," the husband explained. Fortunately, my relatives have booked a kitten from my latest pregnant cat!" 
"Why don't you give some of the 6 cats away?"
"No, no," he replied. "We love them."

I can't understand why he did not neuter or spay the 6 cats. Now one is pregnant again.  
 

1177. An 8-year-old Shih Tzu has an arched back

April 21, 2015

"I better have him checked as she had been having an arched back during the past 2 days," the fair tall lady in her 30s, wearing a contrasting dark blue dress showed me a video clip of her dog walking with a "camel's bump".

"He would go to the bathroom and lie down there," she noted this unusual behaviour.
"Did he have difficulty in peeing?" I asked as house-trained dogs go to the bathroom to avoid peeing onto the apartment.

"No problem."

I palpated the dog's abdomen twice. During the first time, he winced slightly when I palpated the kidneys but the spinal column palpation showed no pain. I got the dog onto the floor to walk. He was walking normally with no hunched back.

"My dog will recover whenever he is at the vet," the lady laughed. Yet there was something wrong with him.

On the second palpation after the walking, I had my assistant do a video. This time, the dog reacted when I pressed the thoracic-lumber spinal column. There was some degeneration or pain in the spinal disc and that was why the dog hunched his back the last 2 days.

"The problem is with his disc at this T/L junction," I said. "He feels the pain and so does not walk to walk much. He walked with a hunched back and went to the bathroom to lie down. In case he needed to pee, he did not need to walk far." This was my hypothesis.

VIDEO


In Singapore, many young pet owners are well educated and do research. They use the smart phone to video unusual behaviours or clinical problems. For this lady, she would not permit me to do dental scaling since I use anaesthesia. "My groomer will do the dental work," she was afraid that her dog could die from anaesthesia.


Some dog groomers now provide dental scaling without anaesthesia and this is what some owners are interested.

 

1176. When parents separate, what happens to the ferocious cat?

The young lady phoned me. She was worried that the nervous stray cat, now housed indoors would be thrown out and left to fend for herself. "My parents are separating next week," she said. "I would not want my cat to suffer from attacks, starvation and diseases but I can't catch the cat."

When parents separate, there is a lot of damage. I recommended her a cat trapper.   

1175. A Chihuahua vomits blood after going to the park

"Heat stress" was diagnosed as the 5-year-old black and white Chihuahua vomited blood and panted after half an hour at the park.

Blood test showed elevated liver enzymes. "The dog had been panting since young," the owner said. "He is fat." 

Could this case be a case of fatty liver?

1174. A 5-year-old Chihuahua has a ruptured uterus

This Chihuahua passes pus in the vagina. Blood test showed neutrophils at 92.8% (normal 60-70%) and platelets very low indicating toxaemia. After treating for 2 days as an in-patient, the dog had to be spayed to remove the pus-filled womb.

The ruptured womb was seen only during the surgery. There was a large inflamed spot adhered to the intestines. This was separated.  The dog passed away 5 hours after recovery from anaesthesia.

The dog was a high anaesthetic risk in view of the very low platelet count. She passed away 5 hours post-op and this was very sad.