Sunday, 27 November 2011

Gin the Tom cat with urinary retention

This October Gin, a tom cat was brought in as an emergency case to the LSPCA vet clinic.  He was not suffering from a situation you automatically consider when you think of an emergency, but instead had the potentially life threatening condition of a blocked urethra.  The urethra is the tube that connects the bladder to the outside world. This blockage, which most commonly caused by a build up of calcium carbonate in the wee causing a gritty paste, leads to the bladder getting fuller and fuller, without the option to empty, causing severe discomfort and damage to the bladder muscle.  As well as the damage locally, the inability to express the urine from the body can lead to something known as ‘post renal azotemia’.  This is simply a build up in the blood of all the waste the body usually excretes, making the cat very poorly. 
Risk factors: Male cats (the urethra is longer and narrower then females), a high protein diet, high calcium diet, dry food diet and low vitamin B6 diet.
Symptoms that may be seen: blood in the wee, inability and discomfort to wee, weeing lots but expressing little, general malaise.
The bladder is very solid when felt and is also very fragile so must be handled with care!
Emergency treatment: Although the blockage must be removed, the priority is to stabilise the cats potassium and sodium levels in the blood with fluids. After which the cat is sedated, with a muscle relaxant and a  cat catheter (a narrow plastic tube) is  advanced into the urethra.  With flushing and slowly advancing the blockage should hopefully remove.
As the bladder muscle has been stretched and sprained, for a few days post block removal it is common that the bladder does not function as normal, simply refilling without contracting to empty.  This means that these cases need several days hospitalisation with the catheter left in place to allow the bladder to drain, whilst administering drugs that will help stimulate the bladder to contract and the urethra to relax, to help function return to normal.  This may take a while, as you would appreciate if you’ve ever sprained an ankle or wrist! Gin was with us for a week before he was ready to go home and was a very patient cat despite all the poking and prodding!
As well as draining and stimulating the bladder, due to the insertion of a ‘foreign’ object into the bladder it is important the cat is protected against infection so Gin was also placed on a course of antibiotics. 
This is not the end of the story though as if the risk factors are not addressed (bar the being male part!) the condition has a high potential to recur. 
Prevention: Feeding wet canned food (this causes a more dilute urine meaning the calcium carbonate is not as saturated as to form a pasty plug) and decreasing the calcium and protein content of the diet.
We are very pleased that Gin is now home safe and well- one of our first patients at the new clinic and such a star of a cat!

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