The Cat That Can't Pee For
2 days
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:
05 May, 2011
Case was first recorded: Around 2000 |
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Be Kind To Pets
Veterinary Education
Project 2010-0129 |
On Sunday, May 1, 2011
(Labour Day in Singapore), a man in his early 50s phoned me as his cat
could not urinate normally for the past two days.
I had
a discussion with Dr Vanessa Lin on the management of this
case as I would be having the afternoon off. As each vet
handles a case of urethral obstruction differently, I wanted
to make sure that this case would be handled the way I would
have had done since this worried gentleman phoned me and I had
assured him that there would be no problem in his case.
When the
patient recovers, everybody is happy. But should the patient
gets worse or dies, litigation and complaints may occur and I
don't want that to happen to any vet in Toa Payoh Vets. As a
licensee, I am ultimately responsible for any complaints
against my vets and staff and the working life is full of
changes and worries when there are more members in a team.
There are certain standard operating procedures I will
want to advise the owner and be recorded in case of medical
negligence litigation. So I had to inform my associate vets as
I was taking the afternoon off. These are:
1. urine collection for analysis of crystals, bacteria
and blood - mandatory. Some vets do not do this and may be
sued for possessing a lower standard of care if the cat
dies since the vet has no defence of urine or blood tests.
This is mandatory in this case.
2. blood collection for health screening is strongly
advised esp. to check whether the kidney is affected and
whether there is a severe bacterial infection. Fever may or
may not be an indicative sign of this infection. If the owner
does not want to pay for this test, this objection must be
recorded in the case sheets.
3. As to whether the urinary catheter should stay in this cat
for 2 days, I left that option to her. However, I said:
"Usually I don't stitch the catheter after thoroughly
irrigating the bladder if the urethra obstruction is a recent
event as in this case. There are different opinions as to
whether the catheter will irritate the bladder if left inside
for more than 2 days, but I leave this option up to you."
For long-standing cases, I do stitch the catheter for 2 days
and may irrigate the bladder again. See my procedures
at:
The hissing cat has
difficulty peeing again
CAUSE OF THE URETHRAL OBSTRUCTION/URINARY TRACT INFECTION?
In this cat, there was no urethral obstruction as the
catheter passed into the bladder easily. I spoke to the owner
the next day as he came for the cat. Monday, May 2, 2011 was a
public holiday as May 1 (Labour Day) happened on a Sunday.
What was the cause of this cat's dysuria problem?
"FLUTD (Feline Lower Urinary Tract Disease) usually occurs in
a male neutered cat over 5 years of age," I was
thinking that this cat could have some injury or infection.
"My cat is only one and a half years old and he is not
neutered!" the IT man said to me.
"5-years is the average age," I said. "Some cases happen
in younger cats. Is your cat busy mating with other cats and
thereby suffering from traumatic injury?"
"Well, my other cat keeps humping him every month. But this
has been going on for several months and there has been no
problem with urination."
I try to be impatient and explained: "Many
events don't happen until they are performed often enough. For
example, people don't get prawn allergies till they are eat
prawns for many times. It is possible that your cat has
traumatic injury to the penile area."
I don't want to appear soliciting for business by advising
neutering of the humping cats and therefore let sleeping dogs
lie. This cat's dysuria was likely to be a case of traumatic
injury but it was pure conjecture at this stage.
FOLLOW UP:
Calcium oxalate ++ crystals were present in the cat's urine.
The first of 3 FLUTD cases, described in
The hissing cat has
difficulty peeing again
had no crystals in the urine during my examination. Dr Vanessa
prescribed the Hills' CD and would do other tests. I was glad
that she had done the urine tests as not all vets test for
urine for urethral obstruction for various reasons, as seen in
my 3rd of the 3 FLUTD cases, described in
3rd FLUTD - The cat drips urine all over the apartment.
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