Case of the month – Poor Tank can’t wee!

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37 Main Rd
SA 5172

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8556 2075
8556 2654

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16 Heathersay Ave
Aldinga Beach
SA 5173

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8556 5498

Tank, a lovely 2-year-old ginger cat came to see us not that long ago for a serious problem. Poor Tank couldn’t pee! That’s right, he had a blockage of his urethra (the tube leading from the bladder out to the penis). According to his owner, Tank just hadn’t been himself that day. A much loved cat - he was under a close eye (especially from the young son!) and all day he’d seemed miserable and had been constantly scratching around in his litter box. Towards the end of the day, his owners noticed Tank was straining and trying to pee in his tray but nothing was coming out. This rang alarm bells and they did the right thing by rushing him into the clinic!

The problem that Tank had was (unfortunately) one of the more common problems that we see in male cats. He had a urinary blockage. This is a complex problem that can be caused by a number of different things. The most common being crystals usually made up of struvites which clump together with mucus and form a plug in the narrow male cat urethra. The opening in the urethral tube is so small that it does not take a lot to completely or partially obstruct urine flow.

Struvite is a mineral composed of ammonium, phosphate and magnesium. These three substances are common in urine and if they exist in high enough levels, they’ll bind together to form the crystal. However, Struvite crystals can sometimes be found in urine and don’t always cause a problem. It is when these crystals combine with mucus and form a urinary plug that they can cause a blockage in a male cat’s urinary tract.

Urinary blockage is included in a group of conditions we term Feline Lower Urinary Tract Disease (FLUTD for short!) There are two types of FLUTD; non – obstructive and obstructive (Tank’s condition was obstructive!). Often the cause for non – obstructive FLUTD is idiopathic (which is really just a fancy name for “unknown”). It causes symptoms of straining to urinate, bloody urine, urinating in unusual places, and licking the urinary opening. This can happen in both male and female cats. Occasionally a bacterial infection causes the problem, rather than crystals. Tank had the obstructive form of FLUTD, which only happens in our poor male feline friends!

Ok, so back to Tank. When Tank came to see us he seemed quiet and miserable. After a quick assessment we were able to feel a large painful bladder in his abdomen that could not be expressed when pressure was applied (in a normal cat, gentle pressure on the bladder will cause it to empty). Luckily his owner had brought him in early so the nasty toxins hadn’t yet had a chance to build up in his blood stream. If the urinary blockage persists for longer than 24 hours, urinary toxins will start to build up and cause serious complications – (vomiting, nausea, appetite loss, life-threatening heart rhythm disturbances) and eventually death if left untreated.

We needed to start treatment immediately! Tank was admitted to the hospital.

Sometimes we’ll do a blood test to check the kidney enzymes and to check potassium levels in the blood – potassium can build up and cause a direct action on the heart. As Tank’s owners were great to pick up the problem early, this blood test was not as necessary. Firstly he was put on an intravenous drip (cats can dehydrate rapidly) and we wanted to ensure his kidneys remained as healthy as possible. We gave him a light sedation and then 15 minutes later a general anesthetic. A urinary catheter (little plastic tube) was used to ‘unblock’ the urethra and relieve the obstruction. Tank’s bladder was flushed with saline a number of times to ensure all of the crystals were removed. Once this was completed, we stitched his urinary catheter into place so it couldn’t pull out. Tank woke up well from his anesthetic and must have felt much happier to know he could now pee!!

When we unblocked Tank’s urinary tract and drained away the built up urine, we saved a small sample to analyse. We found that Tank’s urine had Struvite crystals in it, which caused the problem. So the question arises – if Struvite crystals are sometimes found in normal urine, why do some cats have a problem? There are several factors at play here. The pH of the urine (acidity), the presence of proteins around which the crystals can stick and urinary water content are all important issues. All of these factors combine to produce urine that is supersaturated with crystals. On further questioning, Tank’s owner did say that he wasn’t a big drinker! Cats that don’t drink a lot or are on a dry food diet are more likely to have this problem.

So Tank stayed with us in the clinic for 2 and ½ days. He was a lovely patient and very tolerant of us checking his urinary catheter twice a day. The most important thing was to ensure he didn’t block up again. However, on the second night here, Tank decided he’d had enough and managed to pull off his plastic (buster/Elizabethan) collar and pulled out his urinary catheter himself – stitches and all!! What a naughty patient! We forgave him as thank goodness he was urinating normally without the catheter. That day we discharged him; his owners were thrilled to have him home. Tank continued to improve over the following week.

Tank is now on a special diet and his owners are encouraging him to drink plenty of water to hopefully prevent this from ever happening again. Struvite crystals form when the pH of the urine is too alkaline (high pH), therefore we put cats on a special diet (prescription diet) to acidify the urine. Sometimes we also give them special tablets to help acidify the urine. It is very important that this is all they are fed – luckily Tank likes his new diet!!

We saw Tank one week after his ordeal – he’d completely recovered. He was bright and happy and most importantly – peeing normally! His owners had watched him like a hawk. We’ll do some more urine tests in the future to ensure he’s not getting another build up of crystals and that his urine pH is maintained in a tight range. All in all, this was a success story. Not all blocked male cats are quite so lucky. It is very important to realise this lethal problem can occur very quickly and any signs of difficulty urinating, blood in the urine, urinating in strange places or licking excessively at the penis are all reasons to get them checked out immediately.

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