Case File

Oscar, a male, 6-year-old cat presented to me on a Saturday midday, following the end of consults. He unfortunately had been straining to pass any urine for the last few days and now got to the point where he was unable to pass any urine. The owners aware of the potential seriousness of this situation did the best thing and brought him down to the vets.

On palpation his bladder felt very hard and he was clearly uncomfortable as well as trying to pass urine in the consult room. So, he was admitted for his bladder to be unblocked.

Most cases tend to be related to a condition called feline idiopathic cystitis. But sometimes it can be related to bladder stones instead. Feline idiopathic cystitis is a condition where the lining of the bladder and urethra (the tube connecting the bladder to the outside) becomes inflamed. Sometimes it can get so inflamed the urethra can spasm, causing a blockage. Additionally mucus can build up and can combine with crystals in the urine to form a ‘urethral plug’ which can block the urethra and so the bladder.

Neutered, indoor cats can be prone to feline idiopathic cystitis, which in turn makes them prone to becoming obstructed.

After the initial veterinary assessment, it’s vital to administer pain relief as it’s a very uncomfortable condition for the cat. If left unblocked with time the bladder can get so enlarged it can rupture, which unfortunately can be a fatal condition.

To unblock the obstruction, we have to pass a urinary catheter, from the ‘outside’ into the bladder. This procedure is uncomfortable for the patient, and in Oscar’s case to make as pain free as possible we decided to go for a general anaesthetic, (rather than sedation) so he wouldn’t be aware of what was going on, and be relaxed enough for us to pass the catheter. Now fairly early on we discovered that he had a blockage very near the end of the urethra. But with time and gentle manipulation of a catheter we were able to dislodge the plug. (See picture below)

Following dislodging the plug, we then passed a urinary catheter to prevent re-blocking.

After this we then flushed the bladder to remove as much debris as possible. When it all looked clear Oscar was recovered from his general anaesthetic.

He was then monitored overnight and his urine was collected in a collection bag attached to his catheter.

The following day he was reassessed and we found the urine was flowing very well, clear with no debris. By early afternoon the decision was taken to try him without the catheter in. Now this can always be a tricky part of the procedure as there are always risks the patient will re-block. To help we started him on muscle relaxants and continued his pain relief.  He was already on Cystophan, a medication that supports a healthy bladder wall.

We then monitored closely to see if he would pass urine. After a few anxious hours in which he showed no interest in his litter tray he passed a very long wee!