Thursday, February 2, 2012

The things we do....

A few days ago, I saw a 2 year old male cat for straining to urinate. After a physical exam, he was quickly diagnosed with urethral obstruction, a life-threatening emergency and a common problem in emergency medicine.  I spoke with the client, a woman in her 50's who was acompanied by a child.  At first, I thought the kid was poorly behaved; he beat on the doors, screamed, slammed the chair into the walls, and made it nearly impossible for me to speak to the client.  His yelling was louder than I am capable of speaking, and many times I stopped, waited for a pause in the yelling, and then would continue.  After a few minutes, I realized the child likely was autistic, not poorly behaved.  I tried to be as understanding as possible however his activity made discussing the situation with the client very, very difficult.

Urethral obstruction in male cats is a complex process.  Many times, urethral obstruction is due to a build up of crystals in the urinary bladder, urethral spasm, and blood clots that form a plug in the urethra.  Inability to urinate quickly results in pressure on the kidneys, causing build up of dangerous toxins, electrolytes, and eventually, if left untreated, kidney failure and death.  More information is available at veterinary partner.

The treatment for urethral obstruction is pain control, resolution of electrolyte abnormalities, and anesthesia in order to pass a urinary catheter and relieve the obstruction.  Cats should remain hospitalized for 24-48 hours, depending on the duration and severity of their condition to allow urine to be flushed, kidneys to be healed, and to decrease probability of a second obstruction.  Urethral obstruction can reoccur, and often cats who experience this condition will be placed on a prescription diet, or a canned food-only diet.  Some cats experience multiple obstruction episodes and require surgery to enlarge their urethral opening.

The client began to cry, and her autistic son began to scream.  "I don't have any way to pay for this" she said.  "The cat helps my son, and I just don't know what to do. There's nobody who can help me. I just can't let him go."

The preferred medical treatment was out.  I had to find a way to help this kitty with a budget that could barely cover the exam fee.

I gave the kitty pain medication, and emptied his bladder with a small needle and syringe to relieve the pressure.  I applied a local numbing agent to his penis, and then attempted the impossible- catheterizing an awake cat.  This method is not recommended, as it is painful and usually unsuccessful.  I'm sure most of you can imagine trying to even touch a cat when they don't want you to.... add on top of that, trying to insert a catheter into a cat's penis!  Nevertheless, I had to give it a try, for if I couldn't find a way to unblock this kitty, he would face certain euthanasia. 

I discussed with her the risks of this, and we discussed euthanasia as well.  While her autistic child screamed, she cried, explaining to me how this cat helped her son cope with his disability. I couldn't bear not giving the cat a chance.

We attempted the procedure, and fortunately, were successful.  I sent them on their way with medications, instructions, and strict monitoring parameters.  She called me 3 weeks later to let me know that despite the odds, her kitty had not required further care, and our willness to help her had saved her cat's life.  She thanked me, and I knew we had done something very important for her family.

1 comment:

  1. That is an awesome story. Good for you for helping them out and getting that catheter in! Wow!