Patient care report for feline patient with urethral obstruction

The patient was presented with a history of frequent unproductive squatting in the litter tray for the last 48 hours, off food and vomiting, leading to collapse.

On physical examination the patient was collapsed, tachycardic, hypothermic (36.8⁰C), hypotensive and had pale mucous membranes with a delayed capillary refill time (CRT 2s). His bladder was large, hard and painful to palpate.

A 23G intravenous catheter was placed in the right cephalic vein and intravenous fluid therapy (IVFT) initiated, using Hartmann's. Blood was taken from the jugular vein for complete blood count, serum bio-chemistry, blood gas analysis and to measure packed cell volume (PCV)/total solids (TS).

It was not possible to manually express the bladder so cystocentesis was performed using a 23G butterfly catheter for immediate relief of the pressure. The urine obtained was examined for crystals under the microscope, specific gravity and dipstick, as well as sent for culture to look for bacterial infection and sensitivity to antibiotics. Methadone (0.3 mg/kg IV) was administered as analgesia, followed by general anaesthesia induction with Alfaxan (0.2 mg/kg IV) and maintenance with isoflurane while saline was injected into the urethra to break up any blockages or flush them back into the bladder. The bladder was lavaged and an indwelling urinary catheter, with a closed collection system, was placed for 2 days and then removed. Uroliths were not seen on lateral images of the urinary tract without contrast radiography.