Nursing a patient with feline urethral obstruction

Species: feline

Breed: domestic shorthaired

Age: 10 years

Sex: male neutered

The patient presented in an obtunded state with a bradycardia of 80 beats per minute. The bladder was large, distended and firm. Blood results revealed azotaemia and hyperkalaemia (Table 1). The patient was diagnosed with urethral obstruction and was stabilised prior to anaesthesia and a urinary catheter was placed to relieve the obstruction. The subsequent nursing care received at the out of hours hospital is the subject of this case report.

On arrival peripheral pulses were weak and thready. Mucous membranes were pale in colour, and capillary refill time was prolonged at 3 seconds. Respiration rate was 8 breaths per minute with a mild increased effort. Thoracic auscultation was clear. The rectal temperature was 33.2°C.

The patient presented from the primary practice with a 22-gauge catheter in the right cephalic vein and with an indwelling urinary catheter, a bung was placed on the end of the urinary catheter to allow for patient transportation. The veterinary surgeon prescribed intravenous compound lactate solution at an initial fluid bolus at a rate of 10 ml/kg over 15 minutes. The veterinary surgeon administered a bolus of calcium gluconate, 1 ml/kg over 20 minutes, and a longer-term treatment plan of glucose and soluble insulin was calculated. The urinary catheter was attached to a closed drainage collection system to relieve urine. The patient was admitted into hospital and had ongoing intensive care.