Taz’s toiletting troubles
Taz was 10 years of age when he presented to Northwest Surgeons in 2011 with difficulty in urinating (dysuria). As a younger cat, 8 years previously, Taz had experienced a blockage of his urethra, the tube going from the bladder to the outside. The blockage had been due to crystal / stone formations (uroliths). The stones lodged in the urethra had been flushed back towards the bladder and retrieved surgically (cystostomy).
A special formulated diet can be used to reduce further crystal formation and dissolve existing small crystals in the urine. Despite eating this diet following the recovery from the cystostomy, Taz started to experience episodes of straining to urinate (stranguria) in 2011. Taz’s owner had also noted that for many years that Taz never urinated with a good stream of urine, just a thin, dripping stream.
When Taz presented to the soft tissue surgery service at Northwest Surgeons, he was quite relaxed despite his discomfort in the inability to properly pass urine. Taz is a lovely natured cat and allowed a full examination. Taz was quite a large feline weighing over 8kg when we first saw him in consultation. We are pleased to say that since being treated for his uncomfortable urinary problem at Northwest Surgeons, that Taz has been feeling more energetic and has lost 300g in one month.
To investigate Taz’s urinary problem abdominal ultrasound was performed under sedation. The ultrasound revealed a thickened bladder wall affecting the entire surface area – a sign that this was a long term problem. There was also an obvious amount of sediment and sand in the bladder. An ultrasound guided cystocentesis (sterile urine sample collected by a needle into the bladder) was performed and the sample submitted for bacterial culture and microscopic analysis.
Plain lateral abdominal radiographs were taken under general anaesthetic which revealed two uroliths (stones) present in the penile urethra, one of which was very large. A retrograde study was also performed. This involves injecting air and water soluble contrast liquid into the bladder via a urethral catheter to obtain a clear outline of the bladder and urethra. This confirmed there were no other strictures present in the urethra.
Given Taz’s history and the fact that he had two uroliths lodged in his urethra, the surgery of choice for Taz was a perineal urethrostomy. The aim of this surgery is to remove the penile urethra which is a narrow tube in order to prevent stones becoming lodged. A new aperture, a much wider opening to the urethra is then created surgically. This allows any debris/crystals/stones to pass without obstructing the urethra and also enables a good flow of urine to be voided.
The surgery was successful and Taz recovered well. The surgery has given Taz long lasting relief from his obstructed urethra! He can now urinate good volumes and good streams of urine comfortably.
For Taz, the ongoing treatment was very important. Dietary support is vital and so he was to continue being fed RCW Urinary support (moderate calorie) which he had previously eaten well. This diet will help produce moderately acidic urine, control the content of minerals in the urine and help increase the amount of urine produced. In addition to the diet Taz was also prescribed Cystaid tablets which are a GAG (Glycosaminoglycan) supplement. These aim to restore the protective mucosal/GAG layer (thin layer of mucous) within the bladder wall and decrease permeability. As Taz had previously suffered with stranguria (straining to urinate) and his bladder was very inflamed, this was an important supplement for him. Taz’s urine analysis results confirmed a urinary tract infection was present. Taz was prescribed a course of potentiated amoxicillin antibiotics to treat this infection. Follow up ultrasound guided cystocentesis samples for bacterial culture will ensure the infection is under control.
Taz returned to the hospital 10 days post surgery. He had been urinating well, passing good volumes of urine. The owners were happy with his progress. Taz had lost weight too and was now a very happy cat, purring loudly!!
Urinary tract problems are one of the common conditions seen by our soft tissue surgery team.