James' Urethral Obstruction

James or, James Clark Maxwell the 2nd, as he is formally known as, is a beautiful British long hair who presented to Vetwest Whitfords recently. His owners had noticed that he had been straining to urinate and vocalising in pain. James’ owners had only just brought in James’ brother Taffy for something similar the week before, so were only too aware of the unique lower urinary tract issues faced by felines. Unlike Taffy, who had a case of idiopathic cystitis (inflammation of the bladder causing small, frequent urination that may or may not be painful), James had not been passing any urine at all. In cats, an inability to urinate or pass urine is known as urethral obstruction and is a medical emergency.

When James was examined by one of the vets it was noted that his bladder was very large and firm, making a diagnosis of urethral obstruction highly likely. At this point, James was admitted into hospital for blood work and abdominal X-rays to confirm the diagnosis as well as intravenous fluid therapy, pain relief and urethral catheterisation. Thanks to James’ fast-acting owners who brought him in immediately, James’s bloodwork was normal. A common finding in blocked cats is a high potassium level. High potassium is life-threatening as it leads to cardiac arrhythmias (irregular heartbeat) and can result in cardiac arrest. Once James was stabilised, he was anaesthetised to allow a urinary catheter to be placed and help drain his large bladder. After a few initial attempts, a small catheter was threaded up his narrow urethra into the bladder. The catheter is sutured in place and attached to a collection bag that collects the urine,  this allows the vets to keep track of the amount of urine draining as well as the quality of urine (bloody vs clear). Upon waking up James clearly felt immediate relief as he was purring away, rolling around for pats and wolfing down chunks of chicken.

The staff at Whitfords fell head over heels in love with this big fluffy Casanova who would constantly chat away to you with his chirrups and meows. Unfortunately, there can be many complications associated with obstructed cats, one of which is re-obstruction following removal of the urinary catheter. In James’ case, this occurred when the catheter was removed after a few days in hospital. At this point, the options were to re-catheterise with a higher risk of re-obstruction or referral to a surgical centre for ongoing management. James’s dedicated owners decided to take him to WAVES where a cystostomy tube (tube directly into the bladder) was placed to allow his urethra to rest. James spent around 2 weeks with the tube in place before it was finally removed. He was monitored overnight at WAVES to ensure there was no issue with his urination and thankfully none were reported. After almost a month of going back and forth between vet clinics and hospitals, wearing an e-collar around the clock, restricted exercise and playtime with his brother, James was finally free to go about his normal cat business and enjoy e-collar free cuddles with his family.

James’ owners know that there is always a risk that he will become obstructed again and so have a management plan in place to reduce this risk as much as possible. This includes reducing any stressors (not many in this household), environmental enrichment and most importantly a diet change to a special renal diet (James had evidence of crystals in his urine which is a big risk factor for urethral obstruction).

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