TUBE CYSTOSTOMY TO RELIVE OBSTRUCTIVE UROPATHY IN TWO TOM CATS

P.T. Sutaria1, J.B. Patel1, A.M. Patel1, P.B. Patel2, A.N. Suthar1 and V.S. Modh
1Assistant professor, 2Professor and Head; Department of Veterinary Surgery & Radiology,
Dr. V.M. Jhala Clinical complex, College of Veterinary Science & A.H., SDAU, Deesa-385535(Gujarat). [Received: 09.5.2018; Accepted: 12.11.2018]

A 20 days old male non descript kitten and two years old Persian tom cat were presented with history of anuria
since 24 hours. On clinical examination both felines were lethargic and off feed. The kitten had pubic swelling which
was confirmed as subcutaneous urine infiltration due to urethral rupture and a swollen glans, while the adult feline had distended urinary bladder. On ultrasound examination the bladder was intact and distended. Emergency tube
cystostomy was performed using Foley’s catheter. Both cats made an uneventful recovery and sutures were removed on seventh postoperative day.
Keywords: Anuria, Feline, Foley’s catheter, Tube cystostomy, Urethral rupture.

Tom cats housed in groups suffer from ‘Feline lower urinary tract disease, prob -ably because they share the same litter box amongst many other reasons (Hostutler et al., 2005). The disease gets most frequently diagn
-osed in advanced stage when the cat exhibits obvious discomfort due to inability to urinate leading to distension of urinary bladder on the verge of rupture. Two such cats with severely distended urinary bladder and inability to
void urine were relieved by tube cystostomy.
A 20 days old male non descript kitten and two years old Persian tom cat were presented with history of anuria since one day. The kitten had a subcutaneous abdominal swelling with phallitis. Needle aspiration of
the swelling revealed subcutaneous urine accumulation confirming urethral rupture. Transa -bdominal ultrasonographic examination with 3.5- 5 MHz transducer revealed a distended urinary bladder with thickened wall, while in kidney dilated renal medulla and pelvis were observed. The temperature, respiration rate
and heart rate were elevated in both cases. In both cases complete blood count was within normal range, except neutrophilia in the adult tom. Acute obstructive uropathy causing urethral rupture and cystitis were diagnosed
in a kitten and tom cat, respectively.
In both cases, emergency tube cystostomy was done to avoid bladder rupture and to relieve the backpressure on kidneys. The gen -eral anaesthesia was induced and maintained with a combination of Inj. Ketamine @ 4 mg/
kg. b. wt. + diazepam @ 0.5 mg/kg. b. wt. A caudal ventral midline incision was used to approach the bladder and the 8 F Foley’s Catheter was introduced throu- gh a separate stab incision at paramidline and secured in urina
-ry bladder using purse string suture followed by distension of bulb (Fig. 1). In the kitten fo ur stab incisions were given on the skin above the swollen part to drain the subcutaneous uri ne. The laparotomy wound was closed in rout
ine manner and post operative clindamycin @ 10 mg/kg. body weight I/M, Inj. Tramadol @ of 1.0 mg/kg. body weight I/M once daily for five days. On the 2nd post operative day, swell -ing reduced markedly in the kitten and both cats resumed feeding and water intake. On the 7th post operative day, catheter was removed when urination started normally (Fig.2).
Obstructive uropathy mostly affects cats but is a rarity amongst queens as also reported by Forrester and Towell (2015). It occurs concurrently with lower urinary tract disease as observed in present report. The occult
underlying symptoms were not noticed by both the owners till complete obstruction was manifested. The urethral obstructions due to physical causes like mucus plug, calculi, stricture or neoplasm as have been reported
by different authors (Segev et al., 2011 and Forrester and Towell, 2015), however no physical obstruction could be identified on ultrasound but a thickened bladder was visualized in adult tom. In concurrence with our study, Sumner and Rishniw (2017) attributed up to 53% of urethal obstruction in male cats to be idiopathic due to urethral
spasm and edema.
Ultrasonography is a vital technique while evaluating urinary system as not only the small radioluscent calculi as well as thickness of urinary bladder wall could be

measured. The bladder thickening as well asdilated medulla and pelvis of kidneys could  be visualized clearly but not the urethra as also mentioned by Juszczyk et al. (2006). Dialated renal medulla frequently hints
towards back pressure of urine leading to hydronephrosis as also recorded by Hansen et al. (2015) and hence emergency tube cystostomy helped to not only to preclude bladder rupture but also further renal damage.
Our study was in agreement to Gaber et al. (2014) who reported that tube cystotomy was superior technique in managing urethral obstructions as it maintained urethra integrity for breeding and urination while marsupilization compromised both. The insitu inflated cuff of foley’s catheter was clearly demonstrated on B- mode ultrasound
in accordance with Gaber et al. (2014).
Although complications like tube dislodgement, uroperitoneum and tube blockage have been observed as also reported by Fortier et al. (2004) and Gaber et al. (2014). In the present case, both cats made uneventful recovery with removal of tube seven days after surgery and resumption ofnormal urination.

References
Forrester, S.D. and Towell, T.L. (2015). Feline idiopathic cystitis. Vet. Clin. North Am. Small Anim. Pract., 45(4): 783-806.

Gaber, E., El-Khmary, A. and Abdelwahed, R. (2014). Tube cystostomy VS Bladder marsupialization: Clinical and
Ultrasonographic evaluation in dogs. Alexandria J.Vet. Sciences, 42: 16-27.

Hansen, K.L., Nielsen, M.B. and Ewertsen, C. (2015). Ultrasonography of the Kidney: A pictorial review. Diagnostic
(Basel), 6(1): 2.

Hostutler, R.A., Chew, D.J. and DiBartola, S.P. (2005). Recent concepts in feline lower urinary tract disease. Vet. Clin. Small Anim., 35: 147-170.

Juszczyk, M., Kleckowska-Nawrot, J. and Pospieszny, N. (2006). Successful surgical treatment of urethral obstruction in an elderly cat. Medycyna Wet., 62(11): 1236-1238.

Segev, G., Livne, H., Ranen, E. and Lavy, E. (2011). Urethral obstruction in cats: predisposing factors, clinical,
clinicopathological characteristics and prognosis. J .Feline Med. Sur., 13(2): 101-108.

Sumner, J.P. and Mark Rishniw, M. (2017). Urethral obstruction in male cats in some Northern United States shows regional seasonality. The Vet. J.,. 220: 72-74.

Leave a comment

Your email address will not be published. Required fields are marked *

RSS
Follow by Email
Facebook
Google+
http://www.indianjournalofcaninepractice.org/2018/12/03/tube-cystostomy-to-relive-obstructive-uropathy-in-two-tom-cats">
Twitter
error: Content is protected !!