Bladder Blockage

This is Sinatra.  The shelter folks gave him that name because of his "Ol' Blue Eyes".  Those eyes are pretty droopy here, as he is still suffering from a combination of light sedation, and heavy uremia [waste building up in the bloodstream when the kidneys cannot get rid of it].  He had been straining to urinate for a couple of days, had quit eating, had vomited once.  His urinary bladder was as big as a softball, and felt about as hard.  Not a good situation.  The owners felt he was still able to urinate; they were wrong.

Before trying to catheterize him, we gave him a very light sedative and emptied his bladder via cystocentesis [Do a sterile prep on his belly and put a needle right into the bladder to empty it.].  It would have been pretty hard to backflush any crystals or mucus into that much pressure.  We removed 120cc [versus an average 30cc in a full cat bladder] of the worst hematuria [bloody urine] that I have ever seen.

Lots of times when we centrifuge a bloody urine sample, it turns out to be less than 1% blood cells, even when it looks almost like pure blood.  The tube on the left is what Sinatra's urine looked like.  On the right is a tube that has been centrifuged, showing that the urine is about 10% red blood cells.  This is not good, showing that the bladder is really suffering from being over-stretched for so long.

Fortunately, despite the damage and being so sick, Sinatra is making a really rapid recovery.  He is tolerating his urinary catheter [necessary to let the damaged bladder stay empty while it heals] and is already eating and drinking.  He takes his medicine great and has a sweet personality, even under these circumstances.  I love this cat -- he's easy to take care of, and he's making me look good.

Comments

[Ingenuous Vet]

Do worry about bladder rupture doing a cysto on one that large?

[Doc]

Hello, Jennifer,

On a bladder that large, I worry about it rupturing if I DON'T do the cystocentesis. I have been surprised about how resilient the organ is, though.

I remember a Pomeranian that we opened up in the process of relieving his obstruction with multiple calculi in the urethra and bladder. His bladder was so purple it was nearly black. I really thought it was necrotic and would just disintegrate, rather than healing, but he recovered well.

I also recall a cat whose bladder burst when I palpated it the first time on the exam table. I felt the baseball, then it disappeared. I cannot recall the outcome of the case, as to whether the owners let me proceed or decided to euthanize. I only remember the sickening feeling when the bladder burst.

In most cases, piercing the bladder with a 22-gauge needle is unlikely to cause any problems. It's not like popping a balloon.

This cat was super-great to work with. He didn't bother his catheter, started eating the next day, and was affectionate with staff, and even with ME.

Thanks for reading and writing.

[Nancy Pendleton]

My 10 year old male had this problem. I have to feed him C/D's. He pukes it up. I told my vet and he said keep giving it to him. Now my cat is constapated and had to go in for a "cleaning". Now I have to give a sugary liquid med to him twice a day by mouth. Any other suggestions on the food?

[Doc]

Hello, Nancy,

Dietary management can save your cat from being blocked again, and is well worth while. Most of my patients eat C/D without a problem.

Purina makes a prescription diet called UR that is formulated to address these problems.

Some feline specialists feel that you can substitute a high protein/low carbohydrate diet and achieve good results. If your cat cannot tolerate C/D, this might be a possibility.

If you choose this route, discuss it with your veterinarian and make arrangements to check the cat's urine specimen. You want to be sure that you are actually achieving that acid urine that you need, and that crystal are not forming, and that infections are not developing.

These foods are high protein, low carb (CHO = Carbohydrate)

Friskies Senior
Turkey & Giblets CHO 4.67%

Fancy Feast
Turkey Giblets Feast CHO 0.01%

Friskies Canned Cat
Beef and Liver Dinner CHO 0.80%

Friskies Canned Cat
Turkey and Giblets Dinner CHO 2.05%

Friskies Kitten Formula
Turkey CHO 1.4%

Fancy Feast Flaked Fish
And Shrimp CHO 0% PRO 80.8%

Friskies Special Diet
Turkey & Giblets CHO 0.09% PRO 52%

Fancy Feast Chunky Chicken CHO 6.2% PRO 55.6%

Iam’s Kitten CHO 7% PRO 50%

Purina Pro Plan
Turkey Rice Entrée Ground CHO 7.6% PRO 64%

Purina Pro Plan Total Care
Kitten Chicken & Rice CHO 2.8% PRO 57%

Purina Pro Plan Adult
Ocean Fish and Crab CHO 0.1% PRO 71%

Purina Pro Plan Sardines &
Tuna in Aspic CHO 0.1% PRO 70%

Good luck.

[bladder control]

The cat is so pretty, i hope she get well soon..

-sm