Cat with Urethral Obstruction 1

Cat with Urethral Obstruction

Cat with Urethral Obstruction 2

Sugie is a 4 year old, male neutered feline. He has been brought to the clinic because he

has been going back and forth to the litter box since last night and has had one bowel movement.

He is depressed, lethargic, and will not eat.

Physical Exam Findings:

Weight: 4.5
Temperature: 98.0
Heart Rate: 84 bpm
Respiration: 48 bpm
MM/CRT: dark/2sec

General appearance: Skin is tented

Ears: Normal
Gastrointestinal: Normal
Cardiovascular: Rate is decreased
Respiratory: Rate is increased
Lymph nodes: Normal
Oral Cavity: Normal
Musculoskeletal: Normal
Nervous System: Normal
Urinary/Reproductive: painful upon palpation, bladder is full and distended

Upon clinical exam skin tenting is noted, animals are 5% dehydrated when the skin

returns to its resting position just barely detectably slow (Macintyre, Drobatz, Haskins, & Saxon,

2005). Prior to exam Sugies respiratory rate was 48 bpm, once the veterinarian begins to palpate

his abdomen it elicits a pain response and the respiratory rate increases. A cats normal resting

heart rate is between 150 and 210 bpm. In a cat with urethral obstruction it is not uncommon for

the heart rate to be Bradycardic due to hyperkalemia. A hyperkalemic cat will have ECG

changes, such as tented T waves, widened QRS complexes, atrioventricular conduction blocks,

accelerated idioventricular rhythm, sinoatrial block, ventricular fibrillation, and asystole

Cat with Urethral Obstruction 3

(Odunayo, 2014). The veterinarian may also order an i-STAT electrolyte panel to evaluate renal

function and confirm the hyperkalemia. The results show an elevated potassium level of 8.7

mEq/L and Sodium Bicarbonate is ordered at dose of 0.5 to 1mEq/kg given IV over 5 to 15

minutes to lower plasma potassium concentration by raising pH and driving potassium into the

cells (Norkus).

Urethral obstruction is an emergency condition that can result in death and treatment

should begin immediately (Kahn, 2005). Urethral obstructions usually occur in male cats

between 2 and 10 years of age. It is far less common in female cats because of the wider, shorter

formation of the urethra (Sabino, Boudreau, Mathews, 2010). The first step is to establish

patency of the lower urinary tract by placing a urinary catheter (Tracy, 2000). The veterinary

technician will need to gather the necessary supplies to allow the veterinarian to place the urinary

catheter. You will need clippers, Chlorhex solution soaked gauze, alcohol soaked gauze, sterile

gloves, sterile lubricant, open end tomcat catheter, sterile saline and syringes (for flushing

catheter), a 3.5 or 5 French red rubber urinary catheter, t-port, closed collection system, nylon

suture, needle drivers, and scissors (Herold, 2011). Once the urinary catheter is in place it is

important to obtain a urine sample for urinalysis. The urinalysis indicates a urine pH of 7.5 and

the urine sediment reveals struvite crystals. Due to the high pH and struvite crystals it is

recommended to reduce the urine pH to <6.0 and the urine magnesium by feeding magnesium

restricted diets (Kahn, 2005) such as Hills Prescription Diet s/d. Dissolution may take 4 to 8

weeks. Follow progress with radiographs taken every 2 to 4 weeks and continue the diet 1 month
Cat with Urethral Obstruction 4

after uroliths disappear from radiographs (Summers, 2002). Long term management can include

a Hills diet of c/d or w/d.

It is the technicians job to place an intravenous catheter to have vein access for sedation

as well as IV fluids while the patient is hospitalized. When placing the IV catheter it is important

to use aseptic technique by clipping the area of placement and use a disinfectant to wipe the area

before placing the IV catheter and securing it to the leg using tape to reduce movement of the

catheter. It will need to be monitored for any signs of phlebitis, or local venous inflammation,

swelling at catheter site, redness, pain, pitting edema, and general irritation of the vessel (Sirois,

2013). The catheter will need to be kept clean and dry and prevent the patient from chewing or

licking at it by placing an e-collar.

The veterinary technicians job after the urinary catheter has been placed is to monitor the

collection system for any kinks, blood clots, keeping the prepuce and vulva clean with an

antiseptic (Sirois, 2013) and most importantly monitoring urine output. You will be monitoring

the color and the amount of urine that is collecting in the urine bag every four hours. Normal

urine output is 1-2 ml/kg/hr. To determine the urine output you need to know their weight, the

amount of urine produced, and the amount of time it took to produce it. The formula for getting

urine output is as follows: Urine output= (amount of urine/number of hours)/ weight of patient in

kg (Brashear, 2014). Next you will compare the urine output with the total volume infused, the

goal is to have the two numbers relatively close to each other (Brashear, 2014). Fluid therapy
Cat with Urethral Obstruction 5

will increase renal perfusion resulting in polyuria. Sugies IV fluid therapy will need an

additional 180-270 mL of fluid a day to maintain his hydration status. The technician will also

need to periodically flush the urinary catheter and collection system with saline to ensure it is

flowing and there are no kinks or blood clots.

Cat with Urethral Obstruction 6

REFERENCES

Brashear, Megan. (2014) Urine Output. https://www.atdove.org/articles/Urine-Output.

Herold, Lee. (2011). Unblocking a Cat. https://www.atdove.org/videos/Procedure/Unblocking-a-

Cat

Kahn, C. M. (Ed.). (2005). The Merck Veterinary Manual (9th ed.). (pg 1286). Whitehouse

Station: Merck & CO., INC.

Macintyre, D. K., Drobatz, K. J., Haskins, S. C., & Saxon, W. D., (2005). Fluid Therapy. Manual

of Small Animal Emergency and Critical Care Medicine. (pg 64). Philadelphia:

Lippincott Williams & Wilkins.

Norkus, C. Feline Urethral Obstructions. Retrieved October 22, 2015, from

https://www.vetlearn.com/veterinary-technician/feline-urethral-obstructions.

Odunayo, A. (2014, March) Management of Potassium Disorders. Retrieved October 22, 2015,

from http://www.cliniciansbrief.com/article/management-potassium-disorders.

Sabino, C., Boudreau, A., Mathews, K. A., (2010, September). Emergency Management of

Urethral Obstruction in Male Cats. Retrieved October 22, 2015, from

http://www.cliniciansbrief.com/article/emergency-management-urethral-

obstruction-male-cats.
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Sirois, M. (2013). Animal Care and Nursing. Veterinary Assisting Textbook. (pg 241,242). St.

Louis: Mosby.

Summers, A. (2002). Diseases of the Urinary System. Common Diseases of Companion Animals.

(pg 333). St. Louis: Mosby

Tracy, D. L., (2000). Surgical Emergencies. Small Animal Surgical Nursing. (3rd ed.). (pg366).

St. Louis: Mosby.