Hindlimb skin loss associated with urethral rupture in two cats

The clinical and radiographic features of two cats in which hindlimb skin loss was associated with traumatic urethral rupture (in one case iatrogenic) are described. Both cases were managed successfully but illustrate the need for careful catheterisation of cats and early treatment of urethral trauma.     

Vaginourethroplasty as a salvage procedure for management of traumatic urethral rupture in a cat

This report describes a cat that suffered pelvic urethral rupture associated with multiple pelvic fractures. A vaginourethroplasty was performed as a salvage procedure, via intrapelvic anastomosis of the proximal urethra to the caudal vagina, following failure of a primary urethral anastomosis. Urinary diversion was achieved via tube cystostomy and a vagino-urethral catheter was maintained for 3 days postoperatively. Anterograde cystourethrography was performed at 7 days and 14 days postoperatively. Absence of contrast leakage from the vagino-urethral anastomosis was documented at 14 days postoperatively and the tube cystostomy was removed. An Escherichia coli urinary tract infection was treated following removal of the tube cystostomy and subsequent urine culture revealed no evidence of urinary tract infection. The cat retained normal urinary continence and elimination behaviour during the 7-month follow-up period. Vaginourethroplasty could be considered as a salvage option for management of traumatic pelvic urethral rupture in the neutered female cat.     

Catheter-induced urethral trauma in cats with urethral obstruction

Fifteen cats were evaluated with urethral obstruction. Penile trauma by catheterization was the major indication for perineal urethrostomy. Ten cats had developed a urethral stricture and five had rupture of the urethra following medical management. All cats had abnormalities in penis and/or prepuce and/or scrotal sacs including hyperemia or swelling. Perineal urethrostomy was performed in all cases and they were evaluated for 6 months after surgery. Few complications were noted. Urinary tract infection was the most frequent complication observed. The clients considered their cats to have a good quality of life following surgery.     

Management of obstructive urolithiasis and concurrent urethral rupture in a goat

A 4-month-old, male castrated Alpine White goat presented to the University of Guelph, Veterinary Teaching Hospital, with urolithiasis and a ruptured urethra. A tube cystostomy was performed using an indwelling Foley catheter. Postoperatively, the goat remained in good health, and was discharged with the cystostomy catheter in situ. Five weeks following surgery, the goat was noted to pass urine through its urethra. Seven weeks following surgery, the catheter became dislodged and the goat was observed to urinate normally. Six months following surgery, the goat was apparently healthy and urinating normally. Tube cystostomy may be a useful therapeutic option in the management of small ruminants with obstructive urolithiasis with concurrent rupture of the urethra, especially for cases in which treatment cost is a limiting factor.     

Prognostic factors for successful outcome following urethral rupture in dogs and cats

Twenty dogs and 29 cats were identified with urethral rupture. Males predominated in both groups. The most common cause of urethral rupture in dogs was vehicular trauma, and in cats it was trauma associated with urethral obstruction and catheterization. Clinicopathological findings, type of surgical correction, time to surgery, type of urinary diversion, and duration of urinary diversion were not statistically associated with the outcome. In this study, the presence of multiple traumatic injuries was associated with a poor outcome.     

Evaluation of a polyurethane jugular catheter in cats placed using a modified Seldinger technique

OBJECTIVE: To describe and evaluate the placement of a new design of polyurethane jugular catheter in cats using a modification of the technique of Seldinger. The maintenance and use of these catheters for repeated blood sampling over several days in healthy and diabetic cats is reported. PROCEDURE: Thirty polyurethane jugular catheters were placed in 10 clinically healthy cats and 10 cats with diabetes mellitus using the modified Seldinger technique. Catheters were placed while the cats were under general anaesthesia. RESULTS: The catheters remained in place for a range of 2 to 14 days (median 5 days) with no major complications. In all cats patency of the catheters was maintained until removal. All cats examined had patent jugular veins when assessed 4 or more weeks after the catheters were removed. CONCLUSIONS: These polyurethane jugular catheters, when placed by a modified Seldinger technique, are effective and safe in cats, and jugular patency returns after the catheters are removed.     

Guarded long-term prognosis in male cats with urethral obstruction

The aim of this study was to evaluate the course of urethral obstruction in cats. Forty-five male cats with urethral obstruction or lower urinary tract signs referable to urethral obstruction were included in the study. Follow-up information was gained by telephone interview in most cases and was available in 39 cats. Of the 22 cats with idiopathic urethral obstruction, eight (36%) re-obstructed after 3-728 days (median 17 days). Of 10 cats with urolithiasis, three (30%) re-obstructed after 10, 13 and 472 days, respectively. Of the seven cats with urethral plugs, three (43%) re-obstructed after 4, 34 and 211 days, respectively. Recurrent signs of lower urinary tract disease including obstruction were common in cats with urethral obstruction (20/39; 51%) and occurred in the same frequency irrespective of the primary cause of the obstruction. Recurrent obstruction (14/39; 36%) was the most common reason for euthanasia and was performed in 8/39 (21%) cats.     

Assessment of blood pressure in cats presented with urethral obstruction

Objective: To determine the arterial blood pressure at presentation in male cats with acute urethral obstruction, and to determine whether there was any correlation between these measurements and concurrent metabolic abnormalities. Design: Prospective, single cohort, observational study. Setting: Private, small animal, after‐hours emergency clinic. Animals: Twenty‐eight client‐owned male cats with acute urethral obstruction and no other known coexisting disease. Interventions: Indirect oscillometric blood pressure measurements obtained before blood sampling and treatment. Measurements and main results: Mean arterial blood pressure (MAP) measurements, physical examination parameters, serum blood urea nitrogen (BUN), creatinine, potassium, phosphorus, total calcium and magnesium concentration, venous pH, lead II electrocardiogram, and urine volume in bladder were evaluated. No cats were hypotensive at presentation; 71% (20/28) were normotensive (median MAP=100 mmHg, range 93–140 mmHg); and 29% (8/28) were hypertensive (median MAP=153 mmHg, range 145–176 mmHg). Compared with hypertensive cats, normotensive cats had significantly lower heart rates (P=0.0201) and lower calcium (P=0.0152). For all 28 cats, MAP correlated with serum potassium and total calcium (P=0.0033). Conclusions: Though potassium and total calcium were inversely and directly correlated respectively with blood pressure in cats with urethral obstruction, none of the cats were hypotensive on presentation. Normotension on admission does not support the absence of biochemical and physical abnormalities in obstructed cats.     

Use of a retained urethral catheter in three dogs with prostatic neoplasia.

Percutaneous nephrostomy catheters modified by cutting off the tubing connectors were implanted in three dogs with prostatic neoplasia to relieve or prevent stranguria. One catheter was implanted with a guide wire through a perineal urethrotomy, and two catheters were implanted via celiotomy and cystotomy. Morbidity and complications were minimal. Inflammation of the abdominal incision was present from day 4 to day 8 in the dogs with celiotomy. Urinary incontinence was continuous in one dog and intermittent in two dogs. Hematuria occurred in two dogs. The retained urethral catheter was a suitable palliative treatment for urethral obstruction in three dogs with prostatic neoplasia.     

Pancreatic rupture in four cats with high-rise syndrome

Pancreatic trauma and rupture are rare after feline high-rise syndrome; however, should it happen, pancreatic enzymes will leak into the abdominal cavity and may cause pancreatic autodigestion and fatty tissue saponification. If not diagnosed and treated, it can ultimately lead to multiorgan failure and death. In this case series, 700 records of high-rise syndrome cats that presented between April 2001 and May 2006 were analysed, and four cats with pancreatic rupture were identified. Clinical signs, diagnosis using ultrasonography and lipase activity in blood and abdominal effusion, and treatment modalities are reported. Three cats underwent surgical abdominal exploration, one cat was euthanased. Rupture of the left pancreatic limb was confirmed in all cases. Two of the operated cats survived to date. High-rise syndrome can lead to abdominal trauma, including pancreatic rupture. A prompt diagnosis and surgical treatment should be considered.     

Transpelvic urethrostomy in 11 cats using an ischial ostectomy

OBJECTIVE: To investigate the feasibility and long-term outcome of a modified subpubic urethrostomy technique termed transpelvic urethrostomy (TPU) in cats. STUDY DESIGN: Prospective clinical study. ANIMALS: Eleven male cats with obstructive lower urinary tract disease that could not be relieved, and requiring a surgical urinary diversion, were selected for TPU. METHODS: With the cat in dorsal recumbency, the penis was exposed and the ventral pelvis was denuded by median adductor muscle elevation. An approximately 12 mm x 15 mm area of ischium was removed. The pelvic urethra, 8-20 mm cranial to the bulbourethral glands, was incised longitudinally and sutured to the skin to create a urethrostomy. RESULTS: All cats were neutered males (2-9 years); none were uremic or hyperkalemic at admission. Urine was cultured if there was leukocyturia, nitrituria, and/or bacteriua. Bacteria were isolated from 2 specimens. A patent urethrostomy was created in all cats without operative complications. Except for 1 cat without associated clinical signs, stricture was not evident between 9 and 42 months after urethrostomy. One cat had postoperative urinary incontinence (UI) that resolved within 4 weeks. Two cats each had 1 episode of idiopathic lower urinary tract disease after 6-month follow-up; both responded to medical therapy. CONCLUSIONS: TPU was used as a successful urinary diversion procedure relieving signs of urinary tract obstruction and preventing further obstruction, with few complications. The incidence of UI after TPU remains minimal. CLINICAL RELEVANCE: TPU should be considered as a salvage urinary diversion procedure in cats (as an alternative to prepubic and subpubic techniques). TPU may also be considered as a possible primary urinary diversion solution (an alternative to perineal urethrostomy) for obstructive lower urinary tract disease in cats.     

Successful treatment of traumatic oesophageal rupture with severe cellulitis in a mare

A five-year-old standardbred mare suffered a cervical oesophageal rupture subsequent to a kick. Marked cellulitis and extensive soft tissue damage resulted. Treatment consisted of creating an oesophageal fistula, local debridement and systemic antibiotics. The mare made a long but successful recovery. Treatment of oesophageal rupture in the horse is discussed.     

Spontaneous hepatic rupture in six cats with systemic amyloidosis

Spontaneous hepatic rupture, secondary to the accumulation of hepatic amyloid, was diagnosed in six cats over a two-year period. Previous reports of feline hepatic amyloidosis have documented clusters of cases from breeding catteries. Most affected cats have been Siamese or a related breed and the disease is generally regarded as familial. In contrast, the cases presented here were sporadic, with relatives and other cats in the household not clinically affected. They included a Devon rex, a breed not previously reported with this condition, and a domestic shorthair. Clinical signs in three of these cases had, prior to referral, been misinterpreted as resulting from blunt trauma, immune-mediated haemolysis or a coagulopathy. Antemortem diagnostic features, including new data on the value of hepatic ultrasonography and fine-needle aspirate cytology, are reported. These cases illustrate how the course of this disease can vary between individuals and that, despite the dramatic underlying pathology, hepatic amyloidosis can present a diagnostic challenge and should be suspected in any young adult cat with consistent clinical signs, irrespective of breed or environment.     

Emergency treatment of urethral obstruction in male cats

Cats with mild urethral obstruction are anesthetized, the obstruction removed and the bladder lavaged. Moderately affected cats are sedated and given IV fluids, and usually return to normal soon after the obstruction is removed. Severely affected cats are given IV fluids, NaHCO3 and Ca gluconate, sedated or anesthetized and unblocked. Fluid administration is continued to avoid renal failure. The bladder can be expressed 3-4 times daily or bethanechol given to aid recovery of detrusor muscle function. Halothane, 1% thiopental or thiamylal, or ketamine-acepromazine can be used to anesthetize blocked cats. An 18- or 20-ga, 2 1/2-inch over-the-needle catheter or a lacrimal needle is used to relieve the obstruction, after which a 3 1/2-Fr Silastic or vinyl catheter is used for catheterization and bladder lavage with sterile saline. Cystotomy allows recuperation before definitive corrective surgery.