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Feline Urinary Blockage/Bladder Surgery
Sent to Cat Experts March 28 02:32 PM

What is the usual course of treatment on a male cat with a hisotry of urinary blockage - a lot of "grit" in his bladder? Is surgery to go in the bladder and clean all the "grit" out common? And if you bring a cat back less then a week after a bladder surgery because he’s still not urinating properly, bloody urine and not eating and patient is questioning if internal stiches might have come open, what would your first course of action be at that time?

Customer (name blocked for privacy)
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March 28 9:30 PM (24 minutes and 21 seconds later)
         
Reply to Dr. Vamvakias's Post: Yes, I would like to know your opinion on the matter. My 8 1/2 yr. old male cat had a history of blockage, the last time I brought him in was 3/14/05 - vet unblocked him (he said it was a bad block - high up and he used 5 catheters to get him unblocked) - my cat spent 2 nights in the hospital and I picked him late afternoon on 3/16/05. He did not urinate at all that evening or the next morning, so I took him back in again on 3/17/05. He spent that night in the hospital and on 3/18/05 the vet recommended surgery that involved going into the bladder and "cleaning out" all the "grit" and "sediment". He also mentioned 2 other options, one being the surgery that turns him from male to female, but didn't think that would work in this case due to blockage being so high up and the other just inserting a catheter and giving him fluids, but also didn't think that was the best route to go. I agreed to the surgery to "clean out" the bladder, it was done on 3/18/05 and I brought him home on 3/19/05. I watched him very closely and noticed his urine output wasn't great and also blood tinged. I called the vet on 3/21/05 and he (not my regular vet, he was on vacation) said not to worry, it sounded normal being surgery was done and the inside of the bladder was raw. By 3/23/05 I noticed (on kitchen tile floor) 3 larger puddles, bright red with blood and my cat not eating well. On 3/24/05 he did drink quite a bit, but still not eating well and output poor, so I called the vet again and brought him in. I questioned to the vet (again, not my regular vet) if there was a possibility that he could be blocked or if the internal stitches could have come open. On initial examination, he did not have a temp and his bladder felt large. The vet took him and expressed his bladder by pushing on it. She came back and told me he wasn't blocked but had bladder atony and was going to give him fluids and send him home with meds for the atony. Immediatly following the physical expression of the bladder, my cat took a turn for the worse. The did an ultrasound that did not show a fluid build up (according to them - I did not see it). I had brought him in at 3:00 and by about 5:00 he was gone. An autopsy showed a small hole in the bladder, close to the surgery site, that they said just wore out due to his bladder being stretched. I am questioning if pushing on the bladder of a cat less that a week after surgery was the first thing that should of been done, not knowing if stitches were still in tact? I am questiong if the hole wasn't all the way through, or if possibly pushing on the bladder "popped" it all the way through? And even it was leaking a tiny bit, did pushing on the bladder just "flood" his body with toxins being that he turned worse immediatly and died so fast? I am also wondering if the surgery to "clean out" the bladder is common?
I would appreciate any answers you might have, thank-you.
Reply
March 28 10:39 PM (1 hour and 5 minutes and 48 seconds later)
         
Reply to Dr. Vamvakias's Post: I don't know if any bloodwork was ever done - none that I am aware of anyway.
Answer
March 28 11:39 PM (1 hour and 4 seconds later)
         
ACCEPTEDCheck Mark

 Well, that is where the problem is, in my opinion.

A small tear in the bladder and uroabdomen (urine in the abdomen) will make them sick but not acutely die. The pressure change of a bladder decompressing can have a circulatory affect...but my concern is with this chronic status and surgery, what the electrolytes were doing. Abnormalities in those can be life threatening...and if they were off and he was manipulated and the bladder pushed and he was stressed and painful...it could have started an almost heart attack reaction.

I am so sorry for your loss. I agree that the surgery would be beneficial if the was lots of sediment in the bladder...as a vet I think it is neglectful if no bloodwork was ever done...and might be something to look into.

Dr.V




Dr. D.A. Vamvakias
Veterinarian
Reply
March 29 12:07 AM (27 minutes and 45 seconds later)
         
When should the bloodwork have been done - before surgery or when I brought him back in the final day? It was his heart that went - first his breathing was very rapid, like he was stressed or nervous (he was normally an easy-going cat), then his heart rate dropped to the point when his heart stopped.
Answer
March 29 9:05 AM (8 hours and 57 minutes and 59 seconds later)
         
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