Dec '25 • General discussion
Today's Interesting Photo
In the ER of veterinary medicine we see different cases each day. Each day is a different day. I will say that working night shift we get more weird cases than day shift due to the fact that primary care veterinarians are not open during the day. This week we had a 4.5 YO (year old) MN (male neutered) cat present for vocalizing, which means he was meowing and making a lot of noise. Upon obtaining a history the owner stated that he (we will call him fluffy for now which is not his actual name, to keep the owners privacy) was hanging around the litter box more than usual. They also stated that Fluffy was posturing like he had to urinate and then not producing anything.
Upon basic physical examination Fluffy had what felt like a very full water balloon in his lower abdomen. This was the bladder! It is not uncommon for male cats to get a condition known as FLUTD, Feline Lower Urinary Tract Disease. Crystals form in the bladder and when the kitty tries to urinate the crystal(s) will block the urethra.
In this case we prompted the owners to admit fluffy for inpatient care, owners consented. Typically these patients will stay in hospital for a few days where they have they have care/monitoring 24/7.
After paperwork was complete Fluffy was sedated and we used an lubricated olive tip to gently pulsate flush (sodium chloride) into the urinary bladder to try and push the crystal back in or help it exit the urethra. Thankfully in Fluffy's case the crystal was very close to the end of the urethra and after mild flushing the crystal came right out.
After this it was time to place a urinary catheter. The urinary catheters are sized in a measurement called French (Fr). Typically for the cats we are going to go with a 3.5 Fr to a 5 Fr. It really just depends on the size that looks most appropriate at the time. Side note, it is not uncommon to see some bruising or swelling around the penile area during this procedure. The catheter was lubricated, passed into the bladder and had 1 simple interrupted suture placed to maintain position while Fluffy was moved into the radiograph suite. A radiograph is taken to insure proper placement of the catheter. Once it was confirmed we finish securing the catheter in place by doing 2-3 more simple interrupted sutures and then a Chinese finger trap (note: this is how we suture them in at my clinic because we carry the MILA brand of catheters). We secure the rest of the urinary catheter around the tail with some material tape making sure to leave enough room so the kitty can move their tail freely.
After the catheter is sutured in then we flush the bladder. Typically the bladder gets very irritated when the kitty gets blocked so it is not uncommon for the urine to be red in color and cloudy from the crystals. This is why we flush the bladder to dilute the urine and to help flush out some of the crystals.We don't flush until it is clear but just until it is like a nice peachy orange color if it is really red. Then we hook then up to a urine collection system. The urine collection system holds the urine until we are able to quantify it, which means we measure how much urine Fluffy has produced in a certain period of time. Typically we measure every 4 hours and we compare the amount of urine they are producing to the amount of fluids that we are putting in.
The urinary catheter is typically left in for 24-48 hours. We pull the urinary catheter out when the urine is a normal color. Sometimes they urinate around the urinary catheter. This is not uncommon, especially as the inflammation goes down.
Here is a photo of what the urine dilution gradient looks like. We did dilute it about 3-4 more times past this, however I don't have a photo of those syringes.
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Today's Interesting Photo
