Lucian is a two year old cat that belongs to one of our RVNs, Ches. She rescued him and his mum Lexi when she had just given birth!
Lucian first started experiencing issues with urinating properly last year around Christmas. He was having difficulty urinating which we refer to as stranguria. Stranguria often indicates inflammation of the bladder which we call cystitis. Cystitis can have several potential causes, including bladder stones or crystals, urinary tract infections (UTIs), or in some young cats, stress.
Male cats in particular need to be closely monitored to ensure they are passing urine, as they are more prone to urinary obstructions. This is where the urethra (the tube that carries urine from the bladder out of the body) becomes blocked with mucus or urinary stones, preventing the passage of urine. This quickly becomes a medical emergency as toxins from the urine build up, making cats very unwell and the bladder becomes extremely full and painful.
Fortunately, on this occasion, Lucian was still able to urinate, although he was just passing small amounts. We suspected he had feline idiopathic cystitis (FIC) most likely due to stress of the Christmas tree going up! Changes in the home, such as new items, furniture moving and visitors can be common triggers for stress cystitis in cats. Cats with this condition do not handle stress in the ‘normal’ way so even small changes can cause significant upset.
Cats with FIC do not have UTIs so antibiotics are not required. Instead, we use anti-inflammatories and focus on resolving the underlying stressor. Other treatments include pheromone plug-ins, and sometimes we will use anti-anxiety medications.
Lucian initially responded well to treatment, but after a few months he started to have some flare ups despite still being on medication. We decided to scan his bladder to look for any evidence of bladder stones and take a urine sample to check for infection or urinary crystals. Urinary crystals are small particles that can form in your pets urine. They are made up of minerals which are normally present in the urine. Crystals can develop if the urine is too concentrated, the pH is abnormal or in the presence of infection. Over time, crystals can coalesce to form urinary sediment (larger grains of the crystalline material) which can eventually lead to larger urinary stones.
Although Lucian didn’t yet have a fully formed urinary stone, he did have some urinary sediment. His urinalysis revealed struvite crystals were present, but no bacteria were found. Fortunately struvite sediment can be dissolved so we started Lucian on a prescription urinary diet.
Unfortunately, the diet did not seem to make much difference, and whilst we were waiting 6 weeks for the diet to take effect, Lucian’s urethra became blocked with crystals and sediment from his bladder. Thankfully, his mum recognised the early signs and he was able to receive prompt treatment. Lucian was sedated and a urinary catheter was placed to relieve the blockage.
Sadly in just over a month Lucian had 3 urethral obstructions. He had been on the urinary diet now long enough for the crystals to have started to dissolve but he was still experiencing frequent stranguria. Given that the urinary obstructions can be life threatening, we knew we had to do more to help him.
It was recommended that Lucian undergo a perineal urethrostomy, a surgical procedure which removes the narrow end of the urethra, which is frequently the site of an obstruction. A new wider opening is created making it much less likely for blockages to occur. The surgery isn’t without risk including dribbling of urine and increased risk of urinary tract infections. However, at this stage, the benefits of this procedure greatly outweighed the risks.
Since his procedure, Lucian has been a much happier boy, especially now he’s no longer stressed by frequent vet visits. He is comfortable and has had no recurrence of any urinary issues with no current complications!
We asked Ches how she had felt about his procedure: “I initially wasn’t too sure about Lucian having the perineal urethrostomy as it’s such a big procedure and he is still so young, but I knew it was the best option for him at the time. The operation went perfectly, and he was home the next day! He then spent some time crate resting with his buster collar on – which he wasn’t too happy about! But straight away his urination was back to normal with no signs of straining. He’s still on urinary food to prevent sediment build up and encouraged to drink more water at home. It’s been around 2 months since his operation and he’s completely back to normal with no urinary signs. Thankfully, he hasn’t had any dribbling of urine post-op and he’s happy to not be on his medication any longer.”
