Urethral Obstruction in a Female Cat

Abstract

Background: This work reports a case of urethral obstruction by urolith in a female cat. The patient had a history of hematuria beginning approximately 2 months before visiting the clinic, with anorexia, apathy, emesis, tenesmus and absence of urination. Following physical and ultrasonic examinations, urethral obstruction by urolith was diagnosed. Although feline lower urinary tract disease (FLUTD) is common in both males and females, a urethral obstruction in female cats is extremely rare. This report aims to alert veterinarians to such an occurrence, highlighting the importance of early diagnosis and treatment in view of the severity of the consequences of a urethral obstruction.Case: An undefined, female cat of indefinite age, with a history of hematuria, emaciation, anorexia, apathy, emesis, tenesmus and anuria, presented at our clinic. Physical examination revealed dehydration, discrete rectal prolapse and dysuria. During abdominal palpation, a rigid spherical-shaped structure was observed in the hypogastric region, and complementary examinations were subsequently performed. Hematological examination revealed leukocytosis and increased serum urea and creatinine levels. Abdominal ultrasound examination showed that the urinary vesicle was full, with heterogeneous anechoic content with discrete sedimentation, as well as the presence of a hyperechogenic structure that formed an acoustic shadow at the transition between the bladder trigone and the urethra. In addition, both renal pelves presented dilatation byanechoic content, and measured about 0.5 cm. Treatment with amoxicillin and potassium clavulanate (20 mg/kg administered intravenously) was initiated, and the patient was referred to undergo a surgical procedure to remove the calculus. When exploring the abdominal cavity, the urinary vesicle was identified, which appeared to be rigid. Ventral cystotomywas performed, and calculus was identified in the proximal urethra, which was ‘milked’ into the bladder and removed. The patient showed good surgical recovery, presenting normorexia and normuria after anesthetic recovery. The patient remained hospitalized for 12 h. On the following day, hematological tests showed improvement in leukocytosis and azotemia, and amoxicillin was prescribed with potassium clavulanate (20 mg/kg 12/12 h), tramadol (4 mg/kg 8/8 h) and ketoprofen (1mg/kg SID). The patient was requested to return for a follow-up appointment 5 days later, but the patient did not return.Discussion: Although the low frequency of urethral obstruction in female felines does not reflect the common occurrence of FLUTD, the present report warns of the importance of the final diagnosis in patients with manifestations of urinary tract disorders, especially female animals, in order to exclude the possibility of urolithiasis. This attention will allow the correct treatment of each condition and complete recovery of the patient, avoiding possible obstructions and serious consequences related to the presence of an obstruction for a prolonged period of time. The present work reported a case of feline urethral obstruction, a condition considered rare for females of this species. Urethral obstruction is considered an emergency in the small animal clinic, and the treatment, which consists of clearing and correcting systemic effects, should be rapid as the consequences for the patient can be severe and permanent, and can even lead to death. The possibility of urethral obstruction was not ignored despite the rare occurrence in females, which allowed for rapid surgical intervention to clear and reestablish the urinary flow, which contributed to the successful recovery of the patient.Keywords: urolithiasis, feline lower urinary tract disease, urethral calculus.