Sam – Cystotomy

By October 21, 2011 January 13th, 2012 Case Of The Month

Sam a 9 year old Domestic Shorthair cat presented to our hospital for increased drinking. We obtained a detailed history from the owner that indicated that there were no changes in diet, litter or the environment. On physical examination and bloodwork no abnormalities were noted. We did an ultrasound of the urinary bladder and noted an abnormal density within the lumen of the bladder. We then obtained urine from the bladder and performed a full urinalysis. The urinalysis report indicated the presence of blood in the urine, calcium oxalate crystals and a trace amount of protein. Overnight there was no bacterial growth. Our next step was an abdominal radiograph. As the images below illustrate – there is a large solitary density within the urinary bladder – a cystic calculi or bladder stone.

Sam was admitted to Southdown Animal Clinic for a cystotomy which is surgery performed to remove cystic calculi from the urinary bladder. Sam was on intravenous fluids throughout the procedure and had a urinary catheter placed in the urethra. An incision was made into the urinary bladder and the cystic calculi was removed without complications. The calculi as pictured below is 13 mm round and 7 mm tall with multiple sharp and rough edges that lead to irritation and inflammation of the lining of the urinary bladder.

The surgeon closed the incision with a double layer inverting suture pattern using absorbable suture material to provide a watertight seal. We flushed the the catheter to make sure it was free of any debris. Sam recovered well from the procedure. Since surgery Sam is urinating well and is back be being playful and purring!

Urinary problems in cats can be characterized by one or more of the following signs: increased urination, straining to urinate, blood in urine, increased frequency of urination, vocalizing when urinating, inappropriate urination and a blockage of the urethra preventing urination. Causes include inflammation of the lower urinary tract especially the bladder wall due to the formation of crystals or stones obstructing the passage of urine. As crystals are made up of minerals, too many minerals in your cat’s food can increase the chance of developing them. Crystals can clump together to form stones causing inflammation and pain. In male cats especially, the stones can completely obstruct/block the urethra preventing the cat from urinating – this is a potentially life threatening situation. Being overweight, not getting enough exercise and stress can also contribute to urinary problems. Now that the stone has been removed Sam has been started on a new veterinary diet formulated to prevent the reoccurence of crystal/stone formation. The diet is designed to reduce the mineral building blocks in food. It also changes the acidity of the cat’s urine to aid in dissolving some types of crystals. Sam’s new diet has an increased level of omega-3 fatty acids that help soothe the bladder as it heals. Sam is enjoying his new diet and we will do follow up urinalysis’ to monitor his progress. The calculi has been sent to the laboratory for analysis and we will post the results as soon as they are available.


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