Saturday, August 7, 2010

8. Young male cat passes blood in the urine (haematuria)

"My cat passes blood in the urine today," the woman in her 40s brought in a 1.5-year-old male cat for neutering. "Can you neuter him today?"

"If your cat is passing blood in the urine, he should be treated for this serious problem first. He is not healthy and may die if he is neutered" I said as the cat was presenting the symptom of haematuria (blood in the urine).

HISTORY & GENERAL EXAMINATION
I palpated the bladder. It was half the size of the tennis ball. His penile tip was red due to licking. He was still active, eating and drinking.

I asked: "Did your cat have difficulty in peeing or peeing in small amounts in the litter box?"

The woman said: "For the past week, he pees anywhere in the apartment." This cat was avoiding the litter box as he associated his pain in peeing to the litter box. The owner thought he had started urine-spraying and wanted me to neuter him immediately. There were two other cats in the apartment and he could be marking his territory as an intact male. Stress in living with other cats is said to be a cause of haematuria. So the owner wanted him neutered to prevent urine spraying but she did not say so.

"Do you feed dry food to your cat?" I asked.
"Yes, all my 3 cats eat dry food."

TREATMENT
The cat was still active and eating. He had no fever. His bladder was swollen on palpation. He was less than two years old but he could still be suffering from FLUTD (feline lower urinary tract disorder). Dysuria (difficulty in urination) and haematuria (blood in the urine) were the symptoms. This cat has a case of FLUTD.

CAUSE
More than 60% of the FLUTD have unknown causes and are said to be idiopathic. 20% of the cases are attributed to bladder stones. Bladder and kidney tumours and abnormalities of the urinary tract are unlikely in this young cat. Bacterial infection of the bladder or kidney is possible. Stress is said to be a factor in FLUTD and this male cat was stressed in that 2 other cats in the apartment occupied part of his turf.

TREATMENT
1. Drugs
I injected an antibiotic, an anti-spasmodic and steroidal anti-inflammatory SC and waited for one hour. The cat did not pee but the bladder had swollen much bigger. In some cases, these drugs worked when the cat went home and no further procedures are done. But this cat has passed blood in the urine and was in a more serious condition of FLUTD. He might die from kidney failure if the urinary obstruction was not cleared today.

2. Relieve urinary tract obstruction.
I passed a catheter into the cat. It was difficult to be passed into the bladder at some point but after entering the bladder, fresh red blood shot out strongly like a firing gun. I directed the urine stream to the kidney dish and to a collection bottle. Around 200 ml of red blood was expressed and syringed out and a sample was taken for urinalysis. Pinkish gelatinous tissues also flowed out. The catheter was stitched to the prepuce at two places opposite each other (catheter has holes, see picture).

3. The cat was given domitor 0.1 ml IV sedation. The catheter emptied his bladder of urine. You will note that cat urinary catheters have a very small hole at its tip. This would be OK for normal urine. But the cat with FLUTD had gelatinous mucosal plugs inside the bladder.

TIP: I took out the catheter and cut a bigger hole at its tip so that the mucous plug from the bladder mucosa can get in and be flushed out with the normal saline. I used a 20-ml syringe to pass normal saline into the bladder to irrigate the mucosa of the bladder. I could see pinkish plugs being passed out as I took out the syringe. After another 100 ml of normal saline, the bladder passed out clear saline.
An e-collar was given. The cat was given a slow IV saline drip for the next 24 hours.

4. FURTHER TREATMENT
Another two irrigations of the bladder the next day. The cat was warded for two days.

5. TESTS
5.1 BLOOD TEST for white cell count (infection)
5.2 URINE TEST for crystals (struvite or calcium oxalate), protein (kidney disorder) and bacteria (infections).
5.3 DIPSTICK TEST showed a high urinary pH and lots of blood.
X-rays or ultrasound (bladder stones) and IVP (Intravenous Pyelogram) tests are not done at this stage to save on costs. If FLUTD recurs, these tests may be done.

CONCLUSION
The cat is being warded and observed. No dry cat food. Canned food, prescription canned food or home-cooked food is recommended. Prescription canned food for cats with struvite or calcium oxalate crystals (pending lab results) would be recommended. Repeated bladder irrigations to clear the gelatinous plugs from the bladder for the next 2 days and no dry cat food are a key to success in the management of this case. Owners who would not give the vet the opportunity to do it by taking the cat home on the same day may find recurrence of FLUTD.

TIP: A follow-up urinary pH test every month is advised but few cat and dog owners of cats or dogs with urinary tract disorders or stones will do it. If the urine is highly alkaline, acidify the urine for 1-2 months and give anti-struvite or anti-oxalate canned cat food. Give home-cooked food as an alternative with plenty of water for drinking. No dry food to be fed.

Different cats are treated differently as not all cases have blood in the urine. It is best to consult your vet rather than do self-treatment in FLUTD.



Pictures are at www.toapayohvets.com, goto "CATS"

Monday, May 10, 2010

7. A forgetful veterinary intern?

Theresa, my veterinary intern placed the Burmese cat on the electronic weighting platform, looked at the digital reading in the green-window and said: "2.6 kg". A couple consulted me about the cat pawing her mouth recently.

"Are you sure?" I carried the 7-year-old spayed female Burmese cat. She had a compact body and was well fed. I would be putting her under anaesthesia to do dental work and from my experience, this cat would be heavier.

Mrs Thiele, a tall slim Caucasian lady who would have brought the cat to other veterinarians previously said: "The cat is heavier than that."

"Weigh the cat again," I instructed Theresa. This was a quiet cat and I was much surprised that Theresa could make a mistake. I said: "The cat may be 3.6 kg in weight." The girl who would be studying veterinary medicine in Oct 2010 took the cat from me and put the cat on the weighing platform. "3.6 kg," Theresa said. Mr and Mrs Thiele did not comment and I hope they would be forgiving.

This was a serious mistake which I did not expect Theresa to make at all. This 18-year-old girl had Grade As in her A-level examinations, except for a Grade B in Chinese. Her grades were impressive and she was accepted by a university in the United Kingdom. She was doing internship as the University wanted proof that she had seen at least 2 weeks veterinary practice but she had completed nearly two months.

Having interns can be damaging to the professionalism of the practice when they made such mistakes. The clients just go elsewhere the next time or bad mouth the practice. This is one reason why one big veterinary practice in Singapore does not bother with interns. Nowadays I qualify interns strictly before I accept them. They need to be top in their studies and be accepted to study veterinary medicine. Yet this incident happened. Why? I asked Theresa for an explanation. She said: "I saw 3.6 kg but I said 2.6 kg." This answer was mysterious to me. Was she forgetful?

As for the Burmese cat, Mr Thiele was very happy when I phoned him the next day. He said that the cat was normal and eating. At the consultation, Mr Thiele had observed that the cat was pawing her right side of the mouth but Mrs Thiele said: "The cat put her paws in the left side of the mouth as well."

I injected a mixture of 0.1 ml xylazine 2% and 0.4 ml ketamine in a syringe IM. This sedated the cat for dental scaling. The cat had two long ulcers at the back of the tongue (see pictures) as well as periodontal disease in the side teeth (premolars and molars). Since the cat uses the side teeth for cutting instead of grinding food as in most mammals, it is possible that the cat's side teeth cut into the back half of the tongue, causing two red linear ulcers (see pictures).

Monday, February 23, 2009

Cat Spay & Neuter - Xylazine + Ketamine IM

ANAESTHETIC PROTOCOL FROM ONE PRACTICE

5kg Cat
xylazine 20 at 0.1 ml IM
ketamine 100 at 0.4ml IM

2.5kg
xylazine 20 at 0.05 ml IM
ketamine 100 at 0.2ml IM

DR SING'S EXPERIENCES

In Feb 2009, I neutered a male cat, 4.5kg
xylazine 20 at 0.1 ml IM
ketamine 100 at 0.4ml IM
OK. Recovers <30 min.

I spayed a female cat, 2.5kg
xylazine 20 at 0.15 ml IM
ketamine 100 at 0.6ml IM
Excellent anaesthesia.
OK. Recovers 30-50 min after the end of spay.

For spaying of female cats above 4 kg
xylazine 20 at 0.2 ml IM
ketamine 100 at 0.8ml IM
Excellent anaesthesia.
OK. Recovers >30 min after the end of spay.

Lower doses may need top up with isoflurane gas (via mask,5%, to effect, usually <1 minutes of gas).

Thursday, November 20, 2008

Cat Traps

To:
"David Sing (E-mail)"
Looks like the government organisations are not so keen to loaning out cat traps to members of the public due to protests from cat lovers.

The Please Stop the Free Loan of Cat Traps for the Purpose of Killing Cats Petition to Ms Grace Fu Hai Yien (Minister of State, Ministry of National Development) was created by and written by Chen Zhewei (vegancatsg@yahoo.com.sg). This petition is hosted here at www.PetitionOnline.com as a public service. There is no endorsement of this petition, express or implied, by Artifice, Inc. or our sponsors. For technical support please use our simple Petition Help form.
http://www.petitiononline.com/catraps/petition.html

See this page for cat traps available from Australia
http://www.traps.com.au/cat_traps.htm

Scroll down the page to see comments by person called "Chinky" advocating use of Cat Stop and Scarecrow rather than the conventional cat traps.
http://catwelfaresg.wordpress.com/2008/07/21/the-new-paper-report-about-cat-town-in-jln-pemimpin-near-bishan/




Cat Welfare Society
http://catwelfaresg.wordpress.com/traps/

CWS loans out traps to the public (see below), but is also appealing for donations as they say they need to buy these traps from the US
Traps For Loan

Need to borrow a trap? We can help you out there.

Charges:

We require a $75 deposit. It's fully refundable. We accept cheques made out to Cat Welfare Society, or cash.

What to do

Write into info @ catwelfare.org . Let us have the following information:

1) Why you need the trap

2) Your area.

3) A contact number.

We will get back to you and arrange for you to get a trap from one of us


Seems the cat-trap you mentioned used some years ago, belonged to AVA.
I hope AVA had discontinued using those inhumane cat-traps with hooks, as proposed by Animal Lovers League few years ago.

Here is an article pertaining the cat-traps with hooks, from Animal Lovers League newsletter - Bulletin dated June to December 2002 :

http://groups.msn.com/singaporecats/general.msnw?action=get_message&mview=0&ID_Message=8482

Cat traps

A case was reported to us about a stray cat caught in a cat-trap from the AVA.
While the cat was reaching out for a piece of meat (used as bait) attached on the cat trap by a hook, it got its cheek caught in the hook instead. None of the diners at the coffee shop called the AVA or SPCA.
As it struggled to free itself, the tear on the cheek worsens. It was nearly 12 hours later that the case was reported and AVA collected it and put it to sleep still hooked by the cheek, bleeding and screaming. Thank God for that, as it would have caused more pain to the struggling cat if they tried to unhook it first. We received the call after AVA had collected it.

On this note, we therefore advise that for those who need to use cat-traps, please refrain from using the old traps with the hook. We are now proposing to AVA to discontinue the use of such traps.

The above article is taken from Animal Lovers League newsletter - Bulletin dated June to December 2002.

Hi Blue Mistz,

AVA had modified the sharp hooks in their old cat traps.
Instead of sharp, pointed hooks, the hooks are now blunt, and would not injured trapped cats.

AVA also having new type of no hook cat traps similar to Cat Welfare Society cat traps. I understand people wanting to loan cat traps from AVA, are given a choice of what type of cat traps they prefer - subject to availability.

http://groups.msn.com/SingaporeCats/appealsforhelp.msnw?action=get_message&mview=0&ID_Message=15155&LastModified=4675665177960415905

From: MSN NicknameMiow-miow3 (Original Message) Sent: 3/19/2008 7:40 AM
A friend who was at AVA recently to renew a dog's licence, saw a couple putting a cat trap into the boot of their BMW. Presumably it was another intolerance of the presence of cats into their "precious property".

Please write to the media
1) Letters to the Forum Editor
Please include your full name (as in IC), your address and a telephone contact number. For women, please indicate Miss, Mrs or Ms.
Send your letters via e-mail: stforum@sph.com.sg or Fax (65) 6319-8289

2) TODAY news@newstoday.com.sg

3) MY PAPER at myviews@sph.com.sg

These traps are loan FREE, courtesy of taxpayers. The cats then are killed FREE, courtesy of taxpayers. So you as taxpayers and even if not, as citizens and residents, have the RIGHT to PROTEST!

Resources to base your letters on
Wednesday, December 12, 2007
AVA replies

We got a reply from AVA about a few things we enquired about.

First of all, they DID send out letters to the town councils to express MND and AVA's support for sterilisation. They felt that sterilisation and killing the cats were both necessary components of a community cat programme.

The AVA also encouraged the town councils to work with caregivers and mentioned that the AVA was prepared to give a sterilisation subsidy and whom to call for more information. This letter was apparently sent out to all the town councils in April!

I'm certainly delighted to hear that the AVA is willing to sponsor sterilisations, and perhaps even more importantly, to support sterilisation AND working with caregivers. They've asked the town council to approach them for more information on the programme and for further information on the subsidies. Now the ball is really in the town council's court. Caregivers can (and should) speak with their TCs about getting this programme on the road!

Secondly, the AVA felt that it would be a breach of confidentiality to give out the details of complainants in private estates whom borrow cat traps. What we asked was that if someone borrows a cat trap, that they sign a form saying that they are willing to speak with caregivers if there is anyone there so I'll write to clarify this.

Thirdly, they mentioned that they would be willing to consider handing out the brochure on alternatives to killing cats for people who borrow cat traps. However, they wanted CWS to have a brochure that mentions alternatives to trapping AND killing.

We're clearly not going to do that because we're trying to provide alternatives to having the cats killed. Clearly also if someone borrows a cat trap, they KNOW about the killing - plus it's not a solution to solving the nuisances, so we're going to write about that too.
More at http://catwelfare.blogspot.com/search?q=ava+cat+traps

Cat welfare society
http://catwelfare.blogspot.com/search?q=ava+cat+traps

Monday, September 22, 2008

4. My cat can appreciate my wife's cooking aromas

Sep 23, 2008

"Doctor, my cat can now twitch his nose, life his head and appreciate the smells of my wife's curry in the kitchen," the owner suddenly remarked at the review of his cat's urinary problem after 2 weeks of treatment. I was surprised to hear him saying that his cat had lost his sense of smell for some weeks.

2 weeks ago, his cat had a strong urine smell in his belly. A white hairless skin patch full of urine stains in this belly area. What was the cause? The male cat pees away from his backside and not towards his belly. Even if he was incontinent or had a urinary tract infection (UTI), his urine would dribble onto his backside and anal area. But only his belly which was far away was affected.

This cat had given the owner some headaches. One day, he jumped at a bird near the window sill and fell four storeys down. Fortunately he did not suffer any internal injuries and was alive.

"As a prevention, I close all the windows nowadays when my family is not supervising this cat," the owner said.

"Will it not be stuffy when you don't let air into the apartment?" I asked.

"Yes. But this cat may leap at another bird at the window and crash," the owner said.

"The cat has 9 lives," I said. "He has used up one. But seriously, why don't you buy wire-mesh to cover the window opening?"

The owner was not so keen at this idea, but some cat owners do that, to prevent the cat running out of the main grille door and jumping off the windows.

Now, back to his cat's urinary problems. On instant diagnosis, the vet will assume that this cat has a urinary tract infection. No urethral obstruction as the cat could squat down and pee normally. Normal coloured urine and no urination problems and other signs indicating kidney failure.

Such a strong odour of urine in the belly. The cat licked off the urine but in the process, his rough tongue licked off all hairs in this belly area. This happened for some weeks. Therefore a prescription of antibiotics will resolve this cat's problems.

Yet the anatomy of the cat's male reproductive system would indicate that the urine stains on the belly could not be from the cat's male organ as it is located nearer to the anal area and points downwards and away from the belly normally. This was a normal cat.

"Something is wrong with your litter box," I said to the owner. Of course, it would be best to visit the apartment. The next best thing would be to listen to what the owner had to say. The owner had never mentioned about the litter habits of this cat as it did not occur to him that the litter box was the cause of the problem.

I mean, the cat goes to the litter box, squats and pees and get out. All normal cats do and this cat has had been using the litter box for so many years. He was around 5 years old now.

Well, the problem was really his litter box. The maid had covered the box well with overhanging newspapers. The cat stepped into the litter box. He squatted and peed onto the newspapers. As he stepped out of the box, his belly was splashed with his pool of urine. This happened frequently such that he could not clean himself but he tried to and continuous licking stopped all hair growth. So he had a patch of hairless belly.

Finally the cat gave up, I presumed. Therefore, his belly had urine stains. He lost his sense of smell.

I anaesthesized the cat. Cleaned him up thoroughly and asked the owner to get the newspapers just fitting inside the litter box. Put some sand below the newspapers. He was to continue washing the belly and giving the antibiotics. He was to come back for a review in two weeks.



I did not expect him to come back as most owners would not do when the cat's problems were resolved. However, he did turn up and that is how I am able to write this report.

"I told my maid not to spread the Straits Times over the edges of the litter box. I also punched holes in the newspapers inside the litter box. In this way, the cat's urine can flow downwards to the lower layers," he said.

The cat's belly was no long bald. The cat smelled good. He was a happy man. His wife must be happier too as the cat now stood by the kitchen door while she cooked curry, wrinkled his nose to tell her that her curry was first class and up to his feline standard.

Thursday, December 27, 2007

3. Why should a female cat be spayed?

----- Original Message ----
From: ...@yahoo.com>
To: judy@toapayohvets.com
Sent: Thursday, 27 December 2007 1:54:27
Subject: Query on Cat Spaying

Judy

We own a 6 month old female ragdoll kitten/ cat and we
were wondering whether it is time to have her spayed.
Our cat has had her early vaccinations performed by Dr
Teo E-Shen, Jason at the Toa Payoh surgery when she
lived with her previous owner.

Can you advise whether neutering is recommended? Being
a ragdoll she is not allowed to roam outside, but we
don't plan on using her for breeding. I assume it is
best for her to be spayed? How much notice do you need
to give you so she can be booked in for the operation?
How much does it cost?

Many thanks for your help.

Name given



E-MAIL REPLY FROM DR SING

I am Dr Sing from Toa Payoh Vets. To spay or not to spay a female cat is your personal decision. Most Singapore owners spay their female cats because they cannot stand the loud meowing (caterwauling) which can be a noise nuisance.

For animal welfare activists, all female cats and dogs ought be spayed to prevent unwanted pregnancies and the increasing stray, abandoned and wanted population in animal shelters.

We usually need one day's notice. No food and water to be given to the cat at 8 p.m on the night before spaying. Total cost is estimated to be around S$100.00

Tuesday, June 26, 2007

Cat -- How to stitch up a very big anal wound?

I am using the Google Docs & Spreadsheets for the first time to document this case. Pictures are at www.toapayohvets.
Be Kind To Pets educational story is to share my veterinary experiences with younger vets in other parts of the world as most veterinary surgical books are too brief on the overall management of the case of a large oval anal wound in a cat.

Jun 26, 2007 3.17 pm

What to do with such a large infected oval wound near the anus? The cat had licked out the fatty tissues under the skin. A big gap of 0.5 cm deep. She had stopped pooping. How to close such a big gap successfully?

1. Ideally, put the cat on antibiotics for a few days. Was the wound. But the wound is large.
2. The cat was fat, at 5.5 kg. Would she be able to survive the injectable general anaesthetic?
3. Anaesthesize the cat using xylazine and ketamine.
4. Clip the hairs, wash the areas. Syringe in 6% hydrogen peroxide.
5. Debride --- cut off dead skin edges and remove dead tissues from inside.
6. Relieve anal sacs of oil. Greyish brown oil seen from left gland. Right gland must have had ruptured resulting in a big hole.
7. Trim edges of wound --- convert to diamond shaped wound.
8. Undermine tissues to get loose skin.
9. Cut lowest end to extend the wound. Z-shaped wounds sutured.
10. Avoid anal sphincter (near the anal ring).
11. Elizabeth collar size 10.
12. Best to ward cat for 10 days but owner wants her home.
13. Warn the owner to confine the cat and if she runs around the home, she may rub stitches off.

14. In 14 days, wound will heal and stitches to be removed.






The owner did not return for stitch removal as she was a nurse in a hospital and I presumed everything was all right with the wound healing.