After thirty years of practice it certainly isn’t an unfamiliar scenario for any day of the week. However, Theodore turned out to be a very unusual presentation.
His pet parents, we’ll call them Joe and Susie, had gone on vacation. Nevermind where they went, we’ll just say it’s one of our favorite places in the world and it’s in the Smoky Mountains of Tennessee.
They had been back in town less than two hours when they called, panicked, that Theodore was a cat straining to urinate and incontinent, dribbling urine everywhere he went. Normally an enthusiastic kitty eager to play, talk, greet, be greeted and be stroked, his activity level was clearly down.
We examined him and found all body parts normal as well as temperature, heart and lung sounds. Palpating his urinary bladder we discovered it was of average size, certainly not the huge bladder of a cat whose urinary outflow was obstructed. Furthermore, with gentle pressure a nice stream of urine flowed from his urethra, providing us with the sample we needed for urinalysis.
Chemically there was but a very small amount of blood in the urine and a moderate amount of protein. Microscopically, however, we quickly discovered a massive quantity of bacteria: infection!
Then there was the matter of Theo not feeling well. Simple lower urinary tract infections (UTI) usually do not make patients ill. Typically for a UTI to make a cat sick he must be obstructed or have the infection ascend the ureter to the kidneys.
An appropriately-sized injection of Convenia, then it was time to try to tie the entire picture together. A little veterinary CSI.
Theodore is one of those cats who has a mind of his own. He’s also one of those cats who doesn’t particularly care for a litterbox, so he has a cat door to “go” outside whenever he wants to.
While his family was gone to the Smokies, we were having unusually cold weather here on the Mississippi Gulf Coast, the lowest of which was 19 degrees. Those of you in Minnesota probably aren’t impressed, but for Deep Southerners, that’s cold! Therefore, Theo’s caretaker didn’t think he should go outside and be exposed to such extreme temperatures.
Forced to be inside with a litterbox, we theorize that he probably didn’t urinate at all for the first two to three days. That made his bladder really huge, stretching the musculature of the bladder and desensitizing the mechanisms that would normally prevent him from passing urine involuntarily. The resulting stagnant urine began to rise in pH (decreased acidity) and bacteria ascended the urethra into the bladder. Now Theodore has a weak bladder with an irritated wall, so he has a strong urge to empty the bladder. He has nowhere to “go” but the much-disliked litterbox. However, weak muscles won’t allow him to empty the bladder completely. So the urine stagnates even more, the infection grows exponentially and pretty soon he’s a sick kitty.
Fortunately for Theodore, Joe and Susie’s trip was short and we were able to get him an appointment within two hours of their arriving home, seeing he didn’t feel well and calling us.
That was yesterday. Today we have his blood test results which show that he has some dehydration and a little kidney involvement, but his immune system, combined with the Convenia should give him a quick turnaround. In fact, this morning’s phone call found him feeling much better and having slept quietly all last night. He is, however, still suffering a little incontinence.
We fully expect that as the abused muscles that give him control get back to normal, and the irritation of infection is removed, even the “drippage” will resolve fully.
The take-home message: If you leave your pets in the hands of a caretaker, ensure, in writing, that they know every quirk and habit your pets have. Also, they must do more than just feed and water, they must observe normalcy in each pet. They must have an emergency phone number to contact you if anything doesn’t seem right. Lastly, ensure that your pet’s doctor knows you will be away from home and will be prepared to care for any medical situations that might arise if the pet caretaker were to bring a sick pet into the hospital during your absence.
See you tomorrow, Dr. Randolph.