Urethrostomy in cats: consequences and course of operation
Diseases of animals are no less diverse than in humans. Some diseases are almost asymptomatic, so the owner notices the problem even when it is necessary to perform an operation, for example urethrostomy in cats.
This operation, as a result of which the animal has a new opening for urination, located between the peritoneum and the wide part of the urethra. In recent years, to reduce the situation to surgical intervention is increasingly rare, because there are many drugs that can prevent the process of plugging the channel. The correct diet and information that should be available to owners of animals with urolithiasis, make it possible to avoid surgical intervention.
Urethrostomy in cats is prescribed by the attending physician in those cases when other methods of solving the problem do not give positive results. In addition, the obstruction of the distal part of the urethra can be unremovable, which is why you have to resort to surgery. The urethra is a channel through which urine is excreted from the body. Its structure in cats is characterized by uneven width. As you approach the urethra, it becomes thinner. Most often in this place, there is a blockage. In most cases, the plug consists of salts or blood cells, which is explained either by urolithiasis or cystitis. Sometimes obstruction is the result of injuries, inflammation or tumors.
Perineal urethrostomy in cats can activate the development of urinary tract infections. It is for this reason that specialists prefer to conduct first conservative treatment and only if it does not help, resort to surgical intervention.
There are physicians who avoid such interference because of complications. Urethrostomy in cats, reviews of which specialists are highly controversial, can result in the infecting of the stoma - partial or complete.
Most of the complications arise because of too much stress on the sutures of the mucosa during the healing process. Often connective tissues grow in the opening formed during the operation.
Eliminate the consequences of this kind is rather difficult, the more likely is the deterioration of the condition of the animal itself due to the aggravation of concomitant diseases. Not the last role in the course of recovery is played by the mood of the owners - most often they behave quite inertly and pessimistically.
Preparing for an operation
Owners of almost all animals who are recommended urethrostomy in cats, observed problems with urination. Such disorders contribute to the development of renal failure, most often in acute form. It is very important before the operation to identify this situation and adjust it. Sometimes, catheterization during surgery is not possible, so you have to resort to cystocenesis - draining the urine from the punctured bladder through the abdominal wall.
If the inflammation of the urinary system lasts a long time, it is likely the development of sepsis and anemia, which certainly requires timely diagnosis and optimization. Urethrostomy in cats requires the following tests:
- Ultrasound of the abdominal cavity.
- General analysis of urine and blood.
- A blood test for biochemistry.
- Contrast radiography of the urinary system.
If other diseases are found, additional tests may be required.
The essence of the operation
Urethrostomy in cats, the consequences of which can be quite serious, requires a clear understanding by the owner of every step from diagnosing the disease to fully recovering the animal. The purpose of the operation is to remove the problem part of the urethra. Most often this is a site from the reproductive bone. A short urethra leads to a simplification of the process of urination, especially when the bladder is not completely emptied for a long time, leading to overstretching of its walls. The diameter of the urethra in the pelvic region of the urinary canal is quite wide, which makes it virtually impossible to re-occlude.
Progress of the operation
From various pathologies depends on how difficult or simple will be the operation of the cat. Urethrostomy, accompanied by urolithiasis, which is the most common case, requires a follow-up ultrasound before the operation, radiography, which allows you to specify the final position of the stones and their exact number. After that, the urethra is washed, the bladder is catheterized. If before that the cat kept the function of reproduction, castration is performed. The next step is urethrostomy in the cat. The course of the operation involves stitching a part of the urethra, having a wide diameter, to the skin. The penis is completely removed.
In short, this is the way the urethrostomy is produced in the cat. The course of the operation may vary somewhat depending on the physical characteristics of the animal and the concomitant diseases. In general, under epidural and inhalation anesthesia, the operation ends after 25-45 minutes.
Reconstruction of the urethral stricture
Sometimes, fortunately, infrequently, there is a rupture of the urethra and its stricture. This can be caused by necrosis, excessive pressure on the penis during the operation, catheterization, during which an injury was caused.
Damage can also occur as a result of an external injury. If the problem appears caudal to the prostate, urethrostomy in cats, the consequences of which are more dangerous than the disease itself, can be carried out. To correct the pathology, it is necessary to use the prelone urethrostomy to the right and below the pelvis. Partial impulses are sewn up in case the nearest tissues are alive. In the case of violation of the proximal urethra, it is a question of cystoma or anastomosis. Unfortunately, both these procedures are not an ideal solution: the placement of cystoma leads to incontinence, whereas anastomosis causes various acid-base or electrolyte anomalies.
Urethrostomy in cats, reviews of which make you seriously fear for your pet, sometimes fraught with various complications.
This can be primarily a bleeding. Minimize it by including the cavity of the penis into the urethra sutures. When bleeding occurs, the specialist pushes the injection site, which often stops the blood. Most often it is a non-hazardous event for the life of an animal, which does not require repeated surgical intervention. The color of the mucous membranes and the measurement of hematocrit make it possible to determine the degree of bleeding. At constant and strong establish its presence and ligate it under anesthesia.
In very rare cases, the cat after the operation of urethrostomy can show symptoms of anuria. It occurs in cases where urine was not excreted for more than two days. The likelihood of complication increases with each hour exceeding this time.
Acute renal failure develops in those cases when, before the intervention, the animal was observed an increase in this organ. The second option - if the cat for a long time spent in a state of hypotension and dehydration. Determine the presence of pathology will help urine analysis. Specific density gives a high probability of prerenal causes of insufficiency. Based on the results, treatment will be conducted to eliminate hypovolemia, hypotension and dehydration.
The list of late complications that may occur after the operation is much broader and includes not only pathologies of a random nature, but also an oversight or mistakes of a specialist.
Recurrent cystitis occurs in a third of cats who underwent surgery. Very often it passes asymptomatically, therefore, the animals subjected to the intervention need to make a urine culture every six months.
To identify the causes of such complications, as dysuria, you need to carefully study the place of interference in the search for unsuccessful sutures. The condition of the urethra is assessed by insertion into the bladder of the catheter. If there is a blockage in the sand, it is removed after irrigation by anesthetics. The urine thus obtained is tested for bacterial culture. In case of detection of microflora, it is necessary to conduct a course of antibiotic treatment. Absence of bacteria indicates a possible cause of dysuria - urological syndrome of felines. Despite the fact that in most cases, the operation of a cat urethrostomy, reviews of which provide an opportunity to decide on its own rationality, prevents obstruction, it can not eliminate the possibility of a recurrence of the syndrome. Constant dysuria requires a contrast radiograph to identify other causes of the disease. It can be tumors, stones and stuff.
Stricture is observed quite often. It causes contamination of the joints. According to various sources, this complication occurs in 12% of cases. Avoid the growth of stricture can be due to careful preparation of tissues and absolute attention to surgical technique.
Operational errors leading to the emergence of stricture:
- Insufficient dissection of the urethra, in which bulbourethral glands do not extend beyond the skin. In this case, the tension is very likely to lead to a deepening of the stoma and further stricture. It is to eliminate such a problem that the pelvic ligaments and muscles should dissect to the full thickness.
- Lack of contact with the urethra. In this case, the wound is not overgrown for a long time, the primary tension is the fault. The tissue produced by the secondary tension neutralizes the purpose of the operation, reducing the diameter of the stoma.
- Wrong stitching technique. If you tighten the seams not too carefully, use a cutting needle, probably the emergence of foci of excessive granulation, which can further completely block the stoma.
In addition, stricture appears for non-surgical reasons:
- Occurrence of small urethral ruptures, obtained during catheterization. Occlusion of the urethra after several catheterizations performed is an indication for conduction of the prelone urethrostomy.
- Automutulation occurs when the stoma is damaged by an animal, which is not wearing a protective collar.
- Seams. The ends of the seams must necessarily be long enough that at the time of their removal it was easy to detect. The forgotten seams can provoke the emergence of suture granulation.
A minor stricture can be corrected by neat extension with a small clamp. However, most often we have to perform an additional operation. In rare cases, when the urethra is severely injured and striated, a prelone urethrostomy is performed.
The rehabilitation of a cat after urethrostomy is a process that requires the help and attention of the owners. In the clinic, the animal spends most days after the operation. Here he is put on a special collar, which will not allow him to lick the seams. Antibacterial treatment and preparations for anesthesia are necessarily prescribed. If there is evidence, an infusion therapy is performed. Specialists closely monitor the condition of the animal as a whole and its urination in particular. If his condition is not considered satisfactory by doctors, under supervision the pet will spend some more time.
Restoration of the cat after the operation takes different time intervals. It depends on the physical condition of the animal, and on the prescribed treatment, and on the accuracy of the recommendations of the specialist. Even the mood of the host affects the speed of recovery of the pet.
Restoration of a cat after urethrostomy primarily includes continuous wearing of the collar, as these animals are particularly prone to licking their wounds. Unfortunately, in cases of surgical intervention, this method of "treatment" is only capable of doing harm. Therefore, a collar is required! In addition, it is necessary to regularly process postoperative sutures and give antibiotics prescribed by a doctor according to the recommendations. Usually this is done twice a day. With proper healing, the sutures are removed after two weeks. If the animal has urolithiasis, it is necessary to observe a special diet. Make sure that fresh water is always available.
Owners of animals that have undergone this complex operation are very worried about their pets, create whole communities for more complete information and to communicate with people who have already experienced it with their animals. The questions asked by the hosts are repeated on various resources, so it is worthwhile to answer them separately.
Owners often wonder how cats move away from urethrostomy. It's hard to say definitely, but most animals satisfactorily tolerate anesthesia and surgery. It is not recommended to put a cat on a bed or other high surfaces, because, when coming out of anesthesia, it makes unconscious movements, it can try to jump, which, in turn, often leads to seams breaking. This is one of the reasons why it is worth leaving the animal for a day at the clinic. Rehabilitation of a cat after urethrostomy includes, among other things, monitoring the safe exit from anesthesia. Many animals even after a day remain somewhat disoriented, and therefore at home after the return it is worthwhile to help him to recover, not to jump on high surfaces, to help descend from the hills.
Many owners, in addition, worried that the cat does not eat well after urethrostomy. Most often the first few days the animal eats very little, it is generally quite apathetic these days. You do not need to feed it or insist. A few days to a cat is better to rest. However, if this period is delayed, if the animal does not eat at all, if it has a fever or severe pain, it is necessary to consult a doctor. Lack of appetite against other symptoms may indicate the development of inflammation or infection.
Often asked questions about what to feed the cat after the operation. Urethrostomy is a rather serious intervention, and compliance with recommendations is simply necessary. Most often it is advised to feed the animal with specialized food up to six months after the operation. The doctor will advise the further ration after carrying out of analyzes.
In general, despite the fact that this is quite a serious operation - the urethrostomy of the cat - care after the operation does not require significant efforts. It is enough, according to the recommendations of the attending physician, to process seams, to wear a collar, to watch that the stoma was clean and not overgrown. Antibiotics and pain medications are given only the first time. In addition, it is necessary to control the amount and volume of urination. If it seems that the cat goes to the toilet too often, or all the urine does not come out, or it takes too long to urinate, be sure to consult a specialist. Do you have any doubts about the doctor's recommendations? Contact another clinic to avoid complications that might lead to a second operation.
Sometimes on the stoma there are crusts formed by blood and urine. If their amount is insignificant, they can be removed with a solution of chlorhexidine (0.05%), pre-soaked with peroxide. In this case, make sure that the peroxide does not fall on the mucous membrane. However, with a large number of them, it is better to consult a doctor to avoid complications.
The edema of the resulting hole can last up to 5 days. If more time has passed, but everything looks still swollen, you again go to the clinic.
After the operation, it is necessary for the animal to consume a lot of liquid. We need to closely monitor the weight of the cat. It has been noticed that animals with overweight, who lead a sedentary lifestyle, are more likely to suffer from diseases of the urinary system. Insufficient water intake can also give rise to the development or relapse of the disease.
If the doctor suggests conducting this operation after other types of treatment have been tried, you should not refuse. This intervention is carried out according to vital indications. Blockage of the urethra can lead to poisoning of the body, from which the animal can die. When making a decision, keep in mind that the life of the pet is at stake. And although the operation is quite serious, it gives the animal a chance to have a happy life without pain.
In addition, it must be remembered that this procedure does not cure the disease, which was the cause of the blockage. It only eliminates the cork itself and reduces the likelihood of its occurrence in the future. However, the main disease must be treated additionally, so the main thing now is regular medical examinations and accurate adherence to all the recommendations of a specialist.