Animal diseases 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, such as urethrostomy in cats.
Urethrostomy
This operation, as a result of which the animal has a new hole for urination, located between the peritoneum and the wide part of the urethra. In recent years, it has become less and less possible to bring the situation to surgical intervention, since many drugs have appeared that can prevent the channel from clogging. Proper diet and information that owners of animals with urolithiasis should have available make it possible to avoid surgery.
Indications
Urethrostomy in cats is prescribed by the attending physician in cases where other methods of solving the problem do not give positive results. In addition, obstruction of the distal part of the urethra can be unrecoverable, for this reason it is necessary to resort to surgery. The urethra is a channel through which urine is excreted from the body. Its structure in cats is uneven in width. As it approaches the urethra, it becomes thinner. Most often it is in this place that a blockage occurs. In most cases, the cork consists of salts or blood cells, which can be 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 conservative treatment first, and only if it does not help, they resort to surgical intervention.
There are doctors who do their best to avoid such an intervention due to complications. Cats urethrostomy , reviews of which are highly controversial, may result in stoma infestation - partial or complete.
Most of the complications arise due to too much load on the sutures of the mucosa in the healing process. Often, connective tissues grow in the hole formed during the operation.
To eliminate the consequences of this kind is quite difficult, the more likely the deterioration of the state of the animal itself due to the exacerbation of concomitant diseases. Not the last role in the course of recovery is played by the mood of the owners - most often they behave rather inert and pessimistic.
Preparation for surgery
Owners of almost all animals that are recommended for cat urethrostomy have observed problems with urination. Such disorders contribute to the development of renal failure, most often in acute form. Before the operation, it is very important to identify this situation and correct it. Sometimes catheterization during surgery is not possible, so you have to resort to cystocentesis - the removal of urine from a punctured bladder through the abdominal wall.
If inflammation of the urinary system lasts long, the development of sepsis and anemia is likely, which, of course, requires timely diagnosis and optimization. Urethrostomy in cats requires the following tests:
- Ultrasound of the abdominal cavity.
- General analysis of urine and blood.
- 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 the complete restoration of the animal. The purpose of the operation is the removal of the problem part of the urethra. Most often, this is a site from a polovokolone bone. Short urethra simplifies the process of urination, especially when the bladder is incompletely emptied for a long time, leading to overstretching of its walls. The diameter of the urethra in the pelvic area of the urinary canal is wide enough, which allows virtually eliminating repeated obstruction.
Operation progress
From a variety of pathologies depends on how complex or simple the operation will be in a cat. Urethrostomy, accompanied by urolithiasis, which is the most common case, requires a control ultrasound before surgery, radiography, which allows to determine the final position of the stones and their exact number. After this, the urethra is washed, the bladder is catheterized. If before that the cat retained the function of reproduction, castration is performed. The next step is a urethrostomy in a cat. The course of the operation involves hemming a part of the urethra, which has a wide diameter, to the skin. The penis is completely removed.
Briefly, this is how a cat urethrostomy is made. The course of the operation may vary somewhat depending on the physical characteristics of the animal and associated diseases. In general, under epidural and inhalation anesthesia, the operation ends in 25-45 minutes.
Restoration of a stricture urethra
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 surgery, catheterization, during which an injury was caused.
Damage may also result from external injury. If the problem appears more caudal than 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 a pharyngeal urethrostomy to the right and below the pelvis. Partial gusts are sutured if the surrounding tissue is alive. In case of violation of the proximal urethra, we are talking about a cystoma or anastomosis. Unfortunately, both of these procedures are not an ideal solution: the installation of a cystoma leads to incontinence, while the anastomosis causes various anomalies of an acid-base or electrolyte nature.
Early complications
Urethrostomy in cats, reviews of which cause serious fear for your pet, is sometimes fraught with various complications.
This may be primarily bleeding. Minimize it by including a member cavity in the urethral sutures. If bleeding occurs, the specialist presses on the injection site, which often stops the blood. Most often, this is a non-hazardous event for the animal, which does not require repeated surgical intervention. The color of the mucous membranes and the measurement of hematocrit allow us to determine the degree of bleeding. With constant and strong establish its location and ligate it under anesthesia.
In very rare cases, a cat after an urethrostomy operation may show symptoms of anuria. It occurs in cases where urine has not been excreted for more than two days. The likelihood of complications increases with each hour exceeding this period.
Acute renal failure develops in those cases when, before the intervention, an increase in this organ was observed in the animal. The second option is if the cat spent a long time in a state of hypotension and dehydration. To establish the presence of pathology, a urinalysis will help. Specific density gives a high probability of prerenal causes of failure. Based on the results, treatment will be carried out aimed at eliminating hypovolemia, hypotension and dehydration.
Late complications
The list of late complications that may occur after surgery is much wider and includes not only pathologies of a random nature, but also oversight or specialist errors.
Recurrent cystitis occurs in a third of cats that have had surgery. Very often, it is asymptomatic, so animals that have been interfered with need to do urine culture every six months .
To identify the causes of such a complication as dysuria, it is necessary to study the place of intervention as carefully as possible in search of unremoved sutures. The condition of the urethra is assessed by insertion of a catheter into the bladder. If blockage is observed with sand, its removal occurs after irrigation with anesthetics. Urine obtained in this way is tested for baculture. If microflora is detected, it is necessary to conduct a course of antibiotic treatment. The absence of bacteria indicates a possible cause of dysuria - feline urological syndrome. Despite the fact that in most cases a cat’s operation has a urethrostomy, reviews of which make it possible to independently decide on its rationality, prevents obstruction, it cannot eliminate the possibility of a relapse of the syndrome. Constant dysuria requires a contrast-enhanced x-ray to identify other causes of the disease. It can be tumors, stones, and more.
A stricture is observed quite often. Contamination of the seams leads to it. According to various sources, this complication occurs in 12% of cases. Stricture build-up can be avoided due to careful preparation of tissues and absolute attention to surgical technique.
Operational errors leading to stricture:
- Insufficient dissection of the urethra, in which the bulbourethral glands do not extend beyond the skin. In this case, the tension is very likely to lead to deepening of the stoma and further stricture. It is to eliminate such a problem that the pelvic ligaments and muscles must be dissected to their entire thickness.
- Loose skin contact with the urethra. In this case, the wound does not heal for a long time, the fault is the primary tension. The tissue produced by secondary tension levels the purpose of the operation, reducing the diameter of the stoma.
- Incorrect stapling technique. If you do not tighten the seams very carefully, use a cutting needle, the appearance of foci of excessive granulation, which in the future can completely block the stoma.
In addition, stricture appears for non-surgical reasons:
- The occurrence of small ruptures of the urethra obtained by catheterization. An occlusion of the urethra after several catheterizations is an indication for a pharyngeal urethrostomy.
- Auto-mutation occurs when the stoma is damaged by an animal that has not been worn with a protective collar.
- The seams. The ends of the seams must be long enough so that by the time they are removed they were not difficult to detect. Forgotten seams can trigger suture granulation.
Minor stricture can be corrected by neat expansion with a small clip. However, most often it is necessary to carry out an additional operation. In rare cases, when the urethra is severely injured and strictured, a pharyngeal urethrostomy is performed.
After operation
Reconstruction of a cat after a urethrostomy is a process that requires the help and attention of the owners. In the clinic, the animal spends in most cases a day after surgery. Then they put on a special collar that will not let him lick the seams. Antibacterial treatment and drugs for pain relief are mandatory. If there are indications, infusion therapy is carried out . Specialists closely monitor the condition of the animal as a whole and its urination in particular. If doctors do not consider his condition satisfactory, under the supervision of the pet he will spend a little more time.
Houses
Recovery from a cat after surgery takes different periods of time. It depends on the physical condition of the animal, and on the prescribed treatment, and on the accuracy of compliance with the recommendations of a specialist. Even the mood of the owner affects the speed of recovery of the pet.
Restoring a cat after a urethrostomy primarily involves the continuous wearing of a collar, as these animals are especially prone to lick their wounds. Unfortunately, in cases of surgical intervention, this method of "treatment" can only do much 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. This is usually done twice a day. With proper healing, the sutures are removed after two weeks. If the animal has an urolithiasis, he must follow a special diet. Keep fresh water always available.
Recommendations
Owners of animals that have undergone this complex operation are very worried about their pets, create entire communities to receive more complete information and to communicate with people who have already experienced this with their animals. The questions asked by the owners are repeated on various resources, so it is worth answering them separately.
Owners often wonder how cats move away from a urethrostomy. It is difficult to say for sure, but still most animals satisfactorily tolerate anesthesia and surgery. It is not recommended to put the cat on the bed or other high surfaces, because, coming out of anesthesia, he makes unconscious movements, may try to jump, which, in turn, often leads to disruption of stitches. This is one of the reasons why it is worth leaving the animal for a day in the clinic. Rehabilitation of a cat after a urethrostomy includes, among other things, monitoring the safe exit from anesthesia. Many animals, even after a day, remain somewhat disoriented, and therefore, after returning home, it is worthwhile to help him recover, not to allow jumping to high surfaces, to help descend from the hills.
Many owners, in addition, are worried that the cat eats poorly after a urethrostomy. Most often the first few days the animal eats very little, it is generally quite apathetic these days. No need to feed him force or insist. A few days a cat is better to relax. However, if this period is delayed, if the animal does not eat at all, if it has a temperature or severe pains are observed, it is necessary to consult a doctor. Lack of appetite amid other symptoms may indicate the development of inflammation or infection.
Often questions are asked about how to feed a cat after surgery. Urethrostomy is a fairly serious intervention, and adherence to 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 diet after the tests.
In general, despite the fact that this is a rather serious operation - a cat urethrostomy - leaving after the operation does not require significant efforts. It is enough, according to the recommendations of the attending physician, to process the seams, wear a collar, make sure that the stoma is clean and does not overgrow. Antibiotics and pain medications are given only the first time. In addition, it is worth controlling the amount and volume of urination. If it seems that the cat goes to the toilet too often, or all urine does not come out, or he urinates for too long, be sure to contact a specialist. Having doubts about the doctor’s recommendations? Go to a different clinic to be sure to avoid complications that could lead to reoperation.
Sometimes on the stoma there are crusts formed by blood and urine. If their number is insignificant, they can be removed with a solution of chlorhexidine (0.05%), previously soaked with peroxide. At the same time, make sure that peroxide does not get on the mucous membrane. However, with a large number of them, it is better to consult a doctor to exclude the appearance of complications.
Swelling of the resulting hole can last up to 5 days. If more time has passed, but everything still looks edematous, you are again dear to the clinic.
After the operation, it is necessary that the animal consume a lot of fluid. It is necessary to carefully monitor the weight of the cat. It is noticed that animals with excess weight, leading a sedentary lifestyle, are more likely to suffer from diseases of the urinary system. Inadequate water intake can also give impetus to the development or relapse of the disease.
If the doctor suggests performing this operation after other types of treatment have been tried, do not refuse. This intervention is performed for health reasons. The 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 for a happy life without pain.
In addition, it must be remembered that this procedure does not cure the disease that caused the blockage. It only eliminates the cork itself and reduces the likelihood of its occurrence in the future. However, the underlying disease must be treated additionally, so the main thing now is regular medical examinations and exact adherence to all the recommendations of a specialist.