Cheang Ng Phaik Ling called me today regarding an emergency case of a recently adopted cat who could not urinate. An appointment was made at our panel vet and I met Cheang at the vet's immediately after work today.
When I reached the clinic, Cheang was already there with Mickey, the cat. Apparently, the vet was trying to look for Mickey's penis but could not find one. Cheang said Mickey is always "wet" (probably dripping urine). But where is his penis?
The vet pressed the surrounding area, but there was no penis!
It was obvious Mickey has anatomical deformities. This is also evidenced by the fact that Mickey's two hind legs are deformed. He drags his back legs around.
Now, the problem here is Mickey has not been able to urinate since yesterday.
But Cheang said she saw Mickey's penis hanging out today and she pushed it in. Now, the vet just couldn't get it out again.
Differential diagnoses:
1. Mickey looks perfectly happy and well. Maybe he just drips urine and as long as he can "drip" the urine out, that's the way his body functions. We hope it is this. A few days' observation would confirm this. But Cheang insists Mickey has stopped urinating and there is no dripping either.
2. Mickey's bladder has ruptured, and this would be very complicated and possibly bad news. If the rupture is in the frontal area, it can be repaired, so Mickey would have a fighting chance. But if it is anywhere else, repair would be very difficult and Mickey will die. The urine will toxify the body since it's flowing out from the ruptured bladder into the other parts of the body. A perineal urethrostomy may have to be done as well. Please see this: http://www.vetsurgerycentral.com/urethrostomy.htm
The vet explained in detail using the diagram above.
See Mickey dragging his feet around? He is "deformed' and that is why he has all these problems. He was surrendered to the shelter with his siblings and he was due to be euthanised but Cheang took him out and adopted him. That was about a month ago.
He's a handsome long-haired cat too.
Let's try to look for his penis again.
YES, we found his penis this time. So he definitely has one.
But the vet discovered something else, which was very bad news. There is a high chance of the bladder being ruptured. This is because the vet felt a bladder, but when it was pressed, the contents of the bladder (urine) emptied itself, yet no urine came out of the penis. Where did the urine go? It is almost definitely a ruptured bladder.
We discussed the possibilities.
But look at Mickey...he's so alert and happy.
The vet advised Cheang to seek a second opinion from another vet but she wasn't keen. It would have been good to have a second opinion so that it increases everyone's confidence in the diagnosis. This is a case where X-Rays and ultra-sound would not help, but a second opinion would.
The exploratory surgery would reveal if there was a rupture and where it was. If it is frontal, it can be repaired, but if it were anywhere else, nothing much can be done. The vet said he would advise euthanasia as Mickey would die a slow and painful death.
Cheang could not decide and asked me what I would do. I said I would definitely go with the surgery and give Mickey a fighting chance to live on. There is a chance the rupture can be repaired.
But it was still Cheang's call as this is her adopted pet. I gave her time to decide. The estimated cost is RM1500. Cheang said she needed financial assistance I told her she could apply to PetFinder.my and AnimalCare. PetFinder.my's maximum is RM500, we'll help her with the rest as much as we can but we hope she would be able to raise some funds on her own as well.
Finally, Cheang decided to go for the surgery, but if the rupture is not frontal, she says she would opt for euthanasia. I explained to Cheang that we do not sponsor euthanasia, but would respect her decision. We will subsidise the surgery and hope for the best.
I went to see Mickey before I left, patted him and wished him well.
I felt a little sad as it could be the last time I'd see him, but I kept my hopes high.
Let's hope the rupture is in the frontal area and that it can be repaired.
Since I came back home, I have been praying for Mickey and looking at the clock. The vet had said if it's beyond repair, it would be euthanasia straight away (Cheang's decision).
As the hours ticked by, my hopes grew....that means there is some sort of surgery going on. I called the clinic. There was no reply. Never mind....just pray.
Updates at 4.20pm:
It's good news and bad news, said the vet.
The bad news is the rupture was not in the frontal area but somewhere at the back. This explained the "messiness" we saw in Mickey's anus. The urine had been accumulating in that back portion and had caused the bruising.
The good and almost miraculous news is that (let's thank all Mickey's guardian angels right now....AND a very skilful vet!), the vet managed to somehow insert a catheter through the penis and this catheter now serves as part of the urethra, ie. an outlet for the urine to flow from the bladder to be excreted.
What is left now is to wait for 5 days for the damaged part (the rupture) to heal on its own. With urine now flowing out of the body and no longer accumulating inside, there is a chance the rupture can heal. If it doesn't, another surgery may be possible to rectify the problem.
So, there is hope, folks!
Please pray for Mickey's recovery and another miracle to happen.
We thank our vets for a job well done. This IS a miracle. Pinch me, someone!
I shall be working together with PetFinder.my to see how best we can help Cheang with the cost of the surgery.
I need a rest now....
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