FELINE URETHRAL OBSTRUCTION SECONDARY TO A FOREIGN BODY

Background: Urethral obstruction is a common emergency presentation in male cats. Urolithiasis, plugs, and congenital/acquired abnormalities (such as urethral strictures) are the most prevalent causes, while foreign bodies are extremely rare. This case report describes urethral obstruction in a cat due to a broken urinary catheter. Case presentation: A 12-year-old, male neutered, European cat was presented to the emergency service of the Veterinary Teaching Hospital for stranguria and hematuria, with a history of urethral obstruction resolved by catheterization 5 years before. At hospital admission, the cat was depressed, with a painful and overdistended urinary bladder, heart rate 140bpm, respiratory rate 20bpm, and temperature 38.2°C. Abdominal point of care ultrasound revealed perivesical peritoneal effusion and bladder intraluminal hyperechoic material. Venous blood gas revealed metabolic acidosis and increased values of BUN (229mg/dL), and creatinine (18.7mg/dL). Sacrococcygeal epidural anesthesia was performed under sedation, and a urinary catheter was positioned. During catheterization, a plug was excreted from the urethra and sent for analysis, as well as a urine culture sample. The day after, a complete abdominal ultrasound was done, and an intraluminal linear foreign object was observed in the urethra beyond the presence of the urinary catheter. Additionally, a diagnosis of pyelonephritis of the left kidney and hydronephrosis of the right was made, based on ultrasonographic and urinary findings. The urinary catheter placed the day before was removed, a CT study was performed the presence of a linear foreign body broken into 2 pieces in the urethra was confirmed and urethrotomy was necessary to find the fragments. Nephrectomy of the left kidney, cystotomy and urethrotomy were performed and the 5-year-old urinary catheter was removed. The cat was discharged after 13 days, uneventfully. New/Unique Information: Diagnostic imaging should be considered for any patient who exhibits symptoms of urinary tract obstruction; the passage of a urinary catheter does not exclude the presence of a foreign body as seen in the present case. Furthermore, after the first obstruction event, the cat never experienced episodes of stranguria or hematuria. Finally, to ensure that no catheter fragments are left inside the bladder, it would be crucial to monitor the integrity of every catheter during any disostruction.