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A Tale Of Three Kitties || Mario
Posted on the 15th of December, 2014 at 8:00 AM
Over the next two weeks, I will be sharing stories about three cats I have seen who had a type of urinary stone called calcium oxalate. I originally was planning one entry for this topic but as I began writing their stories, I realized I could not recount history with just a single post. Each story has important lessons about the role of these urinary stones in disease.
Mario is a 15 year old, black and white kitty who never really enjoys visiting me. You may have even heard Mario, his screeches reach our front lobby. I have a special place in my heart for him, even if it is not reciprocal.
I found urinary stones in Mario during routine senior screening over a year ago. The calcium oxalate stones were found in his kidneys (yellow arrow), ureters (blue arrow), and bladder (red arrow). Mario also had a high blood calcium level and elevated kidney values. Unlike our other feline stories, Mario had no symptoms. At least, not yet.
Once we found these abnormalities we had a lengthy discussion about management. We transitioned Mario to a special urinary food. We also recommended a supplement called potassium citrate. This powder helps bind oxalate, one of the ingredients for calcium oxalate stone formation, and raises the urinary pH to make stone formation less favorable. Mario did not tolerate nor like the supplement so we stuck with just the food alone. When we followed up on this labwork, his calcium level dropped back into the normal range, his kidney values improved, and he was still urinating.
Then this October I saw Mario for what we had been dreading for over a year - full urinary obstruction. Stones had lodged in his urethra making urination impossible. This constitutes a medical emergency and can be life-threatening.
We checked his labwork before anesthesia, his kidney values raised slightly due to the urinary obstruction. Once he was anesthetized, we were able to place a urinary catheter and remove significant amounts of bloody urine with black sandy debris. We flushed his bladder copiously to try and remove as much debris as possible. He stayed in the hospital overnight on fluids and did very well. You could tell when he was feeling better because he became more vocal and began swatting at us when we would look in on him.
A month later Mario was back for the same issue. He was depressed, not eating, and not using his litterbox. We quickly evaluated him and sure enough his bladder was enormous. His penis was also extruded (which is relatively common in obstruction) and a stone could be seen near the tip. We gently tried to work this stone out but it just wouldn’t budge. We then used our therapy laser on his penis to treat the inflammation, swelling and pain he was experiencing. After treatment he was more relaxed and with a little more massage we were able to remove the stone and Mario could urinate again.
Mario is back to his old self, yelling at me when he is here but more importantly urinating in his litterbox at home.
Mario’s story shows us that not all cats have symptoms of urinary stones and how important screening can be in identifying underlying issues. I’m convinced that because of the changes we made last year, we have improved Mario’s quality of life and helped protect his kidneys. I’m never happier when I hear Mario screaming to see me in the front lobby, that’s how I know he is feeling “good.”
Posted by: John Clappier, DVM
Previous Article: A Tale Of Three Kitties || Savannah
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