Friday , 22 September 2017

Dr. Amanda Glew & the Christmas Miracle

Bobbi becomes “Bobinette”

By: Dr. Amanda Glew

Every Christmas I ask for a miracle. Of course, it involves an animal miracle, so is may not be too important on the grand scheme of things.  However, for me, my staff, the animal and of course, the owner, it can be life altering. Bobbi was our miracle this year.

Bobbi presented to our Hospital as a blocked cat. This condition happens when a cat forms a plug- either crystal or mucous, somewhere along their urethra, and can no longer pee. Their kidneys quickly become compromised if the blockage is not relieved. Most often an uncomplicated procedure, however, when things go badly, one remembers why prevention of this condition is very important. Narrowing of the urethra (leading to the penis) is a sequelae, as well as lack of bladder tone, contributes to recurrence or imcomplete emptying of the bladder. The constant placement of catheters increases the chances of perforation, and then urine leakage into the abdomen. A urethral tear does not readily heal.

Bobbi had all of the above, and after many days of hospitalization and surgical procedures, we realized there was a tear. His abdomen was filling up with urine. There was only one solution- a perineal urethrostomy, which in layman’s terms, is a feline sex change. I was up to the surgery, or so I thought.  2.5 hours later I had opened the urinary bladder, placed a catheter outwards, realized the hole preventing me from doing this was far down, went in the other way, could not access the bladder from this way, dissected out the cats penis, still could not assess the urethra. Finally I was about to give up.  I had the technician get the owner on the phone- we would have to euthanize.  It was then that the catheter magically slipped into the opening, and urine started to filter through. I was high up, and realized that the new opening I would have to create was dangerously close to the anus. It may not remain open. However, we had urine, so we had a chance.

I called the owner. My staff had become very fond of Bobbi, who, despite his many manipulations, remained in very good spirits.  I did what we call a “Dr. G special” – the deal was, if the cat made it, they pay the additional costs of him from the surgery onwards. If he did not, then their bill to date was all they had to pay  It was what I call a Win/Win situation.  We kept Bobbi with an indwelling urinary catheter for 10 days – he still thought we were keen to have him jump up on our laps, despite the fact he was leaking urine everywhere.  On the 10th day, we all held our breaths as the catheter was removed. Would the tear reopen? Had it healed? Would the catheter stick as we pulled it out? It came out easily, with Bobbi purring the whole time.

You would have thought someone had won the million when the cheers went out that day- Bobbi had urinated on his own!  2 days later, he continued to do so from his newly made opening, and we realized it was time he went home.  It was Christmas Eve.  When the owner asked me to show them what we had done, they looked at Bobbi’s decidedly female genitalia, and smiled “I guess we now need to call him Bobinette”.  Bobbi, aka Bobinette simply gave us his cat smile and continued to purr.  He has no gender identity issues, and is simply relieved to be able to use the litter box once again!

 

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