One of the most common emergencies we see at Columbus Central Veterinary Hospital is the "blocked cat." Predominantly a syndrome found in male cats, a urinary obstruction can also be seen in female cats and dogs of both sexes, but with much less frequency. A "mechanical" urinary obstruction can form from bladder stones, an accumulation of crystals that form from certain minerals in the diet, an infection, or a mucus plug. Neurologic deficits or spasms of the musculature of the bladder and urethra can also cause the inability to void urine. Regardless of the cause, a urinary blockage is a medical emergency and death can occur within 24 hours if not treated promptly.
Male cats are the most prone to urinary blockages because of their anatomy. Their urethra, the pathway from the bladder to the external body, is long and narrow; therefore it is easier for stones, crystals or a mucus plug to get stuck. The initial symptoms of a blocked cat are straining to urinate with little or no urine output, but occasionally, small drops of bloody urine may be seen, vocalizing or crying in pain while straining to urinate and licking the genital area. Very quickly, toxins begin to build when the urine cannot be voided and the pet usually becomes lethargic, quiet and may begin to vomit. A veterinarian can immediately feel a distended bladder upon palpation. The immediate solution is to pass a urinary catheter to relieve the obstruction and empty the bladder of urine. X-rays are taken to look for the presence of stones, or an ultrasound is used to better see a mucus plug or a tumor. Blood work to determine electrolyte levels and kidney function are also performed. The functioning of the kidneys is usually impaired temporarily and sometimes permanently depending on the severity and length of time of the obstruction. Intravenous fluids are administered to "flush" the kidneys and body of the buildup of toxins and stabilize the patient.
Those who watch or play football have most likely heard of a "torn ACL" or ligament injury of the knee. Dogs can suffer the same injury. Larger dogs often suffer an acute injury after a sudden twisting, slipping or impact injury to a hind leg. It could also be a result of chronic degenerative or structural issues with the knee, such as obesity, arthritis, or a luxating patella (knee-cap moves in and out of place). The cranial cruciate ligament (CCL) in the dog may be partially or completely torn in this injury, resulting in hind-leg lameness or non-weight bearing of the leg, pain and possibly some swelling at the knee joint. Typically it is seen in larger breed dogs such as Labrador and Golden Retrievers, Pit Bulls, and Rottweiler’s, but any breed can be affected.
A diagnosis of a torn cranial cruciate ligament is based on a description of the onset of symptoms, radiographs to look for boney abnormalities (positioning or arthritic changes), and manipulation of the knee joint, sometimes with sedation, to feel for "cranial drawer" or abnormal joint laxity. Surgical intervention is recommended for most cases of torn or partially torn CCLs. Smaller dogs under 25 pounds may stabilize and be comfortable without surgical intervention using arthritis medications.
There are various surgical techniques for repairing a torn ligament, and new techniques are evolving. The goal of surgery is to "re-create" the torn ligament using suture material and/or plates and screws. Often, the meniscus, which is the cushion or “shock absorber” between the upper and lower leg bones is torn or crushed due to the instability of the ligament injury. At the time of surgery, the meniscus is evaluated and removed if necessary. The technique used here at Columbus Central Veterinary Hospital is a modified Lateral Suture / Anchoring technique, and our success rate meets or exceeds those published in veterinary journals. After surgery, the patient is sent home with pain and anti-inflammatory medications. We see the typical patient become weight bearing in 5 to 7 days. Strict leash walking for 6 to 8 weeks is followed by a gradual increase in activity. Keeping the patient compliant is often the most difficult part of the recovery.