THE simple things in life are important.

We tend to take every day stuff, like going to the loo, for granted but when they go wrong, disaster looms.

The clock was ticking for our feline patient whose story we began last week. If we were unable to remove the blockage from his urethra, permanent damage to his bladder and kidneys would occur. Left untreated, bladder rupture and death are inevitable.

Most cats who are unable to pass urine become understandably grumpy. Coupled to this, they may be toxic and the fragile, stretched bladder wall is at risk of damage from even careful handling.

As a result, sedation is a good way to start treatment. It provides a compliant patient and it offers the possibility that profound relaxation might allow urine to flow. Unfortunately, in this case, it did not. So we clipped and cleaned around our cat’s back end and prepared to attempt to pass a catheter. Of course, the bladder can be emptied by passing a needle through the abdominal wall and into the blocked organ but, when it is on the point of rupture, this can be risky.

It’s kind of make or break time now. Some cats have a soft, sludgy plug trapped at the narrow part of the urethra at the tip of the penis and it can be relatively easy to clear this. Others, however, have significant quantities of hard, crystalline material blocking the tube.

Occasionally, it can simply be impossible to bypass this and the overfull bladder has to be emptied by other means. Subsequently, amputation of the penis is required. It is not surgery for the faint hearted. Indeed, the editor’s hands are likely trembling, as he runs his red pen over this article.

Luckily, especially since we were well into late evening, we were eventually able to pass a catheter into our black cat and almost instantly the look on his face expressed his relief. The urine that was produced was bloody and murky but fluid therapy and constant draining would help this over the next few days. To aid this, a soft comfortable catheter called a ‘slippery sam’ was sutured in place.

Attaching the open end of this to some tubing allowed the bladder to drain freely without our patient becoming soiled.

Three days later, our patient was able to go home, though his owners were left deliberating what might have happened had they not decided to bring him straight to us that evening.

And what of the future? A particular prescription diet will greatly reduce the chance of further blockage. Drug therapy will reduce inflammation and muscle spasms. Weight loss and easy access to water in every room in the house will help.

But the risk of recurrence remains high.