DOI : https :// doi . org / 10.56496 / ZCQD3790

Cyndi Haslam , RVN , GradCertAVN ( ECC ), CertVNECC

Queen Mother Hospital for Animals , Royal Veterinary College

ENVELOPE chaslam @ rvc . ac . uk

Cyndi is a weekend night emergency and critical care RVN at the Queen Mother Hospital for Animals at the Royal Veterinary College . She is passionate about emergency and critical care . Outside work , Cyndi loves spending time with her two children , two spaniels , two cats and husband , Paul .

ABSTRACT This case study describes a male domestic shorthair cat with urethral obstruction ( UO ). The cat was catheterised by its primary care practice , hospitalised for the day and then transferred to the out-of-hours ( OOH ) provider . On admission of the patient , a urine collection set was in place with the clamp closed , which occluded the urine flow . There was no evidence of urine in the system , despite it having been placed several hours previously . The patient was stuporous and had severe metabolic acidosis , and was given a grave prognosis . Unfortunately , due to the patient ' s critical condition and financial constraints , it was euthanased within 1 hour of admission .

The case highlights the importance of continuity of care when transferring patients to an OOH service . Key nursing points include a focus on metabolic acidosis and the monitoring of trends , and fluid therapy and the effect it can have on acidaemia in these cases . It also highlights the role of the veterinary nurse in monitoring patients with UO .

Keywords urethral obstruction , metabolic acidosis , hyperkalaemia , post-obstructive diuresis , emergency and critical care , nursing

Introduction

Feline urethral obstruction ( UO ) is a common emergency presentation in many veterinary practices . It is seen in 1 in 200 male cats in the UK [ 1 ] . This report discusses the case of a neutered male cat with UO . The patient was transferred to an out-of-hours ( OOH ) clinic following placement of a urinary catheter at the primary care practice ( PCP ).

In patients with UO , monitoring post obstruction is as critical as the initial treatment on admission . The aim of this report is to highlight the importance of monitoring acid – base and electrolyte imbalances and trends in these parameters , which can assist in the early detection of patient deterioration .

Equipment for such monitoring should be commonplace in any small animal veterinary setting and not be exclusive to referral hospitals and emergency providers , as it could be suggested that the lack of this equipment could contribute to the mortality rate of 29.6 % of UO cases seen in PCPs [ 1 ] .

The case report also highlights the impact of human error when nursing these patients , with the aim of preventing such errors in the future .

40 Veterinary Nursing Journal