Page 199 - Problem-Based Feline Medicine

11 – THE CAT STRAINING TO URINATE 191

● Tricyclic antidepressants, such as imipramine ● One cat with transitional cell carcinoma also had
(2.5–5 mg/cat orally every 12 hours) may improve hypereosinophilia.
urinary bladder compliance.
Abdominal palpation of a soft tissue mass in the blad-
Clip the hair and clean around the perineal/abdomi- der neck.
nal area to minimize urine scolding.
Ultrasonography or contrast radiography shows a
soft tissue, space-occupying mass. Generally, a water-
soluble iodinated contrast agent (5–10 ml/kg or enough
NEOPLASIA* to moderately distend the bladder) is used.
Biopsy via exploratory laparotomy or cystoscopy pro-
Classical signs
vides a definitive diagnosis.
● Hematuria.
● Distended bladder. Treatment
● Dysuria.
Surgical resection is rarely feasible due to the high
percentage of tumors that are malignant, the frequently
late presentation and location of the tumor.
Pathogenesis
Tumors of the urinary bladder are rare and those of the
ureters and urethra even rarer.
URETHRAL STRICTURE
Most are malignant epithelial tumors such as transi-
tional cell carcinomas, squamous cell carcinomas Classical signs
and adenocarcinomas.
● Dribbling urine.
Benign tumors occur very infrequently. ● Distended bladder.
● Dysuria.
● Stranguria.
Clinical signs
Usually occurs in cats over 8 years of age. See main reference on page 199 for details (The
Incontinent Cat).
Dysuria and intermittent or persistent hematuria
may occur depending on the type and location of the
neoplasm. Clinical signs
Soft tissue mass may be palpable in the bladder neck. Incontinence associated with a distended bladder (over-
flow incontinence) and dysuria.
Secondary infection may occur.
History of unresponsiveness to treatment for Diagnosis
cystitis.
Radiography. Retrograde urethrography.
Diagnosis Urodynamic procedures. Urethral pressure profilom-
etry may be used to identify focal urethral obstructions.
Urinalysis.
● Hematuria (RBC > 5 phf).
● Pyuria and bacteriuria occur due to secondary uri- CYCLOPHOSPHAMIDE TOXICITY
nary tract infection.
● Sediment may show abnormal transitional cells. Classical signs

Blood tests (hematology and biochemistry). ● Hematuria.
● Normal unless urinary tract obstruction has occurred.