Mick is a 12 years old M/N DMH diabetic that presented with symptoms of FLUTD
Preanesthetic bloodwork was normal except Hyperglycemia. His penis and distal urethra ( last 2.5 cm) were hard, stiff and swollen ( 3 times the diameter of an iv line). No urolith, crystalls on X-ray or U/S. Easy to pass a 5 fr. cath. Urethral wall is very thick, but blood flow still present. Bladder, CUJ, proximal urethra normal. Rectal exam: normal intra-pelvic urethra.
Mick is a 12 years old M/N DMH diabetic that presented with symptoms of FLUTD
Preanesthetic bloodwork was normal except Hyperglycemia. His penis and distal urethra ( last 2.5 cm) were hard, stiff and swollen ( 3 times the diameter of an iv line). No urolith, crystalls on X-ray or U/S. Easy to pass a 5 fr. cath. Urethral wall is very thick, but blood flow still present. Bladder, CUJ, proximal urethra normal. Rectal exam: normal intra-pelvic urethra.
I’m wondering what are the differentials for this cat. I’m thinking some sort of infiltrative neoplasia versus a thrombus ( this cat has a heart murmur as well) that obstructs the main vein???
Sorry abouth the quality of the stils. I took them with my phone from the DICOM online server. I have better pictures, clips if needed.
Thank you
CC
Comments
Seems to be necrosis of the
Seems to be necrosis of the tip of the penis rather than an infiltrative tumor. Possibilities would be trauma, transient obstruction, urethritis. Thrombus is also feasable.
How high is the glucose?
Management would be indwelling urine catheter for a few days but most likley heading towards perineal urethrostomy.
Seems to be necrosis of the
Seems to be necrosis of the tip of the penis rather than an infiltrative tumor. Possibilities would be trauma, transient obstruction, urethritis. Thrombus is also feasable.
How high is the glucose?
Management would be indwelling urine catheter for a few days but most likley heading towards perineal urethrostomy.
Yes, if no improvment in
Yes, if no improvment in 24-48 hours then PU with histo. Glucose is 17 mmol. If thrombus tx with heparin / plavix ? I would probably not being able to see it, right?
Calin
Yes, if no improvment in
Yes, if no improvment in 24-48 hours then PU with histo. Glucose is 17 mmol. If thrombus tx with heparin / plavix ? I would probably not being able to see it, right?
Calin
Wow odd case.. new one on me.
Wow odd case.. new one on me. I’m wondering what the contraindications are for plavix here is any. Diabetes is a hypercoagulative state and the penile tip would be consistent with hypoxia but i have never looked at the doppler of this region so can;t say anythign definitive on the images other than I don’t see neoplasia.
Wow odd case.. new one on me.
Wow odd case.. new one on me. I’m wondering what the contraindications are for plavix here is any. Diabetes is a hypercoagulative state and the penile tip would be consistent with hypoxia but i have never looked at the doppler of this region so can;t say anythign definitive on the images other than I don’t see neoplasia.
I just did a VIN search and
I just did a VIN search and they discussed one case that was remarkably close to what you are describing. Some thought it may be self trauma.
They suggested an e collar, short course of Prednisone (probably not wise in a diabetic) and a little time.
I would suggest the E Collar and if renal function is OK a 3 day course on Onsior. I wonder if this is some sort of wierd neuopathy causing self trauma.
PU should be a last resort and I would obviously not use heparin, asprin or Plavix.
The case on VIN started to resolve on it own- but it did take a bit of time.
Hope he did not get into the owners Sildenafil 🙂
If you have a cold laser you may want to try that and see if it helps. I also think if you have been trained in chiropractic- that may help too.
Thank you Randy. NSAID s are
Thank you Randy. NSAID s are probably a good ideea. Not sure about Pred. because cat has a heart murmur. Transfered cat to a 24 h facility for monitoring over weekend. Weird case. you mentioned VIN.Can you please post/send me the link for the simmilar case discussion.
CC
Here is the link. If you have
Here is the link. If you have trouble viewing let me know and I will copy and paste an e mail link.
http://www.vin.com/Members/Boards/DiscussionViewer.aspx?documentid=3452501&ViewFirst=1
I just did a VIN search and
I just did a VIN search and they discussed one case that was remarkably close to what you are describing. Some thought it may be self trauma.
They suggested an e collar, short course of Prednisone (probably not wise in a diabetic) and a little time.
I would suggest the E Collar and if renal function is OK a 3 day course on Onsior. I wonder if this is some sort of wierd neuopathy causing self trauma.
PU should be a last resort and I would obviously not use heparin, asprin or Plavix.
The case on VIN started to resolve on it own- but it did take a bit of time.
Hope he did not get into the owners Sildenafil 🙂
If you have a cold laser you may want to try that and see if it helps. I also think if you have been trained in chiropractic- that may help too.
Thank you Randy. NSAID s are
Thank you Randy. NSAID s are probably a good ideea. Not sure about Pred. because cat has a heart murmur. Transfered cat to a 24 h facility for monitoring over weekend. Weird case. you mentioned VIN.Can you please post/send me the link for the simmilar case discussion.
CC
Here is the link. If you have
Here is the link. If you have trouble viewing let me know and I will copy and paste an e mail link.
http://www.vin.com/Members/Boards/DiscussionViewer.aspx?documentid=3452501&ViewFirst=1
Monitor the glucose as 17
Monitor the glucose as 17 mmol/l may be a stress response. If in doubt run a serum fructosamine. Was there glycosuria?
Monitor the glucose as 17
Monitor the glucose as 17 mmol/l may be a stress response. If in doubt run a serum fructosamine. Was there glycosuria?
Perfect. Thanks
Perfect. Thanks
Perfect. Thanks
Perfect. Thanks
Vetecho-Â
How did it turn out
Vetecho-
How did it turn out for this cat?
Vetecho-Â
How did it turn out
Vetecho-
How did it turn out for this cat?
bad. After 48 hours in a 24 h
bad. After 48 hours in a 24 h facility, the distal urethra was the same but the tip of the penis was nectrotic and owner declined PU and unfortunatelly euthanized the cat.
Weird case. I srtill think was a thromboembolic event.
Calin
bad. After 48 hours in a 24 h
bad. After 48 hours in a 24 h facility, the distal urethra was the same but the tip of the penis was nectrotic and owner declined PU and unfortunatelly euthanized the cat.
Weird case. I srtill think was a thromboembolic event.
Calin