Monday, 2 March 2009

FUS Cats

There is a very high incidence amongst cats of FUS (Feline Urinary Syndrome) at the moment, unusual, we normally have a big collection around fireworks night.
Females have a much larger urethra and do not usually get FUS they do get cystitis though.
FUS generally affects male cats. Males have a very tiny penis that blocks easily. However if your cat (male or female) can not urinate or keeps going and passing small amounts or it is bloody, anything out of the ordinary see the vet as soon as possible.

FUS is rather an innocuous term but it is actually a life threatening condition. The cat is unable to pass urine. Due to crystals or urethral spasm which is often stress related or idiopathic reasons. The bladder backs up as it can not empty, the cat goes into renal failure and if not corrected and the bladder emptied the cat WILL die.

My cat Ginger got FUS in Tenerife. I went to the best island vet as Tony was not out in Tenerife at that point, the vet refused to empty the bladder as it was not full enough. I was ignorant of the dangers and agreed to go back the next day. I wish l had known what to do and was going to happen. There was also no vet available in the night.

I sat up with Ginger and in the middle of the night he started to fit. I sedated him and went over to see a friend in another block. I had lodged a trainee German vet with her. I asked the trainee to come and put Ginger down for me l would supervise but couldn’t do it myself, trying to put my own pet down was not something l thought l could do.
The lass came over but wouldn’t put Ginger down and begged me not to. I agreed to give him one more go but any fitting and l wanted her to put him down. About 30minutes later Ginger had another fit. I sedated him down again and she refused to put him down saying wait, l refused and despite her protestations put him down myself. She went home sulking, l was emotionally screwed up, going between disgust at her behaviour and pain and guilt in what l had done to Ginger. I next did the second hardest thing l have done, l put Ginger in a plastic bag and put him in the dustbin outside.
When l went back to bed l finally crumbled and l burst into tears which woke hub up, I hadn’t wanted to as he had had a hard day. He was upset at what had happened as he loved Ginger as well and was horrified l had not woken him up with all the drama. I pointed out that l knew he would have struggled to cope with the situation it was easier for me and what with the bloody trainee stressing l couldn’t cope with 2. He understood.

This made me very aware of the danger of FUS. And the fact that the bladder does not have to be very big there may have been a series of short term blocks, possibly un noticed or as they seemed to clear un worried about. In Gingers case he had the short term blocks that cleared l had noticed but did not realise the danger. These probably damaged the kidneys.

Under normal circumstances the cat is admitted and bloods run straight away. This will give an idea of what is happening with his kidneys and other system values. He is put onto fluids appropriate to the blood results.
As soon as possible the bladder is emptied. Sometimes a cysto will be carried out. For this their side is clipped and cleaned over the bladder area (some vets prefer to do this with the cat on their back not their side) A needle is inserted into the bladder and the urine drawn out. This helps take some of the pressure off the bladder.

A cat urinary catheter is then inserted, a cats penis is tiny and insertion can be difficult. Sometimes an eye flushing catheter needs to be placed and saline is flushed along it (retro flushing) to try and push debris (crystals and sediment) back to the bladder.
Finally with luck ok and skill the main urinary catheter is inserted and the bladder is flushed out. Usually a sample is kept to check for crystals type and size.
The urine can be very bloody especially as if there is crystals they have been rolling around and damaging the bladder lining.

If the catheter went in easily then practices vary but the one l was at tend to remove the catheter after a good flushing with several hundred ml of saline. If it is badly blocked then the catheter is sewn in and the cat has to put up with the catheter for several days having it flushed every few hours to help clean the bladder out. Some crystals if large may need an operation to remove them.

If it is impossible to place a urinary catheter then vets will discuss operation choices with the owners to bypass the blockage but this is for extreme cases.

Food changes are indicated for some crystals. The food correcting the body’s Ph and stopping the crystal type forming. In Gingers case it was crystals, the water in Tenerife is very high in calcium and l did not realise how common FUS was there.
One of the biggest factors in UK FUS cats is weight. The amount of obese cats that have it is huge and probably the biggest factor.
If stress related then reasons are discussed about what is going on. Sometimes basic suggested changes can help with a bit of common sense. Other times a good behaviourist can help.

Once a cat has had FUS they may be prone to reoccurring bouts and it can get very expensive. An owner needs to be aware of future ramifications of the condition which their vet should discuss in detail with them. Another good reason to have insurance. And my good old chant go via petplan

Placing the urinary catheter

The bladder is flushed with saline and the urine is often very bloody

The catheter is sutured in place and a line placed on to drain the urine away from the cat, sometimes the line is left off if the cat is restless so he does not twist it.

If they are worried the vet may take an x-ray of the bladder with a "contrast medium" the white oblong is the bladder. Any leaks would show a white explosion or line out of the bladder. In this case all is normal.


Auntie Jane said...

It must have been very distressing for you with Ginger. I have had cats in the past but none had this problem.

Interesting post.

Vetnurse said...

Thanks Jane, yes it was difficult.

TonyF said...

I don't remember any of ours having that either. It sounds absolutely horrible.

Our cats were farm cats, outside most of the time, ( except when hidden, asleep, behind the Rayburn)I wonder if that had anything to do with it. We had other cat illnesses though.

Vetnurse said...

It may have l do not think any studies in depth have been carried out although a high % are indoor cats although there is out door cats affected as well.
Diet plays a part if they are eating lots of natural food rats, mice birds then they are better off than the processed food cat's stones [urinary crystals] are often caused by a ph imbalance.
Out door cats tend to be slimmer as well especially farm/working cats, another big cause of FUS is weight.

JuliaM said...

"l do not think any studies in depth have been carried out although a high % are indoor cats"

If it is diet related, I'd guess there's not a lot of milage for the companies that produce the food in looking into it. It might make people think twice!

Our's eat a mixture of wet/dry food - small portions morning, afternoon and evening - I think it's better than feeding only one thing.

Vetnurse said...

Just the opposite with the food companies Julia huge mileage in fact. Cats with certain crystals are transferred onto special food produced to help change their body ph and dissolve any more crystals.

The is a lot of research going into producing food that does not allow the crystals in the first place. The problem is people assume it is expensive. A bag costs a lot but as less is fed it lasts a lot longer so is cheaper overall and the animals digest the food better.
The other drawback is it does not come in 65 flavours with fancy names that are all basically the same with different salt contents and pretty pictures on the front.

The best way to feed a cat is free choice. Dry is best to do this with, it doesn't go hard and curdly or stick to things.
In natural circumstances a cat will eat up to 20times a day tiny amounts. In a house generally they are fed if 2 times or only once a day this forces them gorge and changes their natural behaviour.

A cat will only eat free choice properly if it has always done so from being a kitten. An adult or older young cat will not often eat free choice but gorge. To do it with an these use dry food and hide small piles around the house, cut holes in small drinks bottles and put food in there to roll out, make food parcels they have to rip apart. All of this will help enrich their natural instincts, (especially if they do not go out or are bad hunters) make them work for food. And help to de stress them as it is nearer to natural for them than a plate.

FUS cats are advised though to be fed moist food although there is dry and wet available as some cats really only like dry.

M.E. Again said...

We've experienced 'blocked Tom Syndrome' or FUS twice with our tamed feral, Luther. Two surgeries - one to clear the crystals and one a year later that totally removed his damaged penis - and here he sits, a contented lump on the sofa beside me. I know it's not something everyone can do for a loved kitteh. The bum has cost us over $5000.00 in vet bills. We thought we were going to lose him a couple of times in the process. Crazy things we do for our pets.

I'm sorry for your loss. BTW Luther is an orange tabby - I'm sort of assuming your Ginger was, also.

Vetnurse said...

Hi M.E. yes you guessed right Ginger was a ginger tom.
Am glad to hear that Luther is ok and a lump of happy purring fur :-). That is radical surgery and one of those last resort operations.