Primary stabilisation for tail avulsion in 15 cats

Outcomes of nine cats with urinary retention after sacrocaudal luxation managed with long-term urinary diversion

OBJECTIVE

To document the outcomes of cats with urinary retention (UR) after sacrocaudal luxation (SCL) and managed with a long-term cystostomy (LTC).

STUDY DESIGN

Short case series.

ANIMALS

Nine client-owned cats with SCL and subsequent UR.

METHODS

Nine cats suffering from non-relievable UR secondary to SCL, between March 2013 and December 2020, had a LTC placed 4.5 days post-SCL (mean, range 3.5-6.0), until clinical evidence of normal urination recovery. The bladder was emptied at least twice daily. No antimicrobial was given during LTC. Indication for tube removal was voluntary micturition with complete emptying for a minimum of three consecutive days. Recheck examinations were scheduled for post-SCL days 7 and 14, as well as for LTC tube removal. Minor and major complications and length of LTC use were recorded.

RESULTS

The LTC was removed 11-42 days (mean 26 days) after placement. All cats recovered normal micturition spontaneously within 17-47 days post-SCL (mean 30.7 days): 1 cat between the 2nd and 3rd weeks, 5 cats between the 3rd and 4th weeks, and 3 cats >30 days after the trauma. Major complications, such tube dislodgement, occurred in two cats, whereas complications resolving after tube removal were recorded in 6 cats.

CONCLUSION

LTC was effective at managing UR post-SCL in 9 cats. All cats recovered normal urinary function within 7 weeks.

CLINICAL SIGNIFICANCE

LTC can be an alternative to manual expression or bladder catheterization in cats with temporary UR after SCL.

Evaluation of prognostic factors for return of urinary and defecatory function in cats with sacrocaudal luxation

OBJECTIVES

The aim of this study was to evaluate outcomes and prognostic factors for cats with sacrocaudal luxation.

METHODS

Medical records and radiographs were reviewed for cats with sacrocaudal luxation. Information obtained from the clinical records included signalment, clinical presentation, concurrent traumatic injuries, treatment details, outcome and survival time. Severity of neurological signs was graded from 1 to 5, based on previous grading systems for cats with sacrocaudal luxation. Degree of vertebral displacement was calculated on survey radiographs. Outcomes were collected from serial neurological examinations and telephone interviews. Cats had to be given a minimum of 30 days to regain urinary function to be included in the study.

RESULTS

Seventy cats were included. Fifty-five of 61 cats (90%) regained voluntary urinary function. A higher neurological grade was associated with a decreased likelihood (P = 0.01) and longer duration (P = 0.0003) of regaining urinary function. No significant associations were found between urinary outcome and age, sex, anal tone, perineal sensation, tail base sensation, degree of craniocaudal or dorsoventral sacrocaudal displacement, concurrent orthopaedic injury, tail amputation, defecatory function at diagnosis and survival. Cats that regained defecatory function had longer survival times than those that did not recover defecatory function (P = 0.03). Defecatory outcome was not significantly associated with any other variables.

CONCLUSIONS AND RELEVANCE

In agreement with previous studies, neurological grade is the most important prognostic indicator for cats with sacrocaudal luxation. Determination of the severity of neurological signs can also aid in advising owners the time frame in which urinary function is expected to return. Faecal incontinence may be a more important prognostic factor than previously suspected.