Creature Comforts

Thanks to my parents, it was hardwired into my brain from a very early age to (as I now tell my children) “start on empty” before going anyplace. Now that I am a parent, I can fully appreciate the wisdom of enforcing this rule, EVEN IF YOU DON’T HAVE TO GO.

It may delay departure by a solid 15 minutes, and may involve some yelling or dishing out ultimatums, but it sure beats dragging a whiny, urgent 6-year-old around in a store the size of a city block frantically searching for a public rest room. It also is preferable to finding oneself on the interstate with 35 miles to the nearest exit or rest area – with a suddenly full bladder.

As a consequence of this habit, I generally don’t allow my bladder to become any larger than the size of a walnut – or so it seems. So, when I arrived for my appointment for the ultrasound, I was very uncomfortable. Although this was years ago, I can remember it very clearly. Trauma does that to a person.

The receptionist checking me in asked in a sweet voice, “You remembered to arrive with a full bladder?” I smiled as nicely as I could while I answered in the affirmative. To my great dismay, she directed me to a seat in the waiting area.

When I was finally called (it seemed like an eternity, but it was likely to have been less than 10 minutes) I was practically dancing with urgency. It took a great deal of strength not to wail in angst when the ultrasound technician announced firmly that my bladder wasn’t at all full enough, and that I’d have to wait a bit longer. I believe I did emit a little yelp as the helpful nurse handed me a very large Styrofoam cup full of ice water to drink to speed things along.

The actual ultrasound was a cosmically painful event. I say “cosmically” because I actually saw stars as the technician pressed on and around my seeming full-to-bursting bladder with the ultrasound probe – all part of the normal scan, she assured me. The imprints where my hands gripped the table are probably still there today, but I got through it without an accident, I am proud to say. What we ladies won’t endure for a safe, healthy pregnancy and baby!

My patients are not nearly as cooperative as I was that day. If they have to go, they go. We do a lot of cleaning up in my line of work. That is, unless they can’t go.

My painful experience pales in comparison to those poor animals I see that can’t urinate. Just imagine feeling like you urgently have to urinate, but being unable to go, no matter how hard you try. Now, imagine this going on for hours – or days – with no end in sight.

This situation can happen to any animal that has a urinary bladder. I have seen urinary blockages in cats, dogs, ferrets, guinea pigs and even a pet raccoon. In most cases, the animals are in great distress – although some are better at hiding it than others.

The typical scenario for cats is that the owners have seen them acting strangely for a few days prior to the day they are brought to see us at the veterinary hospital. They may be hiding a lot, or may be walking around crying, or may be seen visiting their litterboxes frequently. Some urinate (or try to urinate) right in front of their owners. Some lose their appetites, some vomit.

Dogs usually don’t give much warning – they suddenly just start straining to urinate, with little or no urine passing.

Frequent, urgent attempts to urinate, often in inappropriate places like indoors is the hallmark sign of a urinary blockage in an animal. That being said, it is entirely possible for the animal to be experiencing cystitis (bladder infection) and be exhibiting the same symptoms. Cystitis usually is very painful but not immediately life-threatening. A urinary blockage, however, can cause death in sometimes less than a day.

How does one tell the difference? By palpation of the abdomen, usually. As most people who are not trained in veterinary medicine are unsure of what an obstructed bladder feels like, it is best to bring the animal to your veterinarian’s office for this determination.

What we’re looking for is a firm or hard, enlarged urinary bladder that will not empty with firm, steady pressure applied. Yes, it is possible for a bladder to burst when pressure is applied in this way, so care must be used when using this technique – another reason to seek professional help. If the animal strains to urinate while the bladder is found to be full and does not empty, the animal is determined to be “blocked.”

Bear with me here while I give a mini anatomy lesson. The kidneys are paired organs that lie on either side of the spine around the lower back (lumbar area) and are responsible for manufacturing the urine. The ureters are tubes that carry the urine from each kidney to the urinary bladder.

The urinary bladder stores the urine for a time, and the urethra is the single tube that exits the bladder and carries the urine to the outside of the body. If the animal is normal, he has conscious control over the urinary sphincters, which when released, signal the bladder to contract and empty.

The type of urinary obstruction we are discussing here is a distal blockage, or urethral obstruction. In plain terms: you’re making urine, it’s getting into the bladder, but you just can’t pee. How’s that?

Super painful, that’s how. So what do we do about it? Well, attempt to remove the obstruction, silly. But this is sometimes easier said than done. Mechanically, it is simple: the urethra has a plug of some sort that must be relieved. But it is not always in a convenient spot, and is not always something that is easily removed or even moved in some instances.

Anxious to know more about urinary blockages, causes and treatments? Well, you’ll have to hold on ’til next time! Why don’t you sit in a comfortable chair and drink a big cup of ice water while you wait? ‘Kay, see you in two weeks

Daverio is a veterinarian at Williamsport West Veterinary Hospital