Louie is a male kitten that presented at about 9 weeks of age because he was no longer urinating in the litter box and was vomiting. He was initially found as a stray several weeks earlier with a female litter mate. Up until presentation he was acting normally, eating and drinking. On examination Louie was found to have swelling of his prepuce (skin around his penis) and his urinary bladder was very large and painful on palpation. His bladder was able to be expressed (relieved manually) and a urine sample was sent to the lab. He was treated with anti-vomiting medication and antibiotics.
Louie’s urinalysis results showed a significant amount of bacteria and white blood cells, indicating that he had a urinary infection. The next day he presented for diarrhea and again had a large, firm, painful bladder. Louie was kept in the hospital to receive medication to help relax his bladder and for pain, and to monitor him for urethral obstruction. A radiograph was taken to evaluate for internal abnormalities. Louie was found to have a large amount of stool present in his gastrointestinal tract, likely because he was too painful from his urinary problems to defecate. There were no stones seen in his bladder or kidneys that may have caused obstruction. He was treated and went home the following day after having some more regular urinations and bowel movements.
About 10 days later, Louie was re-examined. Although he was producing a little more urine, it still was abnormally small amounts each time. On exam we found he had even more severe swelling and pain of his prepuce and had some grainy/sandy material in that area as well. While discussing the possibility of a congenital defect with his owners, we found that Louie’s litter mate had been suckling (trying to nurse) on his prepuce quite often. This is sometimes a behavior seen in kittens that have been abandoned young and bottle fed by humans. The suckling likely caused trauma to the prepuce and a condition called phimosis or prepucial stenosis (narrowing of the prepuce). This, in turn, caused dribbling of urine, backup of urine into the bladder, pooling of urine in the prepuce, crystal formation and infection.
Louie was taken to surgery to widen the prepucial opening, place a urinary catheter and neuter. He was found to have several large crystals/stones in his prepuce, which were flushed out. A surgical opening was made in the prepuce and the mucosa (inside layer) was sutured to the skin to keep it open. A urinary catheter was placed for several days to help Louie urinate while postoperative swelling and pain were managed.
Louie healed well and the sutures were removed about 14 days later. He has since been urinating normally and using the litter box. He may require follow up surgery in the future, as he grows, to widen the opening of his prepuce. He will also need to be closely monitored for urethral obstruction as an adult.