Monday, March 25, 2019

Mr. A's Surgery

We know how everyone loves to hear about Mr. A and Mr. B, so we thought we would share with you something about what's been going on with Mr. A, lately. We had been monitoring some weight loss over the past few weeks. Then we started noticing that he was acting aggressive towards Mr. B. Suddenly, about three weeks ago, we noticed that his urine started smelling strangely like an un-neutered male cat's urine (if you have never smelled it, un-neutered male cat urine smells very distinct: VERY strong and stinky), and he started urinating inappropriately. We were concerned that he had circulating testosterone in his system, which a neutered cat should not have. This led us to believe that he had something wrong with his adrenal gland.

We took some x-rays and drew some blood, and then looked at his penis under anesthesia. Why would we do that? You may not know this but un-neutered male cats have tiny barbs on their penises, kind of like the barbs they have on their tongues. These barbs disappear when a cat is neutered (or never develop, if they are neutered before maturity). Sure enough, Mr. A had developed barbs on his penis. Since his neuter surgery was uncomplicated and straightforward, we knew that he should not have testosterone in his system to produce these symptoms, this suggested even more strongly that he had a malfunctioning adrenal gland. His testosterone test results were the same as an intact male cat's. We then performed an abdominal ultrasound and found a small mass near his kidney that should not have been there.

A week ago, we scheduled him for surgery. During the procedure, we found evidence of recent bleeding or hemorrhage in the retroperitoneal space (a pocket around the kidney and adrenal gland). The bleeding became active during the surgery, and to control the hemorrhage, we performed a blood transfusion and removed the kidney that was associated with the affected adrenal gland. This was done to remove all of the abnormal vessels and adrenal tissue associated with the mass. It appeared that Dr. Bailey was able to remove the entire mass. Now that Mr. A has had a transfusion, he has sadly been removed from the blood donor list because his blood has been sensitized to blood proteins from another cat. This means that his blood is likely to destroy the red cells of a blood recipient.

The pathologist at our reference lab examined the mass for us and reported an unusual result. He could not see any evidence of tumor, but reported that the mass displayed signs of infarction – dead tissue due to a loss of blood supply. This infarct may have destroyed any sign of a tumor, or there may be a problem elsewhere in the body. Certainly, we don’t know at this point what caused the infarct, which means the outlook on his health is unknown. Right now, he is doing well, and recovering. Our staff is impatiently waiting while the pathologist takes a closer look at his biopsy samples in the hopes that he can give us more information.