FRED BARGA Fred is a 5 year old castrated male who was seen in an office visit in early April. He had been elsewhere twice before for urinating frequently and sometimes out of the litter box. The client was unsure if urine analysis had been done and thought he had treated with antibiotics with partial success, but recurrence happened several weeks after treatment. The physical exam showed a healthy looking 11-pound cat with an easygoing disposition. We took a urine sample, which was free of bacteria, blood, white cells and crystals. The owner also reported occasional constipation and feces being dropped on the floor near the litter box. The combination of these symptoms and the unremarkable urine sample negated a bladder infection/inflammation and pointed toward an anal gland problem. Cats have two musk glands at 3:00 and 9:00 o’clock next to the anus. Normally, they contain a small amount of thick liquid musk to give each cat’s bowel movement a unique “tag-odor”. This is thought to be an evolutionary adaptation so that cats could tell when a strange cat is defecating in their territory. We checked Fred’s anal glands and they were very full of hardened musk, which we expressed with digital pressure. These glands occasionally block fully and will actually rupture through to the skin causing a nasty abscess near the rectum. This has to be addressed surgically when it occurs. When the glands are impacted (blocked with solids) local irritation results. It hurts to defecate so cats hold their stool longer, which leads to constipation. Some cats drag their buttes on the floor trying to empty these glands – others apparently don’t know this trick. Because of pain on defection and poor control of the anal sphincters often feces will be out of the box. A nerve runs thru this inflamed area and goes down to the urethra causing irritation, inflammation and frequent painful urination often out of the box. If manually expressing these glands don’t help the symptoms or if the problem recurs within 2 or 3 months, we recommend flushing the glands out under anesthesia and packing them with long acting antibiotic and anti-flammatory liquid. This usually solves the problem. In the case of Fred, after we emptied the glands we put him on a short course of anti-flammatory medication at home. The client reported that all his symptoms resolved and he’s been fine for 3 months. We have recommended that they bring Fred by every 3 months so that we can check his anal glands and empty them if necessary. This case is illustrative because the majority of urinary problems in cats are not caused by bacterial infection. Many are caused by anal glands problems and crystals in the urine caused by diet. Obviously, a urine analysis is critical to sorting these problems out and treating the situation correctly. Often people attribute these pooping and peeing out of the box to behavioral problems whereas 90% of these turn out to be due to physical problems- often –anal glands problems. William Sullivan D.V.M CASES: DEMON BUCK | DANTE ROSENFELD | FRED BARGA
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