This is Sinatra. The shelter folks gave him that name because of his "Ol' Blue Eyes". Those eyes are pretty droopy here, as he is still suffering from a combination of light sedation, and heavy uremia [waste building up in the bloodstream when the kidneys cannot get rid of it]. He had been straining to urinate for a couple of days, had quit eating, had vomited once. His urinary bladder was as big as a softball, and felt about as hard. Not a good situation. The owners felt he was still able to urinate; they were wrong.
Before trying to catheterize him, we gave him a very light sedative and emptied his bladder via cystocentesis [Do a sterile prep on his belly and put a needle right into the bladder to empty it.]. It would have been pretty hard to backflush any crystals or mucus into that much pressure. We removed 120cc [versus an average 30cc in a full cat bladder] of the worst hematuria [bloody urine] that I have ever seen.
Lots of times when we centrifuge a bloody urine sample, it turns out to be less than 1% blood cells, even when it looks almost like pure blood. The tube on the left is what Sinatra's urine looked like. On the right is a tube that has been centrifuged, showing that the urine is about 10% red blood cells. This is not good, showing that the bladder is really suffering from being over-stretched for so long.
Fortunately, despite the damage and being so sick, Sinatra is making a really rapid recovery. He is tolerating his urinary catheter [necessary to let the damaged bladder stay empty while it heals] and is already eating and drinking. He takes his medicine great and has a sweet personality, even under these circumstances. I love this cat -- he's easy to take care of, and he's making me look good.