VET’S DIARY: Jack becomes Jacqueline

IF I started talking about sex change ops you would be forgiven for thinking that I was about to dive into a discussion about the latest fashion among Hollywood vets serving the pets of the rich and famous of LA, writes Dominic Plumley.

Well, believe it or not, this is something that we do here and the procedure is becoming more common.

Before you start writing letters of disgust to the editor or the RSPCA, I have to admit that I have been a little bit economical with the truth. Of course, the aim of this surgical procedure is not to change the sex of an animal just for the sake of it; it is actually a very intricate operation to solve a particular problem in male cats. The result is that they end up with what effectively are female genitalia – hence the sex change tag.

Perineal urethrostomy, to give the operation its proper name, is sometimes required in male cats that are prone to the formation of crystals in their urine. The urethra, the tube that connects the bladder to the outside world, narrows significantly as it travels through the penis, small bladder stones that pass easily down the rest of the tube often lodging at this point causing a blockage.

Unfortunately, the production of urine by the kidneys is a continual process and consequently there is a constant flow of liquid into the bladder. If the urine is unable to be expelled, because the urethra is blocked, the bladder just gets bigger and bigger until it either ruptures or the urine backs up into the kidneys – both consequences pretty deleterious for the cat, not to mention very painful.

If we are lucky and get onto the case quickly, it is sometimes possible to unblock the urethra by inserting a very fine catheter and retro-pulsing fluid back up the tube, flushing the stone back into the bladder.

You might think that it would be inevitable for the same problem to instantly happen again, however, by placing an indwelling urethral catheter for a few days, free flow of urine can be guaranteed while setting about with specific diets that dissolve the crystals, preventing repeat obstructions.

The problem is always more severe if we are unable to shift the blockage. This can happen if the debris has been there for a couple of days, by which time the patient is usually pretty unwell in himself.

Similarly, repeat episodes inevitably result in scarring of the urethra, which only reduces the diameter further and hence a vicious circle of destruction begins. At this point we are left with little option but the sex change op.

If you are male and of a squeamish disposition you may want to jump ahead a couple of paragraphs. By making a careful incision into the tissue just above the penis, it is possible to locate the urethra bladder side of the blockage. This can then be opened out to form a new orifice that is of sufficient size to be free from blockage problems.

I should point out that we have, by this time, emptied the bladder using a syringe and needle – a technique called cystocentesis – so there is no fountain-like eruption when the urethra is first breached. With the urethra now terminating north of the penis the latter becomes functionally superfluous and is consequently removed to complete the transformation.

This week Jack, a five-year-old neutered tom with a chronic history of urethral blockage, became Jacqueline with a hopefully trouble-free life ahead, at least in the waterworks department.

There are no apparent psychological consequences, recipients of the op showing little or no increased tendencies toward extended shopping trips or pamper weekends away with the girls.