Fluoroscopy-guided balloon dilation of a proximal urethral stricture caused by a urethral membrane in a female cat

Rincon Alvarez, Javier; Smith, Victoria; Broome, Cameron

Abdominal radiographs performed under sedation (ketamine 2.5 mg/kg [Ketavet; Zoetis] and midazolam 0.2 mg/kg [Hypnovel; Roche], IM) showed a markedly distended bladder causing dorsal displacement of the descending colon. Abdominal ultrasonography showed a focal thickening of the mid dorsal bladder wall. Mild right renal pelvic dilation and diverticuli were noted without ureteral dilation. Based on the clinical history, these findings were suspected to be due to a partial urethral obstruction causing chronic bladder distension. Urethral catheterisation using a 3.5 Fr urinary catheter (KatKath; Vigon Vet) was attempted but not possible. Therefore, cystoscopy was performed under general anaesthesia. This revealed a markedly dilated urethra with an abrupt narrowing near the bladder neck. The cystoscope was unable to traverse this narrowing, precluding visual assessment of the bladder lumen. A retrograde urethrogram was performed, which confirmed the presence of caudal urethral dilation with a sharp reduction in the proximal urethral diameter near the bladder neck ( Figure 1 ). The urethral wall appeared smooth and regular. Based on the urethroscopic and urethrography findings, a diagnosis of urethral stricture was made.