In and Out of the Litter Box:
Symptoms and Treatment of Feline Urethral Obstruction
By Dr. Danielle Huval
Feline Urethral Obstruction is a life-threatening emergency that occurs in primarily male cats. It is also referred to as a “Blocked Tom.” Common early symptoms that one may see at home include vocalizing (howling), frequent trips (increased urgency) in and out of the litter box, straining to urinate or defecate, excessive licking of back end, blood in urine or no noted urine in the litter box. Cats may also hide, collapse, and act painful when touched, especially in the abdomen (generally noted when picked up). Within hours a cat may become unresponsive and be suffering from life threatening electrolyte abnormalities. This is a true pet emergency! If your cat is displaying these symptoms, he needs veterinary care immediately!
All cats are at risk for urethral obstruction but it is more commonly noted in neutered male cats. Risk factors include obesity, indoor lifestyle, dry food diet, and cats with previous bladder inflammation or blockage. The blockage occurs in the urethra and can be caused by urine crystals, urinary stones, mucous plugs from an inflamed bladder, tumor, or even just urethral muscle spasms.
A urinary obstruction causes an elevation in potassium levels, which can cause the heart to fail. Correcting potassium levels is of paramount importance and can only be achieved by IV fluids, unblocking by placing a urinary catheter, and possibly the use of IV drug therapies. Anesthesia or heavy sedation is generally needed to pass a urinary catheter. Urinary catheters will remain in place from 24-72 hours depending on how stable and responsive the cat is to treatment. Treatment also includes IV fluid therapy, pain management, and close observation of electrolyte abnormalities and kidney values. It is common for kidney values to be elevated prior to unblocking, most will return to normal within a few days of treatment.
Once the urinary catheter is removed the next step of treatment is monitoring for re-obstruction. Unfortunately, some cats will block again very quickly. Others may improve initially and then re-block within a few weeks to months. Cats are generally monitored in hospital for 12 hours after the catheter is removed. If a cat obstructs three times within his lifetime, a surgery called a perineal urethrostomy is generally recommended. This surgical procedure removes the penis and widens the urethra in an effort to create a larger opening for urine to pass, thus decreasing the chance of re-obstruction.
The good news is that there are ways to lessen a cat’s chance of obstructing or re-obstructing by changing a few things at home. Increasing their water intake helps to dilute urine, diluting out mucous, crystals, and inflammatory cells that may be present in the bladder and that can lead to a blockage. Feeding a canned diet is recommended for this reason. Water can be added to the canned food to further increase intake as well. Some cats prefer only dry food but even these cats may not mind their dry food floating in water. Additional water dishes and water fountains also help entice cats to drink more. A canned diet can lead to more tartar build up but the benefit of a healthier urinary tract outweighs the risk.
Another major risk factor for urethral obstruction is environmental stress. Enriching your cat’s environment can really help. This can be as simple as adding cat toys and providing a way to exercise. Cats need a safe place to hide or be alone when strange people, animals, or other stressors are present. Cats prefer routine and emergency veterinarians often see obstructed cats around the holidays and after their guardians have been on vacation. Clean and plentiful litter boxes also help to decrease household stressors. The guideline for litter boxes in a household is to have one more than the number of cats that reside there.
Although, several articles online mention that it may take 3-6 days for death to occur, this is often not the case. Unfortunately, cats often present to us close to death within hours of showing symptoms of being obstructed. The take home message… Do not wait! A blocked cat is in pain and may not survive the night! Emergency veterinarians are here to help and prompt treatment is truly life saving.
Dr. Danielle Huval is an Emergency Veterinarian at Aspen Meadow Veterinary Specialists. AMVS is a 24-hour veterinary facility providing specialty internal medicine, surgery, neurology, emergency and critical care, physical rehabilitation, pain management, and blood bank services for pets. They are located in Longmont at 104 S. Main St. For more information, go to www.AspenMeadowVet.com.