Initial treatment is focused on correction of life-threatening hyperkalemia, relief of urethral obstruction, intravenous fluid therapy, and monitoring of urine output by means of a urinary catheter that has been sutured in place. Usually treatment must be individualized based on the severity of the condition and other factors that must be analyzed by your veterinarian. Cats with obstruction that has been present for over 48 hours may be lethargic, collapsed or even near death (death usually occurs in 3 to 6 days if untreated). Hyperkalemia: This treatment includes relief of the obstruction (to allow potassium to be excreted in the urine) and medications to either facilitate movement of potassium into cells where it cannot cause adverse effects on the heart (sodium bicarbonate; glucose with or without insulin) or to combat adverse effects of potassium on the heart (calcium gluconate).
Relief of urethral obstruction: Your veterinarian will flush the urethra with a sterile electrolyte solution to dislodge the obstruction. Whether or not your cat will require sedation or anesthesia depends on the alertness of the cat.
Intravenous therapy: IV therapy is usually continued for 1 to 5 days during the time that urine production is increased (post-obstructive diuresis). This occurs because the body must excrete all the waste products that have accumulated during the time the urethra was obstructed. Your cat will be urged to eat and drink during this time. IV fluids are gradually discontinued within 2 to 5 days.
Monitoring of urinary output: A urinary catheter is usually sutured in place to prevent recurrence of obstruction and to monitor urinary output. This also keeps the bladder empty to allow the bladder muscle recover its normal strength if it has been weakened from ,prolonged distension.
Analgesics: Your cat may receive medication to relieve pain (butorphanol) or urethral spasm (acepromazine, phenoxybenzamine).