Anuria (Lack of Urination) in Cats

Anuria is defined as complete suppression of urine production by the kidneys. In a normal healthy animal, the kidney produces one to two ml of urine per kilogram of body weight every hour. If the kidney produces less than 1 ml/kg/hr, the cat is considered oliguric, which means there is little urine produced. If no urine is produced, anuria is diagnosed.

Anuria is most often associated with acute kidney failure. Urinary obstruction, such as due to a bladder stone, results in inability to pass urine but NOT in the kidney being unable to produce it. This is an important distinction between anuria and urinary obstruction. Both are treated very differently.

Acute kidney failure has many known causes such as high blood calcium, antifreeze, various drugs, dehydration, bleeding, Addison’s disease, congestive heart failure, anesthesia, blood clots and infections. All these can result in cat anuria.

Cats with anuria are usually quite ill. Straining to urinate is not part of anuria. That symptom is more likely to be associated with urinary obstruction. Cats with anuria do not have any urine produced and therefore do not feel the urge to void urine.

Anuria is a serious and potentially fatal symptom of acute kidney failure. Emergency treatment is necessary to give the cat any chance of recovery. Cats with anuria have a poor prognosis and many do not recover.

What to Watch For

Absence of urination
Dehydration
Weakness
Lack of appetite
Vomiting
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Diagnosis of Anuria in Cats

Physical examination can help lead your veterinarian to suspicion of anuria. The cat is usually depressed and dehydrated. Abdominal palpation will reveal an empty bladder. The kidneys may be swollen and painful.

Anuria is diagnosed when there is no urine production. Finding the cause of the acute kidney failure may be difficult. To diagnose the cause of the acute kidney failure, blood tests, radiographs (x-rays), ultrasound, specialized blood tests or biopsy may be necessary.

To confirm the lack of urine production, an indwelling urinary catheter may be placed, and urine production monitored. When no urine is produced, anuria is diagnosed, and treatment is immediately instituted.

Treatment of Anuria in Cats

Before treatment, an accurate weight is obtained, and a urinary catheter may be placed to accurately measure urine production and to help guide treatment.

Your veterinarian will administer intravenous fluids using extreme care; the fluid rate must be carefully monitored since it is quite easy to overhydrate an anuric cat. A cat unable to produce urine cannot handle high fluid rates normally used in dehydrated animals. If the kidneys are unable to process the intravenous fluids, these fluids will accumulate in body tissues, resulting in body swelling and weight gain.

In addition to intravenous fluids, there are several drugs that are used to stimulate urine production. These drugs use different methods to affect the kidney and urine production.

Mannitol. This drug will increase blood flow to the kidneys. By increasing the blood flow, it is hoped that the kidneys will improve function. Mannitol is not always used to treat anuria. Some veterinarians feel there are other more effective drugs available.
Dextrose. Concentrated dextrose solution works like mannitol and should produce urine within 60 minutes. This is not a commonly used drug to treat anuria.
Furosemide. This drug affects kidney function by affecting sodium and potassium exchange within the kidney tubules. This electrolyte alteration can result in increased urine production. Furosemide is not recommended if the acute kidney failure is due to administration of a specific class of antibiotics, the aminoglycosides.

After administration of furosemide, urine should be produced within 30 to 60 minutes. If no urine is produced, double the original dose is given. If still no urine is produced, a dose three times the original dose can be given. If there is still no urine production after another 30 to 60 minutes, another drug is chosen to try to stimulate urine production.

Dopamine. This drug dilates the blood vessels, which can increase urine production. Dopamine is given as a constant intravenous drip and not a one-time dose. Urine should be produced within 30 to 60 minutes of starting the dopamine drip. If no urine is produced within 6 hours of starting dopamine, it is highly unlikely that urine will ever be produced.

Home Care and Prevention

There is no home care for anuria. If you suspect that your cat is not producing urine, see your veterinarian immediately. Treatment must begin as soon as possible to give your cat any chance of recovery.

Prevent exposure to substances that may result in acute kidney failure. Antifreeze is the most common cause of acute kidney failure in pets. Do not allow your cats to roam unattended.

Make sure your cat has plenty of fresh water available. If your cat is ill, examination and treatment should begin as soon as possible. Do not delay until veterinary care. If you wait until the kidneys completely stop functioning, the chance of recovery is slim.