Overview of Feline Urinary Obstruction
Is your cat suddenly making frequent trips to the litter box? Is he straining or meowing when he tries to urinate? He may be affected by lower urinary tract disease, most commonly in the forms of urinary obstruction and feline idiopathic cystitis.
Below is an overview of Urinary Obstruction in Cats followed by detailed information on the diagnosis and treatment of this condition.
Feline urinary obstruction (UO) is an acute obstruction of the urinary tract, and although this disease can affect any cat, it is most common in males. This is commonly called a urinary obstruction (UO) and referred to as a “Blocked Cat”.
It can be caused by stones, but usually the cause is a plug of inflammatory debris and crystals, which is part of the common syndrome called feline idiopathic cystitis (FIC). FIC is an inflammation of unknown cause affecting the lower urinary tract. Factors that may play a role in the development of FIC include viruses, diet (dry food diets with high mineral content), stress, strict confinement, and genetic factors (long-haired cats seem to be more affected).
What To Watch For
Usually cats with urinary tract infection and/or obstruction show typical signs of discomfort. They will strain and make frequent and prolonged attempts to urinate, but the amount of urine passed is quite small. Affected cats will groom their genital area excessively, and sometimes they will urinate outside the litterbox. Occasionally, there will be blood present in the urine. You should take care not to mistake these symptoms for constipation and if you notice any of the following, consult your veterinarian. Blood in the urine Increased frequency of urination Straining to urinate Distressed meowing while urinating Increased grooming of the genital region Urinating in inappropriate locations – often in cool smooth surfaces such as bathtubs and sinks
Complete urinary obstruction can develop into a life-threatening emergency within a period of 48 hours. The following symptoms constitute a medical emergency and signal that you should call your veterinarian immediately. Frequent unsuccessful attempts to urinate Lethargy Loss of appetite Vomiting Reluctance to move
Veterinary Care of Urinary Obstruction in Cats
Your veterinarian will want to do a thorough physical examination in order to diagnosis your cat’s problem. In addition, some diagnostic tests, such as a urinalysis, abdominal X-rays, or an ultrasound, may be necessary.
Usually treatment for your cat will consist of relieving the obstruction with catheterization (the insertion of a long, flexible tube) and flushing the bladder with sterile fluid. This procedure will most likely require sedation. Your veterinarian may also prescribe medication for pain and spasm.
There are several things you can do to lessen or prevent the occurrence or recurrence of urinary obstruction. Some of these include: Provide your pet with a clean litter box at all times and frequent opportunities to urinate. Provide plenty of fresh clean drinking water. Some manufacturers offer products such as a pet waterfall to encourage water consumption by cats. Help your pet maintain a healthy body weight and prevent obesity by proper feeding and diet. Feed a canned food product if at all possible. Try to minimize stress for your pet by keeping the environment as stable as possible. Provide scratching posts, climbing toys, toys to chase, and don’t introduce new animals to his environment. Carefully monitor your cat for signs of recurrence. Complete urinary obstruction can develop into a life-threatening emergency with 48 hours.
In-depth Information on Urinary Obstruction in Cats
Feline urinary obstruction (UO) is an acute obstruction of the urinary tract, and although this disease can affect any cat, it is most common in males. It can be caused by stones, but usually it’s cause is a plug of inflammatory debris and crystals as part of the common syndrome called feline idiopathic cystitis (FIC), which is an inflammation of unknown cause affecting the lower urinary tract. Factors that may play a role in the development of FIC include viruses, diet (dry food diets with high mineral content), stress, strict confinement, and genetic factors (long-haired cats seem to be more affected).
Other medical problems can lead to symptoms similar to those encountered in FIC. These conditions should be excluded before establishing a diagnosis of FIC. Some of them include: Bacterial urinary infection (bacterial cystitis). A bacterial cystitis is an uncommon cause of lower urinary tract symptoms in young to middle-ages cats. Bladder stones (calculi or uroliths)Urolithiasis Congenital anatomic abnormality. These are defects present at birth such as outpouching of the bladder. Constipation. It is easy to confuse difficult urination and difficult defecation. Observing your cat’s posture may help because cats assume a more upright posture when defecating. Tumors of the bladder. These are rare in cats. Nervous system abnormalities. These sometimes interfere with the normal control mechanisms of urination. Inappropriate urination as a result of behavioral disorder. Cats are territorial by nature, and when they sense their “space” has been invaded, they often mark their territory by urinating outside the litter box. It might be difficult to distinguish this behavior from symptoms of FIC.
Diagnostic tests must be performed to confirm a diagnosis of FIC with urethral obstruction and exclude other diseases that may cause similar symptoms. The following diagnostic tests are often necessary: Time is crucial in cats with urethral obstruction that has been present for 48 hours or longer. Therefore your veterinarian will take a brief history and perform a rapid physical exam before attempting to relieve urethral obstruction. The presence of a large, firm, painful bladder indicates an obstruction. Your veterinarian may also do an Electrocardiogram (ECG) if your cat is lethargic and has a slow heart rate (bradycardia) due to high potassium concentration (hyperkalemia). These findings indicate that the cat has had an obstruction for more than 48 hours. A Urinalysis will be performed on urine collected after the obstruction has been relieved. Such things as concentrated or dilute nature, pH and presence of red and white blood cells, crystals and bacteria will be determined. A urine culture and sensitivity may be done to check for the presence of bacterial infection. Blood chemistry tests. Several blood tests may be done to evaluate kidney function, blood potassium concentration, blood calcium concentration, acidosis, disturbances of blood sodium and chloride concentrations, and glucose concentration.
After your cat is stable, your veterinarian may recommend additional tests to exclude or diagnose other conditions that may cause urinary tract symptoms and to better understand the impact of FIC and urethral obstruction on your pet. These tests ensure optimal medical care and are selected on a case-by-case basis. Some of these may include: Plain abdominal X-rays may be taken to evaluate for dense stones in the bladder such as those made of struvite or calciumjoxalate. Special contrast X-ray dye studies may be done to evaluate for less dense stones, tumors or anatomical abnormalities such as outpouching of the bladder. Abdominal ultrasound examination may be recommended to evaluate for less dense stones or tumors that cannot be identified on plain X-rays.
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).
Follow-up Care for Cats with a Urinary Obstruction
Follow-up care for your pet is crucial and includes the following: Physical examination and urinalysis should be repeated 5-7 days after discharge from the hospital. Give all prescribed medications and contact your veterinarian if you have difficulty treating your cat or if you suspect there is a recurrence. Provide your pet with a clean litter box at all times and frequent opportunities to urinate. For tips on maintaining the ideal litter box, please read The Fine Art of Litter Box Care. Provide plenty of fresh clean drinking water. Some manufacturers offer products such as a pet waterfall to encourage water consumption by cats. For tips on how to stimulate drinking, please read Tips for Encouraging Your Cat to Drink. Help your pet maintain a healthy body weight and prevent obesity by proper feeding and diet. Feed a canned food product if at all possible. Try to minimize stress for your pet by keeping the environment as stable as possible. If you have multiple cats, please read Reducing Multicat Household Stress. Provide scratching posts, climbing toys, toys to chase, and don’t introduce new animals to his environment to minimize stress and enrich his environment. For tips on enriching his home, please read Selecting the Right Environmental Enrichment for Your Cat.