THE BLOCKED CAT
THIS IS AN EMERGENCY
RECOGNIZING THE EMERGENCY
We have already described the signs of Feline Idiopathic Cystitis (F.I.C.) as straining to urinate, bloody urine etc. If the cat is a male, he is at risk for an especially life-threatening complication of this syndrome: the urinary blockage.
Mucus, crystals and even tiny bladder stones can clump together to form an actual plug in the narrow male cat urethra. The opening is so small that it does not take a lot to completely or even partially obstruct urine flow. Only a few drops of urine are produced or sometimes no urine at all is produced.
It is hard to tell when a cat is actually blocked as the inflammation, urgency, and non-productive straining also accompany cystitis whether or not there is a blockage. The easiest way to tell is by actually feeling in the belly for the presence of a distended bladder. It is often the size of a peach and about as hard and firm as a peach if it there is an obstruction. (Normal bladders are usually soft like partly filled water balloons and non-obstructed inflamed bladders are usually very small or empty). Still, while this size and texture difference is obvious to the veterinarian, most pet owners are not able to feel for the bladder correctly. If there is any question about whether a male cat is blocked, he should be taken to the vet for evaluation as soon as possible.
If the blockage persists 3-6 days, the toxin build up will result in death.
DO NOT PUT OFF HAVING THE CAT CHECKED!
If the blockage persists for longer than 24 hours,
Fortunately, most cats are successfully unblocked. The urinary catheter is sewn in place and will stay in place for a couple of days. Often a urinary collection bag is attached to the catheter so that urine production can be measured. Sometimes, the bladder is filled with sterile fluid and flushed out to remove crystals, inflammatory debris, and blood.
A urine collection bag in use: note that the urine is red with blood.
Occasionally a cat is brought in soon after blocking and achieves an excellent urinary stream immediately after unblocking. These cats may be able to proceed with treatment without having to spend a few days in the hospital or without having to have the catheter sewn into place. Most blocked cats do not fit into this category but is important to realize that some cats are able to avoid more aggressive treatment.
Further, in the event of extreme budget limitations on the owner’s part, a blocked cat can be unblocked quickly and returned to the owner for aftercare. This is not a good idea as the cat is likely to need additional support for the best chance of survival; still, given that leaving the cat blocked would be cruel and ultimately end in the cat’s death, this may be an alternative in some cases.
WHAT HAPPENS DURING HOSPITALIZATION?
After a couple of days of catheterization, the catheter is removed and the patient is observed for re-blockage. He will not be allowed to go home until his urine stream seems strong and relatively easy. Some cats will leak urine at this point as it is painful for them to engage in normal pushing; this is generally a temporary problem. Once he seems to be urinating reliably on his own, he will be released for home care.
WHAT TO WATCH FOR AT HOME AFTER DISCHARGE FROM THE HOSPITAL
In an ideal world, owners can learn how to feel the abdomen for the presence of the firm obstructed bladder. This is hard to teach at discharge mostly because at this point, the cat is pretty sore. There will usually be medications and dietary recommendations to go home with the cat.
It is especially crucial to realize that the cat is at risk for re-blocking
At home, the same straining and possibly bloody urine will still be produced. It is important for the owner to be aware of urine volume being produced and of bladder size, if possible. Any loss of appetite or vomiting should be reported to the veterinarian at once. If there is any concern about reblocking, the veterinarian can determine fairly easily if the cat has re-blocked.
Most cats recovery uneventfully and most do not need continuing medication after they have recovered. Some cats, especially if they have blocked before, will require on-going treatment. Once the cat is no longer obstructed, management is the same as for any other cat with feline idiopathic cystitis that is not obstructed. For more details, click here.
Occasionally the bladder over-stretches while it is blocked and is permanently damaged. Such cats require special medication to help them contract and empty their bladders normally. This is unusual but one should be aware of the possibility.
Urinary blockage is almost exclusively a problem reserved for males. This is because the female urethra is shorter and broader and thus far more difficult to obstruct. When urinary blockage becomes recurrent in a male cat, it becomes time to consider surgical reconstruction of the genitalia to create a more female-like opening. This surgery is called the Perineal Urethrostomy or “PU” for short. Basically, the penis is removed and a new urinary opening is made.
Before considering this surgery, here are some considerations:
WHAT YOU NEED TO KNOW IF YOU ARE CONSIDERING THIS PROCEDURE FOR YOUR CAT:
Page last updated: 7/30/10