What is Feline Urinary Tract Obstruction?
Feline urinary tract obstruction is a life threatening emergency and needs to be addressed immediately if suspected. It occurs when the urethra becomes plugged preventing the cat from urinating. Due to anatomy, it is significantly more common in male cats that females. The most common cause is a urethral plug that is a mix of mucus, inflammatory cells and mineral crystals. This can also be secondary to urinary tract infection or urinary bladder stones (uroliths).
The inability to urinate is obviously quite painful but can result in other systemic signs. Commonly cats will strain unproductively in the litter box. Affected cats are also lethargic, distressed and may vomit or collapse. The kidneys can be damaged as a result of the obstruction and in some cases the damage is not reversible. The obstruction can also lead to heart arrhythmias secondary to a significant elevation in potassium.
Treatment is aimed at stabilizing the cat, supporting the kidneys, delieving the obstruction and addressing any underlying problems as quickly as possible. Common initial diagnostics include lab work to evaluate the kidneys and electrolyte levels, a urinalysis to look for infection or mineral crystals, an ECG to evaluate the heart for arrhythmias, and X-rays to look for urinary bladder stones.
These cats are placed on IV fluids to help support the kidneys while the unblocking procedure takes place. Often cats need to be sedated or anesthetized for the procedure. A urinary catheter is used to relieve the obstruction and with that in place the bladder is flushed of debris with sterile solution. The urinary catheter is often left in place for 24-48 hours prior to removing to ensure that the cat’s kidneys are producing urine and to allow inflammation in the urinary bladder and urethra to subside. If heart abnormalities are noted on ECG they are addressed with medication and correcting the potassium levels with IV fluids. If present, urinary bladder stones may need surgical removal once the cat is stable.
These cats may remain on IV fluids to help keep the urine dilute and support the kidneys. If indicated cats may be started on antibiotics to address infection, anti-inflammatories and pain medication. They may also be put on medication to help relax the urethral sphincter making it easier for urine and inflammatory debris to pass.
Once a cat has had a urethral obstruction they are at risk for reoccurrence. This can happen at any time so it is critical that these pets are closely monitored to ensure they urinate daily. If an underlying predisposing condition was found, addressing this can help prevent a repeat episode but this is not a guarantee. For male cats that do have recurrent episodes there is a surgical procedure that can be considered called a perineal urethrostomy which widens the urethra making these plugs easier to pass though these cats can still become blocked.
If you suspect your cat is unable to urinate you need to see a veterinarian immediately as this is a life threatening emergency if not addressed promptly.