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 a 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 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 feeling in the belly for a distended bladder. It is often the size of a peach and if there is an obstruction the bladder will be about as hard and firm as a peach. (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 for longer than 24 hours, urinary toxins will have started to build up in the system.
DO NOT PUT OFF HAVING THE CAT CHECKED!
Confirmation and Assessment
The veterinarian will feel the bladder in the abdomen and attempt to express urine. Sometimes gentle pressure will actually expel the obstruction but usually the cat will require more aggressive means of relief. The blocked cat will be assessed for dehydration and toxin build up. The urinary toxins that build up in obstructions commonly cause vomiting, nausea, and appetite loss. They can also cause life-threatening heart rhythm disturbances. Your cat is assessed for all these complications as they will need to be addressed.
A partial blockage can be just as serious as a complete blockage. Treatment is usually the same.
If the blockage persists 3 to 6 days, the toxin build up will result in death.
Urinary Blockage Treatment in The Houston Heights
The single most important thing for the obstructed cat is to have the blockage removed. This is done by placing a urinary catheter through the urethral opening and either through the obstruction itself, or using pulses of flushing solution to move the plug back into the bladder where it can be dissolved. This procedure is often painful and sedation will most likely be needed. Some cats are unblocked with great difficulty only. Some cats cannot be unblocked and must have an emergency perineal urethrostomy to re-establish urine flow (see below for details on this surgery).
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.
When the blocked cat has filled his bladder to capacity, his kidneys stop making urine as there is nowhere for it to go. Once urine flow returns, the kidneys quickly begin to correct the metabolic disasters that have been taking place. Often an extremely sick blocked cat can be snatched from the jaws of death by having proper fluid support and by re-establishing urine production. It is amazing how efficient the working kidneys can be in restoring the body’s balance; still, it is important to realize that this is a serious condition and not every cat can be saved.
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.