Cat Urinary Blockage Treatment: infographic

Cat Urinary Blockage Treatment: Emergency Signs & Care Guide

Cat Urinary Blockage Treatment: What Every Cat Owner Needs to Know

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If your cat is straining in the litter, crying out or going back and forth several times without producing urine, it is not a matter of waiting until morning. One of the most critical emergencies in feline medicine is urinary blockage and the sooner you treat your cat for urinary blockage, the better chance your cat has for making a full recovery. At Grove Center Veterinary Hospital, every Gaithersburg cat owner should be aware of the true nature of this condition, its causes and the actual treatment, since an early diagnosis can literally save your cat’s life.

Cats Urinary Blockage is what?

A urinary blockage is a medical term for when the tube through which the urine leaves the bladder (urethra) gets blocked. The blockage is due to crystals, mucous material, inflammatory debris or small stones which plug the blockage. When the blockage of the urethra occurs, urine backs up into the bladder and bloodstream as the kidneys continue to make urine.

Males are much more prone to this condition than females, as the male cats urethra is longer, narrower and much more easily obstructed. This back up of waste products and fluid results in harmful electrolyte disturbances, acute kidney failure and can be a life threatening condition in 24 to 48 hours without cat urinary blockage treatment.

What Causes a Urinary Blockage?

There are several reasons why a cat may develop a blockage, and knowing these reasons can help to better explain why there are times when cat urinary blockage treatment goes beyond merely clearing the blockage.

  • Crystals, either struvite or calcium oxalate, that are formed in urine and can group together to cause a plug.
  • Bladder stones that can become stuck in a constricted urethra.
  • Feline Lower Urinary Tract Disease (FLUTD): This is an inflammatory disease which causes swelling, mucus and debris in the urinary tract.
  • Stress is a well known cause of urinary symptoms in cats and can be caused by any environmental changes or conflict with other pets.
  • Dry food only, non-watered cats, especially diet cats with less water in their diet
  • Obesity and lack of activity associated with an increased risk of urinary problems.

Since stress and diet are so significant, the cat urinary blockage treatment is nearly always followed by a discussion on how to prevent another blockage from occurring in the future.

Recognizing the Signs

Symptoms of a urinary blockage are typically very striking and obvious, if you know what to watch for:

  • Too many futile trips to the litter box.
  • Straining to urinate and very little urine produced.
  • Crying out or making sounds when trying to urinate
  • Blood in the urine or on the floor
  • A tight and painful belly
  • Vomiting
  • Lethargy or hiding
  • Loss of appetite

If your cat has no urine in the urine bag and is straining, then this is a true emergency and you should rush your pet to the vet, even if it is after hours. Cat urinary blockage treatment is likely to be more successful if it is commenced early.

The ways to diagnose a Urinary Blockage

As soon as your cat is brought in with suspected blockage, our team quickly gets to work. Diagnosis typically involves:

  1. A physical exam, which usually involves gently touching the bladder, and can cause pain in blocked cats as the bladder is often quite hard, enlarged and painful.
  2. Blood tests to monitor potassium levels and kidney values, which can have a serious impact on the heart if potassium levels are too high.
  3. Once urine can be obtained: Urinalysis to check for crystals, blood, and infection.
  4. X-rays or ultrasound to see if there are bladder stones and how much the bladder is distended.

Diagnosis and initiating cat urinary blockage treatment can occur in near real time, particularly as cats begin to exhibit more severe symptoms of illness, and all aspects of the diagnosis contribute to the treatment plan.

Treatment Approach

The treatment of urinary blockage in cats is fundamentally based on the following approach.

1. Stabilization First

Veterinarians will first try to stabilize the cat before trying to unclog the obstruction, particularly when blood tests reveal dangerously high potassium. This can include intravenous (IV) fluids, and possibly some drugs such as calcium gluconate or insulin and glucose to stabilize the heartbeat and lower potassium levels to a safer range. This is an important stage in the treatment of cat urinary blockage; unblocking an unstable cat can be very dangerous.

2. Sedation or Anesthesia

It’s not easy to unclog the blockage, and it will need a sedated or general-anesthetised cat. This will help to calm and make your cat pain-free during the procedure.

3. Urinary Catheterization

A vet passes a urinary catheter to clear the blockage, dislodge the plug and allow the bladder to empty. It’s a tricky maneuver to execute because if a person’s bladder is full and swollen, it could cause complications, such as a ruptured bladder or a torn urethra, if done incorrectly.

4. Bladder Flushing

After the catheter is in place the bladder is flushed with fluid to remove any crystals, blood clots or debris that may have been present, and to make sure that the blockage does not reoccur immediately.

5. Hospitalization and Indwelling Catheter (IDC)

Most cats will require the catheter to be in place for 1- several days while in the hospital. The team observes the urine output, and will recheck bloodwork to ensure that kidney parameters and electrolytes are in a normalising state and then keep IV fluids running to support the recovery. This part of the treatment for cat urinary blockage is usually the longest and involves the patient staying in the clinic.

The in-patient treatment for urinary blockage in cats often takes the longest since the bladder wall and the urethra is allowed to heal.

6. Pain Management and Medication

Treatment usually includes pain medication, anti-inflammatory drugs and drugs to relax the urethral spasm to minimize the risk of re-obstruction when the catheter is removed and urination returns to normal.

7. Addressing Underlying Causes

After recovery, the focus is on finding the cause of the obstruction – diet, stress or stones. The part of cat urinary blockage treatment that really decreases the likelihood of reoccurrence in the future.

8. Surgery for Recurrence

If a cat has been blocking repeatedly after trying diet changes and environmental modifications, a surgical procedure known as a perineal urethrostomy may be indicated in which the surgeon enlarges the opening of the urethra, making it less likely that the cat will block again. This is usually only done for a cat who has experienced multiple obstructions in the past but not the current one.

What Recovery Looks Like

The cat will usually be hospitalized until the kidney values and electrolytes are back in the safe zone, and the cat is able to urinate normally without the catheter in place. After returning home, careful monitoring continues; the days immediately following catheter removal are when the risk for re-blockage is the greatest. Be extra vigilant for any signs of straining or a decrease in the number of times they use the litter box during this time period, and get your veterinarian’s advice immediately if you have any concerns. No cat urinary blockage treatment is complete after your feline friend is discharged from the hospital, it’s as important as the actual procedure.

Preventing Future Blockages

Prevention is part of cat urinary blockage treatment, and is a lifelong concern due to the high risk of recurrence in those cats who have had one episode.

  • Include wet food or increase water consumption in general, as this will help keep the urinary system healthy.
  • Follow prescription urinary diet if advised as this will help to control crystal formation.
  • Minimise stress by providing consistent routines, adequate totties and minimising conflict with other pets
  • Keep a healthy weight as obesity is associated with an increased risk of urinary issues.
  • Have several clean litter boxes—particularly in multi-cat households.

The chances of a cat blocking will not be completely eliminated by doing these things, but they will significantly reduce the likelihood and they are a common part of the discussion following any round of cat urinary blockage treatment.

Learning When to Go to an Emergency Room and When It Is Not Necessary to Go

Don’t delay in deciding what’s going on if your cat is straining in the litter box and you aren’t sure if it’s emptying. Every hour a cat goes without treatment for cat urinary blockage, the risk of a medical crisis rises, and a blocked cat can go into crisis within a day. If the clinic is closed, please contact an emergency vet clinic right away and describe the symptoms to them so they can be ready for you when you arrive.

Contact Grove Center Veterinary Hospital when to:

Please call us or your local emergency clinic if you see your cat straining or crying when trying to urinate, or if they just don’t produce any urine. “Wait and see” is really risky in this instance. From the initial emergency appearance of your cat to final urinary blockage treatment, we’re in your corner in Gaithersburg to help you with diagnosis, stabilization, and treatment of your cat’s urinary blockage.

Conclusion

One of the true emergencies in cat health is a urinary blockage, and then one of the emergencies for which quick action makes a huge difference. The goal of treatment for a urinary blockage in cats is to stabilize your cat, dislodge the blockage, and help your cat get better with careful hospitalization and monitoring, and a long-term plan to minimize the risk of future blockages. If you ever think that your cat is straining, but not providing urine, don’t delay. Take to a vet as soon as possible. The early diagnosis and prompt treatment is the most important factor in achieving success.

Frequently Asked Questions

1. So what is the initial treatment for urinary blockage in cats?

The first step is to keep the cat stable, particularly correcting the dangerously elevated potassium level, before trying to relieve the blockage. This will help to shield the heart until the blockage is resolved.

2. Is a cat urinary blockage an emergency?

Extremely urgent. If left untreated, blockages can be fatal in 24 to 48 hours as a result of kidney failure and electrolyte imbalance, so any cat that strains to urinate without producing any urine must be seen by a vet immediately.

3. What causes male cats to be more likely to get a urinary blockage?

Male cats have a longer, narrower urethra than females, and crystals, mucus or small stones are much easier to cause an obstruction.

4. What is the hospitalisation period to treat urinary blockage in cats?

Most cats will be hospitalized for one or several days with a urinary catheter in place until their kidney values and electrolytes are back to normal and they are able to urinate on their own.

5. Is it possible to treat a urinary obstruction in cats without the use of a catheter?

No. An obstruction may only be relieved by passing a urinary catheter under sedation or general anesthetic to dislodge the blockage and safely empty bladder.

6. What surgery will my cat require for a urinary blockage?

Not generally for a first time. For cats with recurrent urethral blockages that do not respond to dietary and environmental management, surgery (perineal urethrostomy) is usually the only treatment option.

7. What do I do to stop my cat from blocking again?

Drinking more water, giving wet or prescription urinary food, decreasing house soothings and keeping a healthy weight are ways to lower the risk of a repeat blockage.

8. How do cats indicate that something is wrong with their urinary system?

The first signs are typically frequent, unproductive trips to the litter box, straining, vocalization while urinating, and a hard or painful abdomen.

9. Is urinary blockage a urinary tract infection (UTI)?

No. A UTI is caused by a bacterial infection, and a blockage is a physical blockage of the urethra. They may happen at the same time but a blockage is a more urgent emergency.

10. What if I wait too long to get treatment?

The waste products and potassium accumulate in the blood and may cause kidney failure, heart problems and death within a day or two of the blockage beginning.

Grove Center Veterinary Hospital is a veterinary clinic in Gaithersburg, MD that offers urgent and compassionate treatment of your cat’s urinary health.

Diabetic - Dog Diet

Diabetic Dog Diet

By now you know that diabetes mellitus is about a lack of insulin and a need to balance insulin given by injection with dietary nutrients, especially sugars, fats, and proteins. Regardless of the patient’s species, there are some basic principles that hold true for the dietary management of diabetes mellitus. First, the obvious: the pet must like the food and reliably eat it. For most diabetic dogs, the excessive appetite typical of the disease ensures this but after regulation is achieved and appetite is more normal, it is important that the dog eats on a dependable schedule. Insulin is typically given only after the pet has eaten so the food should taste good and the pet should want to eat it. Second, the food must be of quality and quantity to maintain a good body condition so that the dog is able to build muscle and a healthy amount of body fat. Some diabetic dogs are very thin while others are too fat. It is important to tailor the diet to the individual rather than to adhere to rigid dietary rules.

The ultimate goal is to feed the dog two similar meals a day, approximately 12 hours apart, with less than 10% of the total nutrients for the day coming from treats. Insulin is given within an hour of eating each meal and this schedule should be maintained with as much regularity as possible.

No diet type has emerged as being optimal for diabetic dogs. The basic idea is to feed the dog a food that will maintain a healthy weight.

Most dogs will not need a diet change, but this may be a good time to re-evaluate your feeding strategy. Here are some considerations:

Treats

Basically, minimize them.

The regulation of diabetes mellitus depends on the balance between the carbohydrates going in and the insulin allowing them to be stored. Many people like to offer the dog a treat after insulin injections or after blood sampling. This can add a surprising amount of calories and it is important to realize that every treat works against the insulin injections you are giving. If treats are felt to be necessary it will be important to determine how many calories are being added to the daily intake this way and adjust the meal amount accordingly. Ideally, treats are small and low in carbohydrates. High fiber vegetable bits usually work.

Fiber

Fiber comes in two types: soluble and insoluble. Soluble fibers, such as beet pulp, guar gum, psyllium, and fructooligosaccharides form a gel that holds water inside the bowel contents potentially softening the stool. They also serve as prebiotics, which means they resist digestion higher in the tract and are presented to the bacteria of the large bowel. These large bowel bacteria break down the fiber-containing nutrients to feed not only themselves but also to feed the animal’s colon cells, improve bowel circulation, and generally contribute to bowel health. The problem is that this resulting stool leads to a higher post-meal sugar surge in the bloodstream, which is exactly what we do not want. 

Insoluble fibers, such as cellulose, bulk up the stool which can be stimulating to the colon. Insoluble fiber is not digested by the colon bacteria and does not offer calories to the pet that has consumed them. This is helpful for weight loss programs as the indigestible fiber contributes to a feeling of fullness without contributing calories. 

After a meal, the starches and sugars taken in with the food lead to a postprandial surge in blood sugar level. Since the diabetic dog is dealing with runaway blood glucose levels 24 hours a day, meals, as necessary as they are, raise blood sugar even further. Our goal with dietary therapy is to blunt this effect. Insoluble fiber in the diet helps accomplish this by slowing the digestion and transit of the food in the gut. Too much insoluble fiber, however, will give the pet a false sense of being full and reduce appetite, which may not be what we want if the pet is underweight. So what are we looking for in a food? If the dog is overweight, we probably want a higher fiber diet (say greater than 15 percent of the dry matter as fiber) but for a more average dog, we want a moderate amount of fiber (5-15 percent of the dry matter). The fiber content noted in the guaranteed analysis will likely not specify if the fiber is soluble or insoluble; you will need to check the ingredient list to be sure. 

HOW TO CALCULATE FIBER CONTENT IN FOOD ON A DRY MATTER BASIS

To calculate the percentage of fiber in a diet on a dry matter basis, look for the “crude fiber” and the “moisture content” amounts on the guaranteed analysis on the food label.

SAMPLE GUARANTEED ANALYSIS

Crude Protein (min)…….8%
Crude Fat (min)………6%
Crude Fiber (max)………1.0%
Moisture (max)………78%

The moisture content is the amount of water in the food on an “as fed” basis expressed as a percent (what percent of the food you are feeding is actually just water). Take the moisture content and subtract from 100 to get the dry matter content of the food (the part of the food that is actually food and not water). For example, if the moisture content is 78% (typical canned food) then the dry matter is 22%. 

Now take the crude fiber value from the guaranteed analysis on the label and divide by the percent of dry matter. For example, crude fiber on the label is 1%, and moisture content is 78%. This means dry matter is 22% and 1 divided by 22 = 0.045 or 4.5%. Our hypothetical canned food is 1% fiber as fed but 4.5% on a dry matter basis. When comparing foods, always compare on a dry matter basis so as to compare “apples to apples”.

The above diet is way too low in fiber for an overweight dog and probably a little light on fiber for a dog of normal weight or thin dog.

High Digestibility Diets: Probably not the Best Thing

There are numerous diets on the market designed for dogs with sensitive stomachs. These foods typically are designed for easy digestion and absorption. While this is helpful to the dog with digestive issues, easy digestion and absorption amounts to higher blood glucose levels after eating. This is probably not the best thing for a diabetic dog.

Similarly, soft moist foods are preserved and flavored with sugars. These, as you might guess, raise postprandial blood sugar readily and are poor choices. These diets are not as common as they once were and should not be confused with canned foods.

Low Fat

A common issue that accompanies diabetes mellitus is elevated triglycerides (fats) in the bloodstream. In humans, this is the doorway to vascular disease, cholesterol deposits, heart disease, and stroke. Dogs do not generally have to contend with these issues but dietary fat becomes more relevant if the dog is one of the 30% for whom pancreatitis is believed to have damaged the pancreas and led to diabetes in the first place. If pancreatitis is in play or if the patients circulating triglyceride level is high, then fat restriction is going to be a must. Further, L-carnitine supplementation may also be of benefit as this nutrient is helpful in fat transport and metabolism. Fat-restricted diets may not be a good idea for very thin diabetic dogs, however.

Other Concepts

As long as the diet is consistent, it is generally possible to work with it in achieving diabetic regulation. Here are some additional tips:

  • If the dog has an additional medical problem that requires a specific diet in its management, then this trumps the suggestions for diabetic management.
  • As long as a reputable food that has passed AAFCO feeding trials is being fed, it should not be necessary to add nutritional supplements.
  • Ideally, a brand of food with a fixed formula is preferred to one with an open formula. Foods with an open formula stick to their prioritized ingredient list on the label and to the guaranteed analysis minimums and maximums, but the exact ingredient amounts are not fixed. A fixed formula food uses specific amounts of each ingredient every time in every lot. In general, non-prescription diets are open formula diets.

Your veterinarian can help you choose the most appropriate food for your diabetic dog. There are several commercial diets made just for this purpose or you may elect to find one on your own. You can also contact a commercial pet nutrition service for further help. Ask your veterinarian if you need assistance.