HOW IS A URETHRAL BLOCKAGE TREATED?
Urethral obstructions are very serious, if left untreated they cause acute kidney failure and death within 48-72hrs, so this really is a life and death situation. As soon as the bladder is unable to empty pressure starts building up in the bladder which also then transfers up the ureters to the kidneys, this back pressure can cause physical tissue damage but essentially prevents the kidneys from filtering out the toxic by-products in the blood and balancing salts, minerals and water in the body.
There are three key stages for treating this condition:
- Stabilisation – The length of this stage depends on how sick the cat is and how long the bladder has been blocked. They will have a catheter placed in their leg so intravenous fluids can be given to rehydrate them and to restore any mineral and salt imbalances present. If there are signs of kidney failure the pressure on the kidneys is released by removing some of the urine from the bladder via a needle through the abdomen (cystocentesis).
- Relieving the blockage – The blockage has to be relieved under a general anaesthetic or a heavy sedation so this can only be done once a patient is sufficiently stable. Under the anaesthetic a urethral catheter is attempted to be placed using fluid and massage to try and displace the obstruction. This procedure is very delicate and has to be done very carefully to avoid damage to the delicate urethral lining. In some cases where this is not possible, or the patient has had several repeated blockages, surgery has to be performed to bypass the urethra (perineal urethrostomy) and in cases where there are stones present in the bladder and operation to remove these from the bladder is performed called a cystotomy
- Post blockage support – a cat will often have to stay hospitalised for several days on intravenous fluids and with the urinary catheter in place to allow for the inflammation in the bladder and urethra to reduce, the underlying cause to be identified and treated and for the kidneys to be supported and monitored after any injury sustained. Some kidney damage can be reversible with medical support but only time will enable a vet to assess if the damage is more permanent. There are many types of medication that will be given to reduce pain, urethral spasm and inflammation which will continue for weeks after the blockage and dietary changes are often advised to prevent the condition reoccurring.
If caught early this is a completely treatable condition, however if treatment is not sought swiftly and the kidneys sustain any damage then the prognosis is less favourable, and the outcome will depend on the severity of the damage.
How can the condition be prevented?
Given the gravity of this condition prevention is by far the better solution by intervening before it gets to the life and death situation. If your cat is showing any signs of cystitis take them for an appointment as soon as you’re able to and try and identify the underlying cause.
Cystitis is most cases is a preventable condition and there are some specific ways that this can be achieved depending on the particular type. However, there are some common basics true of all types:
- Encourage your cat’s intake of fluids. There are several ways that this can be achieved through ensuring you have numerous sources of water in different forms and in different places, but also through feeding them moist food as part of their diet such as fresh chicken or fish, alternatively for some cats you can add water to their dry food.
- Feed them a high meat diet. Cats are carnivores and rely on a high percentage of meat-based protein in their diet. When protein is utilised in the body the by-products are eliminated in the urine and this in turn causes their urine to be acidic which prevents crystal formation and ensures good bladder health. Dry diets rich in carbohydrate cause the pH of the urine to be too alkaline and make crystal formation more likely.
- Ensure you have enough litter trays. The reason the condition is more common at this time of year as cats generally are out and about outside less and so as a result often do not urinate as frequently. Make sure you have litter trays down in the house so they can go when they need. Ensure you have enough for the number of cats as they don’t like sharing, as a rule of thumb you should have one for every cat plus a spare. Cats are more likely to use a litter tray if they are placed in quiet areas of the house and not next to their food bowl, the type of litter used is also important. Many cats dislike fragranced litter and prefer brands that clump.
Jenny Philp
BVMS MRCVS
References
https://icatcare.org/advice/cat-health/urethral-obstruction-cats
https://www.acvs.org/small-animal/urinary-obstruction-cats
http://www.theveterinaryexpert.com/emergencies/blocked-cats-part-1/
