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Urinary Blockage

Feline Lower Urinary Tract Disease signs are straining to urinate, blood in the urine, passing only small amounts of urine being passed after straining, licking the genital area excessively and urinating outside the litterbox etc.

But if the cat is male there is a risk for an even bigger and life threatening problem.  Urinary Blockage.

Urethral Obstruction
Urethral obstruction—when the cat's urethra becomes partly or totally blocked—is one of the most serious results of disease of the feline lower urinary tract. Male and neutered male cats are at greater risk for obstruction than females because their urethra is longer and narrower. Complete urethral obstruction or blockage is life threatening and requires immediate veterinary attention.

Causes
There are many causes of urethral obstruction in cats, but the two most common are uroliths and urethral plugs.

 Urothliths

Urethral plugs consist of a soft, compressible material that contains variable quantities of minerals, cells and cellular debris, and mucus-like protein. Many factors interact to produce uroliths and urethral plugs:

• viruses
• bacteria
• diet
• decreased water consumption
• physical inactivity
• urine retention

• stress and urine pH may all contribute.
  
  The most common mineral associated with urethral obstructions in cats is struvite.                                                                     Previously, the ash content—and more recently, the magnesium content—of the diet was thought to be a primary cause of struvite formation in the urine.       It also was discovered that cats who are fed multiple small meals throughout the day, or who are allowed to eat their food free-choice, routinely tend to produce a more acidic urine, making struvites less likely to form than cats fed only one or two large meals per day.
  
  Mineral deposits also have a greater tendency to form in urine that is highly concentrated or that is retained in the bladder for long periods of time. To encourage adequate water consumption, and thus the formation of urine that is more dilute, fresh water should be available to cats at all times. Fastidious cats sometimes avoid using a dirty litter pan, so owners should provide clean litter boxes to encourage regular and frequent urination.

Signs of Urethral Obstruction
A cat experiencing a urethral obstruction behaves similarly to any other cat with lower urinary tract disease: straining to urinate, frequently attempting to urinate, and producing little, if any, urine. However, as time passes, an obstructed cat typically becomes much more distressed—often crying out in pain. Frequently, owners think that the cat is constipated, when actually the cat is obstructed. The male cat may constantly lick at his penis, and the penis may be protruded. Small sand-like particles are often seen around the penis.

Urethral obstruction is a true medical emergency; any cat suspected of suffering from this condition must be seen immediately by a veterinarian. When the urethra is completely blocked, the kidneys are no longer able to remove toxins from the blood and maintain a proper balance of fluids and electrolytes in the body. If the obstruction is not relieved, the cat will eventually lose consciousness and die. Death most frequently occurs as a result of electrolyte imbalances, which ultimately cause heart failure. The time from complete obstruction until death may be less than twenty-four to forty-eight hours. Immediate treatment is essential.
 

Medical Treatment
Catheterization (passage of a narrow tube up the urethra) usually relieves the obstruction, but other procedures are sometimes necessary. Unless the cat is comatose, catheterization usually requires sedation or anesthesia. After the obstruction has been relieved, treatment varies depending upon the condition of the cat. Dehydration and electrolyte imbalance are treated with intravenous fluid therapy. Antimicrobial medications are frequently given to combat bacteria, and drugs that help restore bladder function are sometimes required.

Hospitalization may range from a few days to several weeks, depending on the severity and duration of the obstruction. Some cats don't survive because treatment is initiated too late. For cats recovering from a urethral obstruction, the first few weeks after hospital discharge are usually the most troublesome because relapses are most common during that period of time.

Surgical Treatment
For cats who continue to experience urethral obstruction in spite of proper medical management, a surgery called a perineal urethrostomy is often suggested. Cats that have undergone the procedure may still suffer bouts of bladder disease, however, they usually will not suffer from the life-threatening urinary obstructions that previously occurred.
Side effects of surgery can include bleeding for up to ten days after surgery, narrowing at the surgical site, urinary incontinence, and a greater incidence of other kinds of bladder diseases. For these reasons, perineal urethrostomy is usually considered to be a last resort.

Prognosis
A few unfortunate cats who have suffered from lower urinary tract disease will experience frequent recurrences of bladder inflammation, re-obstruction, or formation of uroliths.

Fortunately, most others rarely experience the problem again or will have only occasional recurrences.

Home Care
Home care of cats who have suffered from lower urinary tract disease is determined by the cause, and varies depending on the cat's condition and history. Usually dietary recommendations will be made, especially if struvite formation is of concern. Current feeding recommendations for the prevention of struvite urolith formation are as follows:

• Feed diets that promote the formation of urine that is acidic. Most commercial diets currently available meet this criteria. Avoid supplementing such diets with additional urinary acidifiers, because over-acidification can cause metabolic acidosis, impaired kidney function, and mineral imbalance.

•  Feed small meals on a frequent basis or feed free-choice dry foods.

•  Provide clean, fresh water at all times.

•  Provide an adequate number of litter boxes (usually one more than the number of cats in the household), and keep them clean.

• Monitor your cat for urine output and the amount.

• A canned food diet ONLY is preferred.

Prepared by the Cornell Feline Health Center, Cornell University, College of Veterinary Medicine, Ithaca, New York 14853-6401. The ultimate purpose of the Feline Health Center is to improve the health of cats by developing methods to prevent or cure feline diseases and by providing continuing education to veterinarians and cat owners. Much of that work is made possible by the financial support of friends. ©1997 by Cornell University. All rights reserved. Cornell University is an equal opportunity, affirmative action educator and employer

*information from the Humane Society of the United States