Feline Urinary Obstruction
Feline urinary obstruction, also known as feline urinary tract disorder (FLUTD), feline urologic disorder (FUS) or feline interstitial cystitis (FIC), is a life threatening condition that occurs when the urethra (tube that allows urine to pass out of the body from the bladder) becomes blocked and the patient is unable to urinate. As the urine builds up in the urinary bladder the patient experiences not only pain/discomfort but the buildup of toxins in circulation that are normally excreted in the urine. Most importantly the buildup of the electrolyte potassium can cause serious and life threatening effects on the heart. The kidneys can also become secondarily damaged although these changes are typically reversible with treatment.
Feline urinary obstruction is a relatively common condition accounting for approximately 10% of cats presenting to a large urban veterinary emergency service in a recent study. Due to differences in anatomy, this condition is seen primarily in male cats with females being very rarely affected.
Physical causes of urinary obstruction can include bladder stones, mucus plug, urinary crystals and less commonly tumors. Environmental conditions such as stress, decreased water intake and diet can also plan an important role. Although frustrating sometimes the cause of the urinary obstruction is unable to be identified.
Clinical signs/symptoms to watch for include:
- Straining in the litter box (often mistaken for constipation)
- Blood in the urine (known as hematuria)
- Crying, howling or vocalizing in the litter box
- Licking/grooming genitals, tail, hind end area
- Urinating small amounts in inappropriate locations (on clothing, in the bathtub or sink)
In more advanced stages patients can become lethargic and have vomiting or anorexia. If you notice any of these signs please have your pet evaluated by a veterinarian immediately. Patients can become critically ill within 24 hours and the condition can result in death within 48 hours. Time is of the essence! Prognosis is better and treatment is easier (often times with less time in the hospital with less expense) the sooner the condition is identified.
Treatment of feline urinary obstruction includes hospitalization, IV fluids, monitoring bloodwork (kidney values and electrolytes), and sedation for urinary catheterization. Once the urinary catheter is in place and the urine is once again flowing, monitoring for 24-48 hours is recommended (although more severe cases may require longer hospitalization).
Once the patient is discharged from the hospital, lifestyle changes are often necessary. Medications such as pain medication and/or medications to help decrease spasms of the urethra may be prescribed. It is important that you follow all instructions and continue the medications as directed by your veterinarian. Other recommendations include:
- Increasing water intake: this can be achieved by feeding a canned/wet food diet, adding water to dry food, adding tuna or low sodium clam juice to the water bowl and providing multiple bowls of fresh water. There are also cat water fountains that encourage patients to drink more
- Litter boxes: The American Association of Feline Practitioners recommends that the number of litter boxes in the house equals one per cat plus one! Different locations, litter type or litter box type may be preferred by different patients. Try different options to determine which one our cat prefers
- Environmental: Providing environmental enrichment can help to lower the stress levels for some cats. Simple ideas include providing a cat climbing gym/cat condo, providing toys and trying to maintain a schedule. Erratic feeding times, new pets, or bowls/litter boxes near noisy appliances are examples of some feline stressors. Consider using a product called Feliway which is a relaxing pheromone for cats available over the counter at pet stores
Depending on the results of a urinalysis, it may be recommended to feed your pet a specific prescription diet to try to prevent crystals from forming in the urine.
Unfortunately it is impossible to determine if a patient will have a reoccurrence of his urinary obstruction. Some cats never experience another episode or symptom again whereas other patients develop a urinary obstruction as soon as their urinary catheter is removed. Once your furry friend is home please continue to monitor them for any reoccurrence of symptoms. If you notice any signs please bring him in for evaluation by a veterinarian. It is always better to be safe than sorry!