Blocked male cats.
Cats are hardy little survival machines. They tolerate us a lot more than they require us. There are few times when Cuddles needs you to come to his rescue. This is one of them.
Your cat has been going to his litter box every few minutes, maybe he hasn't left it for a few hours. He's crying out in what sounds like pain and you haven't noticed any urination. If he does come out of his box he might drop down and lick at his private areas but still no urine comes out. Please call me at this point. If left untreated a blocked cat will build up toxins and will die from changes in their blood chemistry in 3-6 days. It is a fairly painful and treatable condition.
Male cats block for a number of reasons. They may form plugs made of crystals, mucus and/or tiny bladder stones. They may have severe urethral spasms due to stress. They may have a combination of both plus additional factors. The end result is that they can not void urine from their bladders. This causes the kidneys to stop producing urine and the toxins that the kidneys filter from the blood end up building up. These toxins can make your cat very sick. Vomiting is not uncommon and life threatening heart arrhythmias can also occur.
What are we going to do about it? Treatment depends on just how sick your cat is when you bring him in. If he is alert and manageable I might sedate him before we go any further. If he is very down and out and I am afraid that sedating him might be dangerous I will use a needle and syringe to pull some of the urine out of his bladder to allow the kidneys to clear the blood a little more before we continue.
Sedation almost always accompanies the treatment phase. We will place an intravenous catheter for the post obstruction part of this disease often before we even begin to unblock you cat. When Cuddles is sedated we will pass a urinary catheter up his urethra and into the bladder. This can be one of the most frustrating tasks in veterinary medicine though I feel like I've really found the most hassle free and gentle means of placing a catheter in male cats. Once we get urine flow through our catheter we immediately start them on intravenous fluids. The kidneys are going to do the bulk of the work from here on out and we simply collect and measure urine to be sure everything is going as expected. Once the removal of the obstruction is complete the kidneys will begin working overtime to make up for the accumulation of toxins that occurred during their brief hiatus. This is potentially very dangerous for your cat as it can rapidly dehydrate him and lead to serious health risks.
We typically will keep an unblocked cat on iv fluids and maintain an urinary catheter until the urine is clear of all visible blood and debris. We will then pull the catheter and be certain they are urinating on their own. Sometimes this can take up to three days. As a result blocked cat's veterinary visits tend to get very expensive very quickly. It is not unusual for a blocked cat to go home with a dent in his owner's checkbook to the tune of $700.00!
After your cat goes home they are still at an increased risk for re-blocking for a few weeks. During this convalescing period we will institute a number of treatments to prevent the blockage from reoccurring. This will often include diet changes and enhancement of his at home environment. Sometimes it may also include behavior modifying medications. In rare cases, we may have to resort to dealing with the issue surgically. A perineal urethrostomy involves the surgical removal of the penis and urethra up as close to the bladder as possible. This shortens the urethra and places the opening in an area where the urethra is at its widest. By doing this we prevent future blocking as the cat is able to pass larger plugs and there is less urethra to spasm. Personally, I consider this surgery a last resort for cats that repeatedly block and will do almost anything to avoid it. The way I see it as long as you haven't done it yet any surgery is still an option, once you cut you really can't take that back.
Unfortunately finances are the demise of many of our patients and I think that obstructed male cats are probably over represented in this category. There are always options available and if you find yourself in this position with your cat please don't assume you have to make a choice between a huge bill or the loss of a furry friend. I'm not going to get into the "budget" style treatments for unblocking as I would consider them to be less than best medicine but if that's what it comes to then that's what it comes to. I would prefer to at least try something than to make a final decision based solely on the finances.
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