In the first article on blocked tomcats we looked at what a ‘blocked cat’ is and the signs to look out for. In the second article, emergency expert Shailen Jasani describes how this condition is managed, what steps you can take to try and prevent it from happening, and what the outlook is. Having a blocked bladder is a life-threatening problem and requires urgent treatment.
How is a ‘blocked’ bladder treated? Emergency treatment usually starts with:
A fluid drip (intravenous fluids)
Pain-killer
Blood tests: especially to check potassium level
Abnormal ECG trace in a blocked cat with hyperkalaemia
A blocked bladder can cause high potassium levels (called hyperkalaemia) which can affect the way that the heart beats and can cause death; measuring potassium is therefore very important and an ECG can also be done to help assess its effects on the heart. Urgent treatment may be needed.
The next step your vet will take is to try and unblock your cat’s bladder by inserting a catheter (a silicone tube) into the penis, pushing the catheter along the inside of the urethra into the bladder. As the urethra is blocked this can be quite challenging; however in most – but not all – cases a catheter can eventually be passed. This catheter is usually left in place for up to 2 days; this allows urine to be drained and your cat to start to feel more normal again.
During this time he will be kept on a fluid drip and also be given pain-killers. Repeat blood tests may also be carried out. Once the catheter has been in place for 1-2 days, it is removed and your cat will usually be kept in at the veterinary practice for a short time afterwards to make sure that he can pass urine freely and comfortably before being sent home on pain-killers and possibly other medications. Urine test results may affect your cat’s on-going care at home. For example depending on what type of stone or material was blocking your cat’s urethra, a specific type of diet may be recommended.
A blocked bladder is rarely due to an infection so antibiotics are not usually needed in these cases; they will only be used if an infection is confirmed.
If a catheter cannot be passed through the urethra, your vet may need to drain your cat’s bladder by placing a needle into it from the outside and draining the urine out with a syringe. This procedure is called ‘cystocentesis’ and it can be a life-saving short-term solution in blocked cats. However, if a catheter cannot eventually be passed then an operation will be needed. Even if a catheter can be placed, surgery may still be needed at some point in some cats to remove the stones from the bladder to stop the obstruction from happening again.
Can I stop my cat’s bladder from becoming blocked? It is not possible to prevent this problem in all cases but some steps can be taken to try and make it much less likely:
It is now also possible to buy dry food diets that are designed to try and prevent your cat from getting a blocked bladder and in certain cases to try and treat existing problems. However in some cats with on-going problems, feeding a wet food diet may be the only option.
Minimising ‘stress’ is also considered important. For example:
Not all cats find living with other cats stressful!
In multicat households some cats are too afraid to use the litter trays provided often enough – not urinating often enough may contribute to your cat getting a blocked bladder
Some cats prefer certain types of cat litter and litter tray designs
If your cat is an indoor cat then providing multiple litter trays, including some that are covered and secluded, may help
You can also take steps to encourage nervous outdoor cats to go outside by for example providing a covered retreat immediately outside the cat flap
What is the outlook for my cat with a blocked bladder? Having a blocked bladder is a life-threatening problem and requires urgent treatment. However although some cats do not survive this problem, nowadays the majority will recover from the initial episode if they receive the treatment that they need in the right timeframe. Some cats then go on without ever having another episode; in other cases a second episode does not occur for years. However there are a small percentage of cats that suffer another episode quite soon, within days, weeks or months.
In a small number of cats, episodes keep recurring and an option of performing surgery may need to be discussed. This surgery, known as ‘perineal urethrostomy’, has pros and cons; it is not always successful in preventing obstructions in the future but for some cats it is the last option available to try.
About Shailen Jasani
Shailen has spent the last 12 years working in Veterinary Emergency and Critical Care. This has included six years at the Royal Veterinary College, London; 3 years as a primary clinician in first opinion emergency practice; and 3 years as a trainer and mentor to vets and nurses working in primary care Out-of-Hours practice. He is currently working on various projects in an independent capacity. He also founded and runs the Ralph Site, a non-profit pet loss support resource.
The Veterinary Expert| Pet Health
The veterinary expert provides information about important conditions of dogs and cats such as arthrits, hip dysplasia, cruciate disease, diabetes, epilepsy and fits.