I know this COVID epidemic has changed my normal routine drastically as it seems to have done with the whole country.  I spend more time at home, rely on pickup orders from the grocery store, cancel vacations in favor of “staycations”, and wear a mask everywhere.  My pets have especially noticed my change in routine.  My husband now works primarily at home, and someone seems to be around the house all the time.  Although my cats do not show it, this has significantly changed their normal routines of sleep, stretch and repeat.

Whenever a cat’s normal routine is disrupted, which can include anything from a move, a new baby, a new pet, moving a litterbox or changing the litter, a different food, or owners being around more, they can develop stress cystitis.  This is a localized reaction within the bladder that causes swelling of the bladder and urethra.  In male cats, with a narrowed urethra compared to a female, this reaction can cause complete blockage of the urethra and become life-threatening quickly.  This can also happen in female cats but much less commonly.  It becomes life-threatening quickly because when a cat cannot urinate, toxins build up that can lead to kidney failure and electrolyte changes that can cause major heart abnormalities.  However how do you know if your cat has a problem?

What signs do I look for?
Cats that are having trouble urinating will:

  • Go in and out of the litterbox multiple times
  • Urinate outside the litterbox or in inappropriate places
  • Strain in the litterbox for extended periods
  • Lick his/her genitals
  • Will not be interested in eating or vomiting
  • Will cry or meow loudly
  • May not produce any urine despite multiple attempts to urinate

Should I wait a few days to see if the issue resolves on its own?
No. If you suspect your cat is not able to urinate properly, you should seek veterinary care IMMEDATELY. As mentioned before, this condition can be life threatening and very painful for your pet.

How does my veterinarian know if my cat is unable to urinate?
Your cat will be rushed into the clinic when you arrive and your veterinarian will feel his/her bladder and attempt to express urine. If your veterinarian is not able to express urine or only a small amount, this means that your cat is blocked. Diagnostic testing such as bloodwork, urinalysis, and radiographs will be performed to assess the degree of toxin buildup in the body from the inflamed bladder and will help determine if your pet has other common issues that can cause a urinary blockage including crystals, infection, mucous plug, or stones.

What is the treatment?
For the majority of female cats and some male cats, cystitis can be treated with medications and possibly a change to a prescription urinary diet. Most male cats however, will need more intensive treatment. The single most important treatment for a complete urethral blockage is to have the blockage removed. This is done by placing a urinary catheter. This requires pain medication and sedation. Your cat will also remain in hospital for at least 24 hours to receive intravenous fluids and restore healthy urine flow. Oftentimes, bloodwork abnormalities also need to be corrected. After the recommended time of catheterization (a minimum of 24 hours), the catheter is removed and the patient is observed for re-blockage. This can happen in about 15-20% of cats.

You may ask, “Is it really necessary that my cat stays in hospital that whole time? Can’t you just sedate him, pass a urinary catheter to unblock him, then send him home with medications?” Unfortunately, that is not a good idea as your cat is likely to need additional support for the best chance of survival. He is at a very high risk of blocking again if we do this method since the medications have not had time to be effective and his bladder will most likely need flushed with IV fluids to reduce inflammation.

How can this be prevented?
The best preventative measures include:

  • Diet and water intake: We typically recommend a special urinary diet to help prevent crystal formation and additional blocking issues. A urinary insult is more common in cats that have low water consumption, so we also recommend adding a fountain, watering down dry food or offering wet food, and ensuring fresh clean water is available at all times.
  • Reducing stress: Make sure your cat has plenty of quiet, safe spaces and provide high and low areas to explore. Be sure that you have at least the same number of litterboxes that you have cats and each cat should also have its own feeding area and bowl. For more suggestions, visit https://indoorpet.osu.edu/cats.
  • Weight loss: A urinary insult is more common in cats that are inactive and obese. Please follow your primary care veterinarian’s recommendations on weight management.
  • Surgery: When a urinary blockage becomes recurrent in a male cat, it becomes time to consider surgical reconstruction of the genitalia to create a shorter and broader opening. This surgery is called a perineal ureterostomy or PU. A PU is not 100% curative and can have its own complications (i.e. resistant urinary tract infections, strictures or spasms that are not fixed with surgery, general anesthesia concerns, etc.).

Remember, the team at Diley Hill Animal Emergency is open 24 hours a day, 7 days a week. If you are concerned that your cat may have a urinary blockage, DO NOT WAIT. Give our Client Care Team a call at 614-829-6444.