A Potentially Fatal Combination – Male Cats and Urinary Obstruction

by Lyn T. Garson, CVT, CCRP

Any one of a variety of clinical issues or injuries could send your cat to the emergency clinic. Several of the most concerning are difficulty breathing, seizure, excessive vomiting, allergic reactions and traumatic injury. These are obvious medical emergencies, yet other urgent conditions could present with less conspicuous signs and symptoms revealing the tip of a life-threatening iceberg. One of the most critical is when a male cat stops urinating due to a urinary tract obstruction.

Referred to as a “blocked cat,” the sudden inability of male cats to urinate is a dangerous and commonly seen medical emergency in which an obstruction occurs in the urethra, preventing normal flow of urine from the urinary bladder to the outside of the body. The urethra is a tube passageway that transports urine from the urinary bladder, out of the penis, and into the litter pan. Because the male cat urethra is long, narrow, and forms a curve, it can easily become plugged with material containing inflammatory cells, or a clump of mucus-like protein, minerals, crystals, and/or gritty stone formations (called calculi). Urinary obstruction in female cats is extremely rare due to their larger, straight and shorter urethral opening.

What exactly causes an obstruction to form is not well understood despite decades of research, however, recent studies indicate a complex relationship between bladder abnormalities, changes in nervous system and hormones, and high sensitivity to environmental stress – all contributing factors. Blocked cats are typically indoor neutered males, between one and ten years of age. Overweight cats receiving little to no exercise, and those living in multi-cat households have been identified to be at greater risk. An increased incidence of urinary blockage occurs during winter months.

Even the most astute pet owners may be oblivious to their cat’s daily bathroom habits. Cats are private, modest creatures after all, and we normally wouldn’t have reason to accompany them to their litter box. However, changes in a cat’s usual routine could indicate significant problems. Once urine flow is obstructed, either partially or fully, a blocked cat is only able to urinate small amounts at a time, tiny droplets, or not pass any urine at all. Blood is visible or the urine may be red-tinged. Be watchful of anything out of character for your cat as irregularities in behavior or routine can be a sign that your cat is in pain and alerting you that something is wrong. Blocked cats often experience pain when their abdominal area is pressed, and may prefer solitude by hiding due to discomfort. They tend to lick their genital area excessively. Typically they display intensified meowing or howling, appear restless or agitated, and make frequent trips to the litter box in a painful attempt to pass urine. Repeated straining to urinate is often mistaken for constipation since the cat spends prolonged periods just sitting in the litter box with their tail held up or straight out. Urinating directly outside the box, or elsewhere around the house, especially on cooler smooth surfaces such as tile flooring, sinks or bathtubs, is also a common sign of trouble.

Blocked cats are a true medical emergency requiring immediate attention. This is not something that resolves on its own, and the longer treatment is delayed, the less chance of survival. Cats endure a growing state of discomfort even after just a few hours of being blocked, however they may not be noticeably despondent or evasive right away. In some cases, the disorder may be a urinary tract infection that can be more easily treated, however do not assume you have the luxury of time – even a day or two can mean the difference between life and death if your cat is actually blocked. Left untreated, blocked cats become increasingly distressed very quickly. Lethargy, nausea, vomiting and appetite loss soon follows. The kidneys are not able to filter out waste products or maintain the proper fluid and electrolyte balance to sustain life. Toxins begin to build up within 24 hours. Collectively, these imbalances cause life-threatening heart rhythm disturbances ultimately leading to heart failure. Blocked cats may seem relatively fine one day and can die within a short time period, sometimes in as little as 48 to 72 hours.

Emergency treatment involves insertion of a urinary catheter, under sedation, to relieve the obstruction allowing urine flow. An intravenous (IV) catheter is placed and IV fluids are administered. Urinalysis and blood tests are performed and monitored. Radiographs may be indicated to check for presence of stones in the bladder, kidneys, or ureters. Urinary obstructions can be a one-time occurrence, although more often are chronic with recurring cases requiring repeated treatment and possible surgery.

Decreasing life stressors are an important component of prevention and ongoing treatment for
at-risk cats. While not a guarantee, certain measures can help reduce environmental stress and provide an overall healthier lifestyle. Quality canned food diets are preferable to dry kibble. Prescription diets may be indicated by your veterinarian. Clean, fresh water is of utmost importance to keep urine more dilute. Drinking fountains specifically for cats are commercially available to encourage increased water consumption, although some cats simply enjoy a dripping kitchen or bathroom faucet. Offer both types of litter boxes – open style and hooded – and keep them meticulously clean. For ease of entry and exit, use shorter-height boxes for elderly or arthritic cats, and avoid placement requiring stairs to access. In multiple-cat households provide one extra litter box more than the total number of cats. Place boxes in quiet areas away from furnaces and other noise-producing appliances. When possible, minimize changes in routines. Prevent boredom and weight gain by providing environmental enrichment activities such as daily interactive playtime sessions, window perches, cat trees and scratching posts. Brown paper (never plastic) bags, cardboard boxes, and paper towel rolls make safe entertaining cat toys. Cats left unattended may be comforted by soft music, television, or videos featuring birds and squirrels. Leave blankets or clothing with your scent on them for cat napping in warm sunny spots around your home.

The best preventive strategy is observation and interaction with your pet on a daily basis. Once you are already familiar with their normal behaviors, potential problems are more readily apparent. Pay close attention to anything out of the ordinary and seek veterinary care without delay if your cat shows any indication of discomfort or unusual behaviors. Remaining diligent through early detection and timely treatment for blocked cats is often a lifesaver.