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Why Can’t My Cat Pee?

Posted 07.13.17 by Alison Bradshaw, DVM

Urinary problems are one of the most common reasons for clients to bring their kitty into the vet. Usually I see the patient that is having litter box issues and urinating all over the house, straining to urinate, or having blood in urine. Some of these are medical problems such as cystitis (bladder inflammation), kidney disease, bladder stones or crystals, diabetes, or urinary tract infections. Then some are primarily behavior problems caused by changes in the household, new animals, or changes in litter. Cats are also unique in the fact that stress can actually induce medical urinary problems in patients that are prone to this.

These various urinary diseases in cats are placed under the broad title of Feline Lower Urinary Tract Disease (or FLUTD).
Most of these diseases can be treated medically with prescription diets, anti-inflammatories, antibiotics, or anxiety medication; but there is one condition that is an emergency that must be addressed immediately or it is fatal: a urethral obstruction. It is actually a result of feline lower urinary tract disease which causes clumps of cells, blood, small bladder stones, or crystals in the urine that form a plug in the narrow urethra. It is most common in male cats due to their anatomy.

The classic presentation for a urethral obstruction is a young male kitty that suddenly keeps squatting in the litter box, but nothing or very little urine comes out. You can also see pain exhibited by hiding or vocalizing, vomiting, not eating, and lethargy. If you ever see any of these signs, bring your cat to the vet immediately. Usually the veterinarian has a high suspicion based on clinic signs and abdominal palpation. The bladder is very large, very firm, and painful. The diagnosis can be confirmed by the inability to manually express the bladder, a large bladder on x-ray, and lab work results. This is a medical emergency, and treatment must be implemented as soon as possible. If left untreated, the bladder can rupture or the patient will go into metabolic acidosis and multi-organ failure.

The most important part of treatment is relieving the obstruction. This is done by very quickly sedating the patient, and passing a urinary catheter. In some cases this can take some time depending on the difficulty of flushing out the urethral plug. Once the obstruction is relieved the bladder is drained, and the urinary catheter is secured in place. I usually leave the urinary catheter in place at least 2 days to allow bladder and urethral inflammation to go down and reduce the risk of immediately re-blocking. Also these patients need to be hospitalized on IV fluids to flush out the kidneys and the uremic toxins that have accumulated. Pain medication and antibiotics are also commonly used based on the doctor’s discretion.

If the patient ever has a urinary blockage, I make sure the owner is aware that the patient MUST eat a prescription urinary diet for life. These diets are specifically designed to dissolve stones and crystals, reduce the formation of stones, and keep the urine at a suitable pH to avoid bladder infections. Cats that are prone to have urinary issues will have more, so prevention is the key! It is extremely important that cat owners are very observant and act quickly when signs of a urethral obstruction occur. The prognosis is good only if fast action is taken.


The Pet Hospitals– Collierville

Dr. Alison Bradshaw

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