Straining to Pee is a True Emergency
December 22, 2021
Urinary blockage, or urinary obstruction (UO), is a very common disease that occurs mostly in male cats but may also affect female cats and dogs. It is a life-threatening emergency that must be seen immediately by a veterinarian. In all cases the condition is life-threatening if left untreated.
What is a Urinary Blockage/Urinary Obstruction?
Urethral obstructions are life-threatening emergencies that can occur in cats and dogs. They most commonly occur in male cats due to the urethra being narrower than it is in females. Urethral obstructions can be caused by plugs (a mix of mucus, crystals, and inflammatory cells), stones, blood clots, tumors, scar tissue, lesions, or congenital defects. Environment and stress can also play a role in cats becoming obstructed, as stressed cats can have a greater inflammatory response and increased urethral spasms.
Symptoms of a Urinary Blockage
Prior to the actual obstruction occurring, your cat may be inappropriately urinating, frequently urinating, and/or have bloody urine. Once the cat is actually obstructed, they may vocalize, strain to urinate with no production, vomit, and/or become increasingly lethargic. It may seem like he or she is constipated. They may be going in and out of their litter box multiple times, producing little to no urine at all. You may notice your pet crying or howling when trying to urinate, or you may notice new or unusual behavior like hiding. If you note any of these signs, a veterinarian should evaluate your cat immediately.
Some symptoms to look out for include:
- Straining to urinate
- Blood-tinged urine
- Accidents outside the litter box
- Lethargy
- Decreased appetite
- Vomiting
The case of the Obstructed Dachshund
Willie was an adorable 4-year old male dachshund who presented to his regular veterinarian for vomiting. Upon examination, they noticed his abdomen was very tense, and his bladder was large and firm. His veterinarian took radiographs to get a better idea of what was happening internally and to potentially confirm a urinary blockage.
After they took the x-rays, it was obvious that Willie was in fact obstructed. He not only had urinary stones in his bladder, but urinary stones lodged in his urethra, therefore not allowing him to urinate.
He was most likely vomiting from being in pain, as that is a common secondary response. His veterinarian transferred him to Atlantic Street Pet Emergency Center to alleviate the obstruction and surgically remove the stones.
Willie underwent surgery to remove three urinary stones from his bladder. They were submitted for analysis along with a urinalysis and culture so we would know exactly what type of stones he had developed, and how to prevent them from occurring again. Willie was started on a prescription urinary diet to help lower the chances of any crystals or stones from forming again.
Willie made an incredibly fast recovery from surgery and was able to return home to recover with his family the following day.
What to Do if You Think Your Pet Is Blocked
These obstructions are life-threatening for several different reasons. When the bladder fills, the pressure builds and starts to damage the tissue. In severe cases, the tissue can actually die and the bladder can rupture. This pressure also backs up and affects the kidneys and can subsequently cause kidney failure. Potassium, which is usually excreted in urine, becomes elevated in the blood. This potassium has a direct affect on the heart and slows the heartbeat − and if severe enough, can cause cardiac arrest.
Treatment
Due to the critical nature of this condition, it’s important for cats to be seen right away by their veterinarian or an emergency vet if he/she is showing any signs or symptoms. Urinary obstructions can cause acute renal disease from increased pressure in the renal system and the inability to eliminate urea and other waste through the urine.
Action is taken immediately when these cats come into the veterinary clinic. Bloodwork is performed to assess kidney function and potassium levels. The urine is evaluated to look for blood, white blood cells, crystals, and bacteria. A radiograph is taken to look for stones. The cats are started on IV fluids for dehydration, diluting potassium, and kidney support. If there is an increased potassium level, typically insulin, dextrose, and calcium are used to drop it quickly. Blocked cats are typically sedated or anesthetized in order to pass a urinary catheter. The urinary catheter is left in for 24-48 hours. This allows for the bladder to be flushed out and for inflammation in the urethra to go down. Cats are also started on anti-spasmodic and pain medications.
A diet change may be necessary if crystals or stones are found. Decreasing stress and environmental changes can be helpful in preventing these cats from obstructing again. Many do well but some become obstructed again. If this happens, surgery that can be performed to open the urethra.
What You Can Do to Prevent Your Cat From Getting Blocked
It is always important to observe your animals when they eliminate to ensure that they are producing urine and not straining. There are also a few preventive measures you can take to help avoid a urinary blockage in cats:
- Keep your cat hydrated
- Provide plenty of enrichment/toys to reduce stress
- Keep the litter box clean
If your cat has shown symptoms of a UTI or has had a urinary obstruction before, ask your veterinarian if a urinary health prescription diet may help. These are specially formulated to promote a healthy bladder and help dissolve struvite stones and calcium oxalate crystals.
If you’re ever unsure if your cat or dog is suffering from a urinary obstruction, don’t hesitate to seek medical care through your primary care vet or through a 24-hour emergency hospital.