Mary Allen
Urinary stones, pebbles, plugs, or swellings can block the urethra in cats so that the animals can no longer urinate or only droplets come out. This can result in life-threatening urinary retention. How to recognize such an emergency and how it is treated, read here.
How Can You Tell if a Cat’s Urethra is Blocked?
If you find that your cat isn’t urinating anymore or is only able to urinate drop by drop, a blockage in the urethra is the most likely (because it’s the most common) cause. With outdoor cats, however, it is often not easy to check how much urine they are urinating. With these tomcats, the problem is often not noticed until very late.
The tomcats usually try very often but unsuccessfully to urinate and are often very restless as a result. They constantly visit the litter box or want to go outside. When trying to urinate, many tomcats show their pain by meowing, ruffled fur, and a so-called pain face (ears folded down to the side, forehead wrinkled and the eye area slanted as a result).
You can also tell from a hanging head, a hunched back and changes in behavior (loss of appetite, withdrawal, possibly aggressiveness when touching) that the cat is in severe pain. If you feel his abdomen very gently, you may feel the blister as a large, bulging ball.
Often with urethral obstruction, the tip of the cat’s penis swells. You can easily see this by looking at the anogenital region. In their distress, many hangovers lick the painful penis, causing it to swell even more and become even more inflamed. In the worst case, penile tip necrosis can occur because the blood supply is interrupted by severe swelling. Then the tip of the penis turns dark red or bluish and may have to be amputated (penis tip resection, see below).
If the blockage of the urethra has existed for a long time, the affected tomcat becomes apathetic and can eventually die.
What Should I Do if My Cat Won’t Urinate Anymore?
Even if you have the feeling that the cat is otherwise fine, you should immediately pick up the phone, let your vet know what is going on and bring the cat to the practice or clinic as soon as possible.
A urethral obstruction is always an emergency.
The sooner your cat is treated, the better his chances of survival.
Why is it Life-Threatening if the Cat Cannot Urinate?
Even when the urethra is blocked, the kidneys continue to produce urine and it backs up in the bladder. At some point, the bladder is full and begins to overstretch, which puts a lot of strain on the bladder wall, so that the bladder can even rupture, or bladder paralysis can remain as a result of the urinary retention.
In addition, the urine backs up into the renal pelvis. Since the kidneys are in a solid connective tissue capsule, they cannot avoid the pressure, and the kidney tissue is squeezed, so kidney damage can remain even after the urinary blockage has been eliminated.
But not only the pressure is a problem, but also that so-called urinary substances can no longer be excreted as intended. Waste products of metabolism accumulate in the blood of cats with urethral obstruction, eventually causing what is known as urinary poisoning (uremia). In addition, the electrolyte balance, which the kidneys normally keep in balance, gets out of joint and this particularly affects the heart function.
The circulatory strain in the case of prolonged urinary retention leads to a higher risk of anesthesia and can make it very difficult to treat the problem.
How is a Urethral Obstruction in Cats Treated?
Your vet will attempt to clear the urethral blockage as soon as possible. A sedative injection or short-term anesthesia is often necessary so that the muscles of the bladder and urethra relax and the hangover allows the treatment. The circulation may also have to be stabilized with medication and an infusion.
There are a number of ways to get rid of urinary retention: urethral massage
Small stones in the tip of the penis often simply block the outflow of urine, as the urethra narrows significantly there. In the simplest case, a gentle massage of the penis and gentle squeezing of the bladder is sufficient to allow urine to flow through the urethra (which has been relaxed with medication and thus widened).
Sometimes a rectal massage of the urethra on the pelvic floor is also successful if small stones are stuck where the urethra describes an arc around the pelvic bone.
Flushing back the urinary stones using a urinary catheter (retropulsion)
Urinary stones can usually be flushed back into the urinary bladder by carefully pushing a thin urinary catheter into the urethra and at the same time using an attached syringe to press the sterile liquid into the urethra. Once the stones are back in the bladder, urine can drain out through the catheter.
Depending on the type of urinary stones, these can then be dissolved with the help of a special urinary stone diet (struvite stones) or must be surgically removed (calcium oxalate stones and others).
Depending on the severity of the disease, the cat may have to be hospitalized and keep the urinary catheter for a few more days.
Puncture of the bladder (cystocentesis)
If the bladder is extremely full or if the urethra cannot be catheterized, urine must be sucked out using a bladder puncture. This is very easy to do by puncturing the bladder directly with a cannula through the abdominal wall and then sucking it out with the attached syringe.