Major obstructions of the urethra can occur with the first episode of FLUTD or during subsequent
attacks. With partial or complete obstruction of the urethra, the lower abdomen
becomes distended and painful to touch. An obstructed cat spends a lot of time
straining to urinate (many owners mistake this for constipation) without producing
Female cats do not obstruct as frequently as males, because their urethra is
wider and crystals and plugs pass easier. However, females can become
obstructed with urethral uroliths.
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As pressure increases in the upper urinary tract, the kidneys fail and stop
making urine. Wastes build in the blood, leading to uremia (a toxic buildup of
urea). The cat loses her appetite, acts sluggish, and begins to vomit. If
unrelieved, irreversible kidney damage occurs, leading to death. Thus, it is of
vital importance to relieve the obstruction as soon as possible. Keep in mind
that cats often seek seclusion when they are ill or in pain; therefore, a cat
with symptomatic FLUTD should not be allowed outdoors.
Treatment: A cat with a plugged urethra needs immediate veterinary
attention. This is an emergency with potentially life-threatening consequences.
An obstructed male often protrudes his penis. You can massage the penis by
rolling it between your thumb and index finger. This may crush the plug and
allow the material to be expelled. Even if this is successful, veterinary
attention and possible hospitalization are required.
Even if you can remove the plug so the cat can now urinate, you must take
the cat to your veterinarian for follow-up veterinary care. Any plugs or
crystals that are passed or collected should be analyzed so the correct
treatment plan can be developed.
To relieve an obstruction, your veterinarian should first relieve the
pressure in the bladder by emptying it via cystocentesis, a procedure in which
a fine needle attached to a syringe is inserted into the bladder through the
abdomen and urine is drawn into the syringe. This allows time for the kidneys
to start functioning again and the cat to be stabilized with intravenous fluids
prior to sedation. Relieving the obstruction must be done under sedation or anesthesia. Your veterinarian
will insert a small, soft, rubber or flexible polyethylene catheter through the
urethra into the bladder to relieve the obstruction. Intravenous fluids are
continued to rehydrate the cat and increase the flow of urine. Antibiotics may be prescribed
to prevent or treat an associated bladder infection. After obstruction, many
cats need continued intravenous or subcutaneous fluids for several days, until
kidney function returns to normal and the cat is voiding normally.