It was a cold, snowy evening when Mrs Taylor brought Bob in to see vet Joanne. The weather had been awful all week and Bob had spent most of his time gazing longingly out of the window at the ever-falling flakes. He didn’t enjoy being inside, but he hated the snow more. And what made it worse was Mrs Taylor entertaining her endless stream of friends and acquaintances at her legendary pre-Christmas gatherings; all of which made Bob want to run and hide.
Over the past few days, Mrs Taylor had noticed Bob had been even more unsettled than usual. He had been passing blood-tinged urine and licking his nether regions with increasing regularity. That evening though, he was clearly in a lot of discomfort, yowling and straining in the litter tray; seemingly unable to pass any urine at all. So Mrs Taylor had made a rather urgent appointment.
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From the history, Joanne already had a pretty good idea what was going on. And a quick examination of the patient and palpation of a very large and rock-solid bladder confirmed her diagnosis; urinary obstruction.
Blocked bladder in cats
Urinary obstruction is often known as a blocked bladder and is a potentially life-threatening condition most commonly seen in male cats; especially if they’re overweight or prone to stress. It means there is something physically restricting the passage of urine out of the bladder via the urethra; usually either because of a urinary stone, a plug of inflammatory material like mucus or even because of a spasm of the urethral muscle. It can also be a sequel to feline idiopathic cystitis (often caused by stress). If the cat cannot pass urine, the bladder will continue to get fuller and fuller. And if not treated, could potentially even rupture. The back pressure on the kidneys can also cause irreversible damage and concurrent electrolyte abnormalities can severely affect the heart.
Joanne had seen plenty of these cases in her ten-year career and explained the problem to Mrs Taylor
Unfortunately, Bob had rather a taste for soft-centred cat treats as well as the occasional bit of tuna, cheese or even scraps of the Sunday roast and now tipped the scales at a little over 7kg. This, in combination with his recent stressful home-life had probably been to blame for his current condition; causing a cystitis which had subsequently led to the blockage.
Bob needed to be unblocked
However, to do this requires the cat to be stable enough to undergo an anaesthetic. And because of the risk of complications with organ function, it is usually advisable to run a blood sample first. Once unblocked, some cats require placement of an indwelling urinary catheter to keep the urethra patent (open and working); which obviously means they must remain hospitalised. Nearly all cases will require medications to resolve the inflammation and any subsequent damage to the muscles and nerves of the lower urinary tract. It is also prudent to investigate for any underlying cause and treat whatever is found.
As Joanne went through the process, Mrs Taylor began to realise this was not going to be cheap
She would do anything for Bob and would always have found a way to pay for his treatment. But thankfully she didn’t have to worry, as Bob was covered with a very comprehensive insurance policy. This meant Bob’s care could start right away and Mrs Taylor could put all her energy into hoping Bob made a speedy recovery.
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Early treatment usually means a better outcome
Bob’s blood sample was taken which thankfully showed only minor changes; likely due to the fact that Mrs Taylor had brought him in as soon as she realised he was in such trouble. Once anaesthetised and on a drip, Joanne examined Bob’s penis and found a small mucus plug obstructing the end. This had likely formed due to the inflammation associated with cystitis. The mucus was carefully swabbed away which allowed Joanne to fairly easily pass a catheter into Bob’s bladder and release a large amount of very dark and bloody urine.
His bladder was then flushed with sterile saline, the catheter sutured in place and a collection system attached in order to monitor Bob’s urine output. In most cases, the urinary catheter is kept in place for 24-48 hours, and until the urine runs clear, as this reduces the chances of a re-blockage. This obviously meant Bob would have to stay in the hospital. And, much to his disgust, wear a plastic cone collar to prevent him disturbing either his intravenous fluid drip or his urinary catheter. To add insult to injury, he was also required to take a number of medications; including anti-inflammatories, muscle relaxants and pain relief.
Don’t underestimate the importance of the recovery period
Bob became a bit of a favourite with the nursing staff. He received a lot of love and attention which thankfully helped to reduce his stress levels. After 48 hours, his blood values had normalised, his kidneys were working well, and his urine was nice and clear. Joanne decided it was time to remove the urinary catheter. And, as he was eating and drinking well, he could be free of the intravenous drip too. Bob would, however, need to remain in the clinic for another 24 hours; this is to ensure he was now able to urinate normally again.
Joanne had also received the results from the lab from the sample of urine she had sent off on the first day. The results revealed that Bob’s urine was jam packed with crystals. Although urinary crystals don’t always lead to a cause of a urinary obstruction such as a stone, with the history and the amount of crystals seen, Joanne felt it was a good idea to start Bob on a special prescription diet designed to dissolve the crystals and potentially prevent any further problems. Mrs Taylor’s bells-and-whistles insurance policy would also be of great help here too; as Bob would likely need to stay on this new diet for life. Although the full cost of his food wouldn’t be covered, Mrs Taylor could continue to claim for a substantial amount of it as an ongoing condition, so easing the burden on her own pocket.
After his emergency visit, treatment, and three days in the hospital Bob was weeing normally in the litter tray and was allowed to go home.
Mrs Taylor was given strict instructions to get Bob to lose weight. And was provided with plenty of ideas to help reduce his stress levels at home. Joanne made Mrs Taylor aware that reported rates of recurrence vary between 5 and 40% of cases and that at the first sign of any potential problem, she ought to bring him in to be checked over. Thankfully, Mrs Taylor heeded all Joanne’s advice and when Bob next came in for his routine vaccinations, he was a much more slimline 5kg and was happily enjoying his urinary diet. She also reported that the use of pheromone adapters at home and providing plenty of quiet hiding spaces had resulted in a much calmer and happier Bob too. And she promised to keep her social calendar a little more empty next Christmas.
Some details have been changed to protect client privacy!
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