Blood. There is bloody urine in your cat’s litter box, and he is nowhere to be found. Finally, you find him curled up and hiding under the bed, looking at you with scared eyes and making the saddest yowl you’ve ever heard. Time to call the vet. Feline lower urinary tract disease, FLUTD, can affect cats of any age and more prominently occurs in males. FLUTD generally involves the urinary bladder and the urethra (where urine is stored and passed). Today we are focusing on blockage of the urethra, though the term can encompass many different disease processes.

Urine carries away waste products from the body – these need to dissolve in order to pass properly and while some are soluble and easily dissolved, others need a perfect environment. Problems can occur when the environment within the bladder is not optimal for these waste products to dissolve. Sometimes the PH can change, creating a change in the bladder environment and allowing crystals to form. This may be due to bladder inflammation, infection, stress, or trauma. Once these crystals form, they can pile together with mucous and urinary waste debris to create a “plug” in the urethra. A potential urinary blockage is considered a medical emergency if left untreated for too long and can be fatal. All of the waste products normally passed by the body will build up within the bladder, and the bladder will get larger and larger as time goes on.

Cats experiencing symptoms of a urethral blockage usually show signs of discomfort (think about how it would feel to try to urinate sand!), which can look like: vocalizing during urination, blood in the urine, frequent urination in only small amounts, trying to urinate but nothing is coming out, urinating in strange places or reluctance to use the litter box, inappetence (not wanting to eat) and lethargy. If your cat shows any signs of urinary related discomfort, we recommend you call your veterinarian right away.

There are a few tests that may need to be done to evaluate the problem:

  1. Urinalysis: (several tests performed on a urine sample taken by the veterinary team) a nurse will look at this under the microscope and check for signs of infection or other abnormalities in the urine
  2. Urine culture: this tells the doctor what bacteria are present in the urine and therefore which antibiotic to use (and helps decrease antibiotic resistance, as the doctor won’t have to guess which medication will work)
  3. Bloodwork: this evaluates how your cat’s kidneys and other vital organs are functioning, how they are handling extra waste product build-up and will show any electrolyte imbalance.

Of course, everything varies on a case-by-case basis: no two cats are alike! In a mild case, a diet change and medications are all that is needed to correct/maintain this condition. In extreme cases, the blockage needs to be flushed out surgically – the plug is broken up and flushed out, then a urinary catheter is placed into the urethra and flushed. The catheter is sutured into place so it won’t fall out while allowing urine to be continuously excreted, as the cat will need to be hospitalized on IV fluids after this procedure. This allows their overworked kidneys to flush out all the buildup of waste products, dilutes the urine to make dissolving waste products easier, and re-establishes a good electrolyte balance. Once the veterinarian has determined it’s time, the urinary catheter is removed and the patient is monitored for urine output and to ensure they are able to urinate comfortably. Depending on the patient, they are sometimes sent home with medication to help relax the bladder to make it easier for them, as well as pain control and antibiotics. A prescription urinary diet is often required for the remainder of the pet’s life to ensure an optimal ph and prevention of further crystal formation.

There are many factors that may cause a urinary blockage: stress, infection, inflammation, trauma, a disease occurring elsewhere in the body, and even physical abnormalities. Frustratingly, the cause can largely remain unknown. Listening to your cat, knowing their daily habits and keeping tabs on any changes while working together with your veterinary team is paramount to ensure the best possible care of your feline companion.

Written by: Sam Doherty, Receptionist