Three-year-old Teddy wasn’t acting right, and his owner hadn’t seen him urinate in a couple of days. He presented to our clinic as an emergency because he was very weak and vomiting. Initially his owner  thought he had eaten part of a sponge, but as soon as we did our initial exam, we uncovered the true cause of Teddy’s illness – a blockage of the urethra, the tract through which urine leaves the body. Teddy had an enormous bladder that he couldn’t empty.

Male cats can become “blocked” when debris, small stones or plugs obstruct the urethra from the bladder. The urethra in male cats is longer and narrower than in females, making it easier to become blocked. When urine cannot be eliminated from the bladder, pressure from the bladder backs up to the kidneys and damages them. Dangerous metabolic waste products that would be eliminated in the urine then build up in the bloodstream. Urethral blockages can be life-threatening to a cat, and quick intervention is needed for the best outcome.

Teddy was critically ill. He had a low body temperature, was severely dehydrated, and his kidney blood parameters were higher than our in-house chemistry machine could measure. We placed an IV catheter, took X-rays looking for stones in his urinary tract, started decompressing his bladder and began the unblocking process. He was placed on heating pads and started on IV fluids. We were able to remove a plug of material from his urethra and submitted it to a lab for analysis. We flushed his urethra and placed a catheter to keep it open. We then flushed his bladder to try to remove some of the debris that remained inside it.

It took a few days of fluids, medications and bladder flushes, but Teddy’s numbers stabilized, he became able to regulate his temperature, and he started eating again. We were able to place him on a special veterinary diet designed for cats with lower urinary tract disease. His plug analysis came back as struvite, a combination of several minerals. Struvite crystals, plugs and stones can be prevented by the diet we chose to feed him, and he will need to eat this diet exclusively for the rest of his life to prevent recurrences. Teddy has made a full recovery, and his owner is very happy.

One of the problems with urethral blockages is that owners can mistake their cat’s straining in the litter box for constipation. There are some subtle postural differences when cats urinate versus defecate, but if a cat is straining in the litter box, be sure to figure out whether he is (or has been) able to pass urine. Teddy liked to go outdoors, so it was hard for his owner to know that he hadn’t been eliminating normally. At our clinic, we treat all straining male cats as possibly having urethral blockages and have them come in as soon as possible.

Antibiotics and other medications, supplements and diets may be needed to treat cats with urethral obstructions. The first 48 hours after the urethral catheter is removed is a critical period during which obstruction can recur. For cats that reobstruct more than twice, we consider a surgical procedure that shortens the urethra and opens it up to an area with a larger diameter so that is it difficult to obstruct. There are risks to the surgery, so it is reserved for cats that cannot be properly managed with medications and diet.

Male cats eating all dry food tend to be at the highest risk for developing obstructions. This is because of reduced water intake (canned food is 70 percent water) and the individual cat’s metabolism of the minerals in his or her food. The condition is complicated by infections and other problems that cause inflammation in the bladder. We’ve seen some dry superpremium diets frequently trigger struvite formation in some cats, so if you only feed dry food to your male, be sure to discuss his risks of urethral obstruction with your veterinarian. If your male cat exhibits signs of straining in the litter box, be sure he is able to pass urine completely. If he can’t, seek immediate veterinary attention.

Written by Dr. Wexler-Mitchell of The Cat Care Clinic in Orange, CA
Copyright © 2012 The Cat Care Clinic