Liza Cahn, DVM
Have you noticed your cat straining to pee, making frequent trips to the litter box with little to no result, or crying out in pain? These could be signs of a urethral obstruction (also known as a blocked cat), and it’s a life-threatening veterinary emergency. Let’s explore the common symptoms and causes of urinary obstructions in cats, and what to do if you notice your furry family member straining in the litter box.
What Is a Urinary Obstruction and Why Is It an Emergency?
Urinary obstructions occur when the urethra, the tube that carries urine from the bladder out of the body, becomes blocked. This blockage prevents your cat from urinating normally, leading to a buildup of toxins in the body. Without prompt treatment, this can quickly lead to dangerous electrolyte abnormalities, abnormal heart rhythms, kidney failure, bladder rupture, and death.
While urinary obstructions can affect any cat, they are more common in young to middle-aged male cats, overweight cats, and those with a history of urinary problems. Commonly, these are also indoor cats living in multi-cat households. Urinary obstruction rarely occurs in female cats.
Symptoms of Feline Urinary Obstruction
Recognizing the symptoms of urinary obstruction is critical for your cat’s health and well-being. However, early symptoms can be easy to miss, and also overlap with those of several other less-urgent urinary issues, such as urinary tract infections, bladder stones, and feline idiopathic cystitis (inflammation of the bladder known as FIC). Feline lower urinary tract disease (FLUTD) is the umbrella term for all of these conditions.
Early symptoms of urinary obstruction include:
- Straining to urinate (this can sometimes be confused with constipation or straining to defecate)
- Frequent trips to the litter box with little or no urine produced
- Vocalization (crying, meowing) while trying to urinate
- Excessive licking of the genital area
- Blood in the urine (hematuria)
As the condition progresses, pet parents may notice:
- Vomiting or diarrhea
- Lethargy or weakness
- Loss of appetite
- Hiding or withdrawing
- Abdominal pain (reluctance to be touched)
- Dehydration (dry gums, sunken eyes, prolonged skin tent)
- Collapse
- Death
Any male cat experiencing urinary issues must be seen by a veterinarian as soon as possible. This may mean going to an emergency clinic. When in doubt, see your veterinarian – it could save your cat’s life. The buildup of toxins, electrolyte abnormalities, and irreversible organ damage can begin within 12 hours of your cat being unable to urinate, and if untreated, the condition will result in death within 3-6 days.
Causes of Urinary Obstruction
There are several possible causes of urinary obstruction, which can either be partial or complete. Blockages are often caused by urethral plugs (made up of crystals and mucus) or small stones that become stuck in the urethra. Inflammation and swelling or spasms in the urinary tract can also lead to narrowing of the urethra, resulting in an obstruction. While less common, tumors are another possible cause.
Urinary obstructions are more common in male cats than in females because the male urethra is longer and narrower (and thus more likely to become blocked). Other risk factors for developing urinary obstruction include cats who are overweight, dehydrated, or have a history of urinary issues.
How Common Are Urinary Blockages in Cats?
According to data extracted from the medical records of nearly 500,000 cats who presented to more than 920 Banfield Pet Hospitals in 2015, feline idiopathic cystitis was the most common cause of lower urinary tract signs. Urinary obstruction was diagnosed in 22-55% of male cats presenting with lower urinary signs.
How Veterinarians Diagnose Urinary Obstructions
If you are concerned that your cat is not peeing, it’s critical to see a veterinarian right away. Your vet will begin by gathering a medical history and performing a nose-to-tail physical exam. During the exam they will feel your cat’s abdomen in order to palpate their bladder. In a normal cat, the bladder will feel small or squishy like a water balloon. In a blocked cat, the bladder will feel hard and large like a baseball. The bladder will likely be painful, and your vet will not be able to express urine from it.
Additional testing may involve x-rays or ultrasound to visualize the bladder, and blood and urine testing to determine the extent of toxin buildup, dehydration, and electrolyte abnormalities. An EKG may be used to assess heart rhythm.
Treatment for Blocked Cats
Treating a urinary blockage begins with emergency stabilization and removal of the obstruction to restore normal urine flow. This involves inserting a urinary catheter through the urethra and into the bladder to drain accumulated urine and flush out any debris. This is generally performed under sedation or anesthesia. Intravenous fluids and medications will also be given to rehydrate your cat, correct electrolyte imbalances, flush out toxins, relax the urethra, and help manage pain.
After the immediate emergency is addressed, the focus shifts to identifying and treating the underlying cause of the blockage. This may involve dietary modification, often with a prescription diet designed to dissolve crystals or prevent stone formation. Antibiotics may be prescribed if an infection is present. In some cases, surgery may be necessary to remove large stones or correct other issues. If your vet is unable to pass a catheter or your cat has had urinary blockages in the past, they may need a surgical procedure called a perineal urethrostomy (PU) to create a wider urethral opening.
Your cat will likely need to be hospitalized with a urinary catheter in place for 3-5 days so the veterinary team can monitor their recovery, ensure proper urine flow, and manage any complications. Regular blood and urine tests will be conducted to assess kidney function and overall health. Once your cat is urinating normally and their bloodwork has stabilized, they will be sent home for additional care and monitoring.
Recovery and At-home Care After Urinary Obstruction
At home, you should continue to give your cat any medications prescribed by your vet. It will also be important to feed your cat a prescription urinary diet, such as Hills C/D or Royal Canin SO, for the rest of their life. These diets help prevent and dissolve crystal formation and promote bladder health by maintaining an appropriate urine pH. Increasing your cat’s water intake, for example by feeding canned food or providing a water fountain to encourage drinking, is also an important part of their ongoing care.
When your cat returns from the hospital it is important to monitor their urine output closely, to make sure that obstruction does not recur. Your vet will provide you with detailed instructions and let you know what to watch for.
Prognosis and Risk of Recurrence
The good news is that with prompt and appropriate veterinary care, most cats recover fully from a urinary obstruction. The survival rate for cats who receive timely treatment is generally high (90-95%), although can vary based on factors such as the severity and duration of the obstruction, the cat’s overall health, and the underlying cause. Cats with prompt treatment and no underlying health conditions often have the best chance of recovery.
Unfortunately, cats who have one urinary obstruction are at risk of developing another in the future, with recurrence rates estimated to be 15-40%. Cats with repeated obstructions may benefit from PU surgery.
Prevention of Urinary Obstruction
While in some cases urinary obstruction is inevitable, the following can help lower your cat’s risk factors.
- Healthy body condition – Keeping your cat at a healthy weight by meal feeding and providing opportunities for exercise is one of the most important things you can do for their health. Overweight cats are at risk for several medical conditions, including diabetes and arthritis.
- Diet – If your vet recommends a prescription urinary diet for your cat, this should be fed exclusively, and ideally as a wet food to help increase water intake. Otherwise, be sure to choose a WSAVA-compliant complete and balanced diet appropriate for your cat’s lifestage.
- Stress reduction – Stress is a known risk factor for feline lower urinary tract disease. Minimize stress in your cat’s environment by providing plenty of litter boxes, vertical space for climbing and perching, and opportunities for play, enrichment, and exercise.
- Increase hydration – Encourage your cat to drink more water by providing fresh, clean water at all times, using water fountains, and incorporating wet food into their diet.
- Regular veterinary checkups – Schedule regular checkups with your veterinarian to monitor your cat’s urinary health and detect any potential problems early on.
- Financial planning – Urinary obstruction is a costly condition to treat (generally around $750 to $3000), and one that requires emergency veterinary care. That’s why it’s recommended for all pet parents to have pet insurance or an emergency fund in place.
Urinary obstruction in cats is a common and serious condition that requires immediate treatment, but with prompt veterinary care, most cats can recover fully. Regular vet checkups, a balanced diet, plenty of fresh water, and a stress-free environment are all key to ensuring your cat enjoys a long and healthy life. Remember, if you notice any signs of urinary problems, don’t hesitate to seek veterinary care.