Bailey, a 10 year old Siamese cat, presented for urinating outside of the litter box and vocalizing during urination. Physical examination revealed a large, firm urinary bladder and Bailey was diagnosed with urinary tract obstruction.
Urinary tract obstruction can be caused gritty, crystalline material blocking the urethra, stones (urolithiasis), urethral stricture, or masses. This is a life-threatening emergency. When urine cannot leave the body, the toxins in urine are re-absorbed into the bloodstream. The most significant of these is potassium. When potassium is reabsorbed, it causes a slowing of the heart and can eventually cause the heart to stop. Kidney failure can also occur rapidly as a result of urethral obstruction. Due to these concerns, Bailey was admitted for hospitalization and treatment.
Treatment consists of sedation and placement of a urinary catheter into the bladder, which is typically left in place for 1-4 days. During this time intravenous fluids and pain medications are administered and urine production is monitored.
It is important for owners to know the complications that can occur secondary to urinary tract obstruction, many of which are potentially life-threatening. Urethral tears or translocation of bacteria into the urinary tract resulting in urinary tract infection can occur during urinary catheter placement. Kidney failure occur secondary to urinary tract obstruction. Fluid overload can occur in some patients with compromised cardiovascular systems or other conditions. The bladder can also rupture if urinary tract obstruction is not caught in time.
A common problem is recurrence of the condition. In fact, this was not the first time Bailey had issues urinating. He had been treated previously for blood in his urine, vocalization during urination, and urinating outside of the box. It is important for owners to know that urinary tract obstruction is often a recurrent and frustrating condition. Cats may re-obstruct in days, weeks, months, years, or never. How a particular patient will do long-term is difficult to predict. Bailey was eventually discharged following treatment and has not had any issues urinating thus far. Recommendations to help prevent recurrence of the condition were discussed with his owner. These include maximizing water intake (using canned food and/or a water fountain), feeding a prescription diet, Cosequin or Dasequin supplementation (which Bailey was already on), reducing environmental stress, adding Feliway plug-ins to the home, and continuing a prescription to help Bailey to urinate normally. Still, it will be very important for Bailey’s owner to continue to monitor his urination patterns and seek veterinary care with any concerns.