# Urinary Blockage-Long



## bino2two (May 8, 2010)

I know there are many posts regarding this subject throughout this forum and I've spent many hours searching all the posts in this forum, but there are still some questions on my specific situation that I couldn't find addressed (or they were and I don't understand). 

On Thursday, 4/29 I took my male, indoor, 8 year old cat to the hospital due to vomiting, lethargy, seclusion, not eating, not drinking, etc. He was admitted with a complete urinary blockage. The vet immediately inserted a catheter, passed the crystal blockage, and drained red fluid from the bladder. Baytril, dexamethasone and subcutaneous fluids were administered. By Thursday night the cat was still very lethargic but core temperature was good. By Friday morning the cat was much more alert and somewhat aggressive. The vet continued treating with subcutaneous fluids and flushing the bladder, and urine was getting better but still pinkish. By Friday night the cat was improving and started drinking lots of water. Improvements continued (eating, drinking, yellowish/clear urine) into Saturday morning and since the hospital closed at noon for the remainder of the weekend the vet suggested removal of the catheter and discharge instead of transferring to an emergency clinic. The vet did kidney blood work noting the numbers were pretty high but expected given the trauma endured over the previous days. I agreed and took the cat home early Saturday afternoon, armed with zeniquin and methigel for treatment at home. 

At home on Saturday the cat urinated small amounts in the litter box 5 separate times and was drinking fairly well. Not all was well though as he started leaking urine on himself. By Sunday morning he had stopped drinking and continued leaking urine on himself, with no attempts at using the litterbox. On Monday I took the cat back to the vet and he expressed the bladder manually passing all the urine without issue. He sent me home with dexamethasone to promote drinking and eating. On Monday and Tuesday the cat drank well but continued leaking urine on himself with no normal urination.

I took the cat back to the vet Wednesday morning at which point the vet inserted another catheter noting no blockage, but urine pinkish in color. He administered a treatment program of subcutaneous fluids, and bladder flush twice daily. By Thursday the cat was alert, eating, drinking and draining clear urine. On Friday morning the vet removed the catheter and the cat urinated a large amount in a litterbox on his own. The vet did kidney blood work again and noted the numbers were half of last discharge, but just high of the normal range. I took him home Friday night noting he was much better behaviorally. Within 15 minutes of being home the cat tried using the litterbox ~ 5 times with no urine passed. Throughout the night he tried many more times in the litterbox, and many times outside the litterbox, all with no urine passed. His demeanor got worse throughout the night. 

I took the cat back to the vet Saturday morning and the vet inserted another catheter to get him through the weekend. He noted no blockage and drained a full bladder of urine with minor pink tint. With the catheter inserted he was able to express the bladder without issue, but if he pulled it out, couldn't express the bladder at all. He analyzed the urine and saw no grit or crystals. He administered convenia injection and dexamethasone injection. I now have the cat home and he is drinking a lot, draining clear urine via the catheter and sleeping. 

The vet seems a bit stumped and suggested I bring him back Monday morning to regroup. He thinks that we may to visit a specialist to get an ultrasound, and/or visit a surgeon for evaluation for a perineal urethrostomy. In my readings it seems that the issue is most likely bladder nerve/muscle damage, or urethral inflammation/irritation, etc. The bladder nerve/muscle damage doesn't seem logical based on the fact that the cat has exhibited an ability to urinate on his own, and his urge to go even if he can't. So logic leads me to urethral issues but since there was no blockage on catheter 2 and 3, it isn't a reblockage. Could it be inflammation/irritation from multiple catheters? Could the stress of the last 9 days be causing problems? Or are there bladder stones that don't block urination when a catheter is in place but block urination without a catheter?

I feel like this has gone beyond standard treatment that solves these types of problems and I want to get as many opinions as possible. My vet seems to be on top of things but at his own admission he hasn't seen many cases of blockages getting this far. 

Any feedback, thoughts, comments are genuinely appreciated. Thank you.


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## SpaceyKP (May 8, 2010)

I'm not entirely familiar with the subject, but I would think that getting an ultrasound would be a good idea. That way the vet can really see what is going on inside and have a much better idea of how to treat it.


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## SonoGrl13 (May 10, 2010)

Is your cat a male? It would seem to me that because of the longer urethra that male cats could easily have a urethral flap or valve that would need surgical correction. But I agree with the above post, have the ultrasound just to be sure kidneys/bladder are clear, but most likely a urethral issue. The ultrasound besides showing bladder calculi, should also show if there is debri in the bladder. Your cat could be having urethral spasms as well (and the obvious crystals). In humans, it is common to get stones stuck in the urethra and we also see that on ultrasound, but with cats it would be trickier, but its worth asking. It's called sonourethrography they inject a bit of saline in the urethra and look with ultrasound. I have found nothing on the use of this in cats, but it is a simple procedure and if they can do in on a baby in the nicu (size of a cat) i don't see why they couldn't do it on a cat. If your cat is female, well disregard the above and I am stumped. 

I found this link:
http://www.ncbi.nlm.nih.gov/pmc/article ... 96/?page=1
and a way more graphic one (beware):
http://www.acvs.org/AnimalOwners/Health ... ctionCats/

I hope that it all works out for you and your kitty
K


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## bino2two (May 8, 2010)

Thank you for the responses. Had the ultrasound done today and he has a transitional cell carcinoma tumor in his bladder. It is pretty large, is located on the valve of the urethra and is causing his inability to urinate. The vet said this is pretty rare, especially in cats. Surgery isn't possible due to the location of the tumor and the drug therapy coupled with a catheter doesn't seem like a real good alternative either. So as much as it pains me, I'm going to put him down.


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## SonoGrl13 (May 10, 2010)

Oh my gosh, I am so so so very sorry to hear this news. I am very aware of TCC in humans, it seems that it is rare in cats I am a bit surprised because your cat is so young. I know how you feel, as my own cat is fighting for her life right now. Our cats are our family, and when they suffer we feel it as well. This must be such a hard time for you. Please take your time to spend as much time with your kitty as possible before he goes, and take all the time in the world to heal from your loss. 
Thoughts are with you and your cat,
K


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## bino2two (May 8, 2010)

sonogrl. Thank you for your thoughts. I put him down yesterday morning and it's been very tough. My thoughts are with you and your cat in her battle for life.


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## Syrth (Oct 17, 2009)

I just read over this whole thread and now im worrie sick. My 10 month old cat is having a very very similar problem, he's due for 2 eco-graphs this month....


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## Julie Carvill (Jun 30, 2010)

I am very sorry. I just put my kitty down last week.


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## Kobster (Feb 1, 2007)

So sorry to hear this! My heart goes out to you!


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