Feline lower urinary tract disease (FLUTD) is a term that encompasses many urinary issues in cats. This may be urinary tract inflammation, infection, presence of crystals and stones in the urinary bladder, urethral spasm, and urethral obstruction, or it can be idiopathic feline cystitis, meaning no exact cause has been identified.
For the purpose of this article, we will refer to a urinary bladder obstruction, which is the most common issue, but there are also cases of ureteral obstructions (tubes that connect kidneys to the bladder) in cats that may be subtle unless both kidneys are affected, and can lead to reduced urine production and distension of the affected kidney. Urinary tract blockage, or a blocked bladder, refers to the inability of the cat to urinate. This occurs due to an obstruction of the urethra.
If your cat is straining to urinate, constantly going in and out of their litter box, passing very little or no urine at all that may be bloody, and is crying in pain while having a distended abdomen or vomiting, they need to be checked out by your vet immediately. This condition can be fatal if not treated in time.
Stage 1: Strange Peeing Behavior
Cats who are suffering from urinary tract issues, whether they’re a result of stress, infection or stones/crystals, exhibit several odd signs in the very beginning. They may go to the litter box frequently but produce little if any urine. They may cry out when attempting to urinate. They will often lick their genitals furiously after each attempt to pee, and if your cat is a male, you may see his penis sticking out.
If there is no urine whatsoever, your cat either has a urinary blockage, or they have an advanced case of cystitis that is causing them to strain due to the pain while their bladder is actually empty. Only your vet can establish what the case is.
Initially, these changes may start off as subtle, but you will see that something isn’t quite right. Your cat may still be eating at this stage, but they will start to feel unwell very quickly. Monitor and familiarize yourself with your cat’s urination habits so you can pick up even subtle changes quickly. The sooner they see the vet, the more likely they will make a full recovery before the blockage actually occurs or gets worse.
Stage 2: Severe Pain
As the kidneys continue to produce urine, the bladder fills and begins to overstretch, which will cause severe pain. A cat may respond to this pain by hiding or acting increasingly distressed. They will definitely react if you try to pick them up or touch their lower abdomen. You may feel their abdomen is tense and distended.
Urethral obstruction occurs almost exclusively in male cats due to the smaller diameter of their urethra. They will continue to strain and may still pass a few drops of urine that can become bloody, or there will be no urine at all.
Stage 3: Lethargy and Nausea
As the urine in the bladder puts pressure on the kidneys, cats will become systemically unwell. Waste products build up in the blood, causing azotemia, elevated urea and creatinine, and a very high potassium level, called hyperkalemia, which are all normally excreted in the urine.
Potassium is an electrolyte that is necessary for the nerve signal transmissions, fluid and blood pH balance, and muscle contractions, including the heart muscle. High levels may cause life-threatening cardiac arrhythmias and heart damage. Kidney failure leads to nausea, lethargy, weakness, wobbliness and lack of desire to eat. If a cat has not received medical attention by now, they could very well die within the next 24 hours.
Stage 4: Collapse
Severe dehydration, bladder distension, kidney failure, and toxins in the blood lead to imbalances in the electrolytes that keep the body running smoothly, as already mentioned. This will have a detrimental effect across all organ systems, but particularly the heart.
Cats with a blocked bladder will have a severe disruption in the blood gasses and blood pH, often leading to a life-threatening metabolic acidosis. If the bladder has ruptured, urine in the abdominal cavity causes further complications and will predispose the patient for sepsis, low blood pressure, worsening hyperkalemia and azotemia, alongside severe dehydration and metabolic disbalance.
All of these can lead to death, even if adequate treatment is administered at this point.
Stage 5: Death
Death from a urethral blockage can occur quickly, sometimes as little as 24 hours, if the cat had very subtle initial signs of illness that got missed, while usually death would occur within 48 hours.
I can’t stress this enough: A urinary blockage is a life-threatening emergency. If you notice your cat is having any of these symptoms, don’t do a web search and ask your favorite advice blogger what to do: Instead, pack your cat in the car (or the bus, or a taxi, or a friend’s car) and get him to the vet ASAP. Yes, it’s going to cost a lot, especially if you have to go to the emergency clinic, but even if you can’t afford to treat him, at least be kind enough not to let him suffer unnecessarily.
We can’t stress this enough: A urinary blockage is a life-threatening emergency. If you notice your cat is having any of these signs, don’t do a web search and ask your favorite advice blogger what to do. Instead, pack your cat in the car (or the bus, or a taxi, or a friend’s car) and get him to the vet ASAP. Yes, it’s going to cost a lot, especially if you have to go to the emergency clinic, but even if you can’t afford to treat him, at least be kind enough not to let him suffer unnecessarily.
Has your cat ever had a urinary blockage? If so, what changes have you made to your cat’s diet and lifestyle so it doesn’t happen again? What warning signs did you see before the blockage occurred or in the early stages of the condition? Share your answers in the comments.
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