Urinary Blockage

MeggzzAugust 20, 2011

The Friday before last, my male cat, Todd, had a urinary blockage. This is his second one this year. The vet said he had crystals blocking him, so they catheterized him and kept him over the weekend to make sure he wouldn't reblock. They gave me the Hill's Prescription Diet C/D and told me he would have to stay on it for the rest of his life. They also gave me antibiotics to give him. Alright, well this past week, he was a little bloated(?), but was urinating okay. He is acting normal..and just yesterday he started leaking urine and keeps cleaning himself. Do I need to take him back to the vet, or is this something he will get over..?? Last time he had to go to the vet about this, a few days after he came home, I had to take him back because he wasn't urinating right and the vet expressed him and said he wasn't blocked and was probably just sore from being catheterized and gave me more antibiotics to give to him. He wasn't leaking urine that time though. I had to express him some for a day or so after that until he started urinating normally. I've tried expressing Todd this time and nothing has happened.. He just gets angry with me when I try. Maybe I'm not doing it right, but I've researched how to do it online and it seems like I am. After I try to express Todd, he goes to the litter box and urinates some. I don't really understand how he is using the litter box and leaking too.

I'm a little concerned about my vet because all they told me this time was to watch and make sure he urinates. They didn't tell me what kind of crystals my cat had. I don't even think they did a urinalysis. It wasn't on the bill.. They didn't tell me how Todd might act when he got home, as in possibly being sore and not wanting to urinate right. I noticed when reading online about other people's cats who have had blockages that their vet sent them home with pain medicine for their cat too. Mine did not. I also read that their vets gave them Hill's Prescription Diet S/D to dissolve the crystals and then gave them Hill's Prescription Diet C/D to prevent them. Should my vet have done that?

I feel like if I take Todd back to them, they will say the same thing as they did when he blocked the first time or that they will think I didn't feed him his proper diet or something. I have given him all of his antibiotic dosages properly. He finished it yesterday. I keep his litter box clean and feed him the Hill's Prescription Diet C/D. I change his water often so that it stays fresh. I know he's drinking enough water because he sits at the water bowl a lot, just drinking away. I really hope he isn't blocked again. Maybe he's just feeling sore..or developed a UTI. I don't know.

What are your thoughts on all of this?

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My Shih Tzu had kidney stones and had to have emergency surgery. Hers were caused by struvite crystals. I took her to a holistic vet that put her on a dehydrated mix that I make up and mix with raw turkey. In addition he gives her Chinese Herbs 2 weeks of the month. Just had her donwn for her yearly checkup and she was crystal free after 3 years. YEA

    Bookmark   August 20, 2011 at 8:06AM
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With all the distrust you've expressed, I'd change vets entirely and get your boy a second opinion. If Todd has to go through the same procedure again you might as well start out with an office you're more comfortable with. Whether they are doing everything correctly or not, you shouldn't feel hesitant to call and inquire about anything, ever. I found some doctors will take the extra time with me to explain in detail everything and others will just want to treat and send me away. This medical stuff is complicated and I like to feel confident when I leave the office that the doctor is competent. There's nothing worse than coming to the internet and finding out your pet didn't get the best treatment. I don't like the fact that you're saying pain meds are a common rx and Todd wasn't offered any.

I think you've come to the right board anyway and should get some accurate advise about blockage treatment. I got rooked before with a urinalysis diagnosis and the advise I got here was top-notched. Saved my cat and myself a lot of grief.

Oh, and you can request a copy of the actual urinalysis report to put your mind at ease there and have complete info.

    Bookmark   August 20, 2011 at 8:30AM
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Sometimes blocked animals have that 'leaking' because their bladder is so full the pressure from a distended bladder will manage to push some urine around a blockage. I'd be more concerned if he were also 'bloated'.

Or this may be just a form of overflow incontinence where the bladder isn't emptying completely when he voids.

If it were me, I think I'd touch bases with the vets and describe to them what you are describing to us. You know of course if he is not voiding, it is a true emergency and you cannot 'sit' on it.

    Bookmark   August 20, 2011 at 9:16AM
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Having lived for YEARS on the rollercoaster of cystitis with crystals, meds, surgery, prescription foods, and frequent recurrences of trouble, I can only recommend that you get your cat into professional care straight away. The current practice of catheterising every cat who blocks is helpful for emptying the bladder in acute blockage, but it causes inflammation too-thus the passage is sore and possibly swollen (can they swell inside?) so any remaining crystals (it takes time for the food to work) will be extra painful to pass, the cat avoids urination as long as possible because of the pain, the lack of irrigation from passing urine gives crystals a foothold and there you go. It's a terrible cycle that's difficult to control.

It seems to me that you don't feel a trusting connection with your current vet. Have you discussed your misgivings with your vet? If you've attempted to establish information sharing with your vet and are not getting the answers you need, please change or ask for another doctor in the practice. Your cat needs help and you need to know what you need to do, and more precisely what you need to be watching for. It's un-nerving but you can get your cat onto a routine of maintenance that will slash the rate of recurrence.

Mine didn't stop the cycle of crystals-surgery-prescription food-crystals-surgery-etc until I put him on a high protein all wet diet. Eventually I stopped the prescription foods because I honestly couldn't see the benefit of feeding corn to my cat. He also got pretty fat on the prescription diet. The combination of diet and environment stopped recurrence-keeping a cat's home as stress-free as possible will help in controlling this.

Meanwhile, you need a vet who you can work with to get past the inflammation and pain issues. Don't be afraid to ask for pain medication. Buprenorphine is excellent. Metacam isn't recommended for cats, even in dilute doses, as it may cause other problems. Antidepressant meds may be helpful too. If amytriptylline is prescribed, please monitor your cat's peeing-it stopped two of my cats from peeing completely. Switched meds, they started peeing again. Weird and probably not terribly common.

Once you're past the inflammation stage, then you may consider working through other possible contributors to cystitis. Maintenance is a TON easier than bringing your cat off of the acute stage. Best of luck and keep posting please.

    Bookmark   August 20, 2011 at 10:47AM
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Well, I took Todd back to the vet today. The same one. She actually went into more detail this time about what was going on with him. She said that he was in fact blocked again. So, he has to stay over the weekend..again. She said his urethra is extremely narrow and that he's producing a lot of crystals. They are clumping together so he could possibly be trying to form stones. She's going to take an x-ray of his bladder(?) and see if he has any. She told me about how if he had any, they would have to go in and extract them. I asked her about the food that was supposed to dissolve the remaining crystals and she said that was what the C/D was for. She mentioned PU surgery and told me how it's done and stuff. I asked her about how much it would be and she is going to find out and tell me Monday when I go pick up Todd. I am really considering the surgery. I want what is best for him. Sorry for all of the she said's and she told me's.

    Bookmark   August 20, 2011 at 8:39PM
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I'm so glad you took him back in. I have been down that road with one of my cats and one of my daugther's cats (same litter) and two of my mother's over the years. What was going on with your cat happend to my mother. She had taken him in repeatedly for caths, and he was producing urine (same scenario I suspect) but he died in the night, probably of a burst bladder. Two dogs ago, we had a mini schnauzer with the overflow incontenance and if wasn't a nurse, I'd have not known what was going on.

My tomcat and my dog both went through those surgeries and their outcome was wonderful and they did well and never had any more urinary issues. It wasn't cheap, but was just as cheap as all the calls for caths and vet stays and etc. Had I known before the fact I'd already have nearly a thousand in the cat, before the surgery, I'd have just gone for it right off the get-go.

Our wonderful family vet performed the surgery on my cat. No need to send him off somewhere. He and his partner are wonderful surgeons and he is a great diagnostitian. My cost for the procedure was about $700 I think. He was a barn cat.......LOL........lived to be sixteen and died from cancer. I used to call him my six million dollar man.

    Bookmark   August 20, 2011 at 9:21PM
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I had a long post a few months ago about my cat that blocked. I'm not sure if you read it or not but I was supposed to keep him on the C/D diet for the rest of his life but I didn't want him eating that crap so he was only on it for a week or so.

Ever since his surgery, he has been on 100% wet food. I buy the highest quality I can find. I also put him on a supplement that supports urinary health and he hasn't had any problems since then, luckily.

I'm including a link to the supplement I used. It's supposed to support bladder health plus dissolve any crystals in the urine. I'm not sure if it contributed to my cat not blocking again but it may have helped.

Hope your boy is feeling better.

Here is a link that might be useful: Bladder Supplement

    Bookmark   August 20, 2011 at 9:42PM
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@calliope - I'm sorry about your Mother's cat! Poor thing.. I am willing to cough up whatever amount needed to pay for this surgery because I know Todd goes through a lot when he's having urinary issues. I don't want him to keep going through that. My vet said that either her or the other vet that works there could do the surgery, but there hasn't been one done there in a while. The girl I usually see is pretty fresh from college, so I'm a little worried about her doing it due to lack of experience maybe? The other vet owns the clinic and has been a vet for a long time. I would feel more comfortable with him doing it, but I'll discuss all of that with them when the time comes to do it.

@chi83 - Yeah, I was wondering if there was an alternative to the C/D. My vet said Todd would need to stay on it even after he has the surgery.. It's so expensive and I've read a lot of bad things about Hill's foods and such. I might give the wet food and urinary supplement a try. Thanks for the link! =]

    Bookmark   August 21, 2011 at 12:06AM
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Meggzz, not only is it expensive but it's full of gross ingredients like by-products and gluten and things I wasn't comfortable with my cat eating. You can get a premium food for the same price so I think you would be better off doing that plus maybe a supplement in the beginning to discourage crystals and soothe the urinary track. The powder I used is supposed to be used twice a day for two weeks I think, then the maintenance is twice a week. I'm still on the original little container I bought so it lasts a while. All 3 of my cats had no problem eating it and don't seem to notice when I add it.

I'm not a vet though so it's just some advice based on my experiences. The ER vet who did the emergency surgery told me the food type doesn't matter as long as it's wet. It was my local vet that told me he had to stay on the c/d for life and conveniently she sells it in her office, so there's that. :)

Good luck!

    Bookmark   August 21, 2011 at 7:25AM
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Neither did I put mine on the expensive diet from the vet. He went on the urinary health purina off the supermarket shelf and wet food.

    Bookmark   August 21, 2011 at 9:11AM
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Today, I called the vet and they told me that over the weekend, they had sewn in a catheter and it came out and that Todd is retaining urine even with the catheter in.. Has anyone ever heard of this? It doesn't sound right to me. They didn't tell me everything, but they think it might be that he lost his bladder tone. They are supposed to call me back later with full details on what is going on now. I'm really worried.. If it is his bladder tone, hopefully it can be fixed.
-Will post more when vet calls me back.

    Bookmark   August 22, 2011 at 11:46AM
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All the vet told me was that she managed to get the catheter put back him Todd and that she is going to keep him overnight again, giving him fluids to try to flush out the crystals..

    Bookmark   August 22, 2011 at 9:54PM
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If the bladder was over distended then the tone can be lost. It is usually temporary but the trick is to keep the bladder small - in other words they need to leave the catheter in place. My guess is they should have him catheterized for several days before pulling it. I would not be in a rush to get the catheter out of him. Another thing that should be considered is putting him on IV fluids - this will increase his urine production and with the catheter in place will aid in flushing the crystals out of his bladder. The crystals are very much like a fine sand and will settle to the bottom of his bladder so these cats are at a risk of reblocking in the first few days after the catheter is pulled if the bladder has not been adequately flushed. He should be on antibiotics and pain meds they can even add another drug to decrease the urethral spasms - ask about this.

The Hills c/d diet is an excellent food for cats to prevent crystal formation but it is not a diet that will dissolve crystals that are already present. For this he needs s/d or another diet called urinary S/O. A wet food is better than a dry food at this stage. He should stay on a dissolution diet for a good month before switching him to c/d. He can stay on urinary S/O indefinitely. In Todds case, because he has had several episodes of blocking, I would not chance putting him on anything else than a prescription diet formulated for this problem.

If the vet is reluctant to try additional meds and measures before going to a PU then I would get a second opinion. BTW - if the catheter is in place and not kinked then urine will flow independent of bladder tone. Ask if they flushed the catheter with saline to see if the crystals have just blocked it. Also ask what the results of his urinalysis showed and what type of crystals were present. Two types commonly seen are struvite and oxalate...struvite will dissolve, oxalate not so much. These are the acronyms in the S/O diet .


Good luck to poor Todd I hope he gets this sorted soon.

    Bookmark   August 22, 2011 at 10:05PM
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Can't they irrigate the bladder through the catheter?

    Bookmark   August 22, 2011 at 11:14PM
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The vet said they are stuvite crystals. She didn't say whether or not the catheter just got blocked, but I talked to the other vet that own the clinic and he doesn't want to do the PU surgery just yet because if Todd had it done and got fat and stuff, the surgery would have to be redone. He just said that we really have to monitor Todd and feed him the right kind of food. Todd gets to come home later this afternoon.

    Bookmark   August 24, 2011 at 3:47PM
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I'm so sorry he's having to go through this (you too). I hope all is well when he comes home today.

    Bookmark   August 24, 2011 at 4:27PM
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Well, here I am again.. Todd came home last Wednesday and was doing fine until today. He's bloating up again, but peeing in the litter box as well.. I tried expressing him earlier when he was calm and some urine came out. I tried again later and I couldn't get anything to come out because he was squirming too much. I cannot afford to take him back to the vet... What am I to do...?? I am so upset. I thought his problem would be fixed after this past second trip to the vet..

    Bookmark   August 28, 2011 at 12:58AM
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If he is blocked you have no choice but to take him to the vet again because he will die if you don't. I know how difficult dealing with this can be. You get on pins and needle and second guess yourself constantly. Been there and done that.

That's how it was for me before I got the surgery on my cat. I spent a lot of money too back and forth to the vet for caths. I'm so sorry. If you cannot afford the procedure or the repeated trips to the vet, you will have to make the choice of whether you need to euthanise him. Don't let him go with blocked urethra. It is not a pleasant way to go.

    Bookmark   August 28, 2011 at 10:14AM
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I second what Calliope wrote.
Prior to getting the PU surgery, we spent way more money on emergency trips to the vet, overnights, unblocking, etc. than the actual surgery cost. And since the surgery (almost 4 years ago), our kitty has not had one single problem.

    Bookmark   August 28, 2011 at 1:16PM
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I know I have to take him back to the vet either way.. I think I'm going to take him to a different one since my current one doesn't want to do the surgery yet. I really think he needs it.

    Bookmark   August 28, 2011 at 3:16PM
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Meggzz..........I was wondering about Todd. Were you able to get him in to a vet. I was concerned because your last post was on a Sunday.

    Bookmark   September 1, 2011 at 10:31PM
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I hope she followed chi83's advice on 100% wet diet.

    Bookmark   September 2, 2011 at 5:54AM
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