Urinary Obstruction

What is it?

Urinary obstruction is a potentially life-threatening condition. The urethra is the structure that carries urine from the bladder out of the body. This passageway can be blocked due to many different causes such as bladder stones, inflammation, hematoma, prostatic disease, stricture, neoplasia, neurological disease, etc. When a blockage occurs the urine is unable to drain from the bladder. This will eventually build up to a point where the fluid, electrolyte and acid-base status of the animal is affected and acute kidney failure and death will commence within 2-3 days if it is not properly managed.

When the patient has complete urinary obstruction, it is an emergency and they will need general anesthesia for a urinary catheter to be passed in an attempt to re-establish patency to the urethra. Prior diagnostics (diagnostic bloodwork, urinalysis, abdominal radiographs) will need to be performed to determine the cause of obstruction. Depending on the cause of obstruction some patients may also need additional surgery such as cystotomy (if bladder stones are involved) or other diagnostics (biopsy if a urethral or bladder mass is suspected, urine culture if an infection is suspected, referral to a neurologist if a neurological disease is suspected).

Clinical Signs

  • Straining to urinate with repeated attempts
  • Crying in discomfort while trying to urinate
  • Vomiting
  • Anorexia
  • Depression
  • Muscle stiffness
  • Abdominal discomfort/pain
  • Shock
  • Comatosed

Aftercare

  • The patient will be hospitalized and will have the urinary catheter in place for 2-3 days to establish continual patency whilst the underlying condition is supportively treated
  • The patient will then be discharged for home monitoring with supportive medications such as pain relief, muscle relaxant and possible antibiotics depending on the cause
  • The patient will likely be prescribed a urinary diet that they may need to continue in order to reduce the recurrence of future blockages
  • An Elizabethan (E) collar (“cone”) may be provided to be worn if the patient is excessively licking at the trauma site to prevent further trauma

Prognosis and Complications

  • Urinary obstruction carries excellent prognosis of 90% if it is treated within a reasonable timeframe
  • Recurrence rate varies and can be relatively high ranging from 11-43%
  • Cats that recur and have multiple obstructions may require perineal urethrostomy (surgery to remove the penis and to widen and shorten the urethra) to reduce the recurrence rate.