We often get calls about cats that are straining to urinate or have blood in their urine. One of the first questions a veterinary staff member automatically asks after you have told them your cat is having issues urinating is: ‘Do you own a male or female cat?’. Many of our callers may be flustered by this question and find it irrelevant and inappropriate to ask.
However, the fact is male cats are very prone to getting blocked (lose the ability to urinate) after suffering from a bladder infection.
It is not to say female cats can’t get blocked but they rarely do and I have personally never come across one. The theory is the male urethra is very sensitive and after so many bouts of infection/inflammation, it simply goes into a spasm or can get blocked with sludge or crystals.
If you notice your male or female cat struggling to urinate, you must get them to a vet as soon as possible. For those of you who have ever endured a cystitis (bladder infection), you can totally relate to the pain and burning sensations that come with cystitis. For those of you haven’t, consider yourselves lucky. It is important to get your cats sorted as soon as possible.
Your cat is in a world of discomfort and so you must act fast.
Cats can develop a bad correlation with the litter box as a result of the painful experience they endured when using the facilities. This may lead to your male or female (entire or desexed) cat to start spraying urine all over the house and not wanting to use their litter boxes. As for male cats, the longer you leave them straining, the higher the chances your cat will get blocked and that is a life threatening emergency that will end up with a massive vet bill.
Cats with cystitis usually frequent the litter box way more than usual. They will sometimes vocalise and if you happen to be watching them in their litter box, you may notice very small amounts of urine being passed each time. Some owners will also notice there is a bloody tinge to the urine being produced. The worst case scenario is realising your cat is unable to urinate at all at which stage your cat’s life hangs in the balance. We are often presented with very sick male cats that are at the brink of death. We must immediately unblock them but their anaesthetic poses a huge risk and some do not pull through.
The most common cause for cystitis in cats is related to a buildup of crystals in their urine.
That is usually secondary to inappropriate diets that lead to an alkaline (basic) ph of the urine and this leads to the development of crystals. By far, the most common crystals cats develop are ‘Struvites‘. However, there are other causes like different types of bladder infections. Cats being cats can also suffer from what we refer to as idiopathic (unknown cause) cystitis where they do not have crystals or infections and we simply believe stress can cause them to develop a sterile cystitis! Interesting, huh?
Treatment of cystitis is often aimed at the cause. If you have an infectious cause, appropriate medications are dispensed and so antibiotics are commonly prescribed. However, if crystals are also involved then dietary changes are made that aim to dissolve the crystals and prevent recurrence. As for idiopathic cystitis, I often go on a CSI mission of investigating any changes in the household that are occurring that may be disrupting my feline patient’s routine. I always recommend Feliway (pheromone that the queen produces around her kittens to make them feel secure and happy) spray or diffuser to help take the edge off my cats and help them chill out.
Now is the right time to talk to you all about ‘Basil’, my 5-year-old male desexed Siamese patient.
A couple of weekends ago, I had the honor of meeting him on my weekend on call. He was in hospital with an indwelling urinary catheter. The poor boy had gotten blocked up several times (about 3 times in total) over the past couple of weeks. Each time, he was admitted, anesthetized and a urinary catheter was passed and after a day or two, he was sent home on his merry way. My colleagues admitted him on the thursday and by friday morning, he had managed to pull out his urinary catheter. He was anesthetized yet again and another catheter was passed without any issues.
Being the anal vet that I am, I popped in to check on him around 9 p.m. Friday night to make sure he is travelling well. To my utter dismay, I saw him looking all smug and proud of his successful extraction of his urinary catheter whilst his massive Elizabethan collar was still on. I was furious but there was no point anaesthetising him at that hour so I turned off his IV fluids to prevent further distention of his bladder and was praying to come in the next morning to see he was able to use his litter box and thereby not needing another anaesthetic.
Saturday morning came and there was no sign of urine and Mr. Basil had a very distended hard bladder.
I sat his mom down and explained that he needs to be taken down to a vet specialist for a urethrostomy procedure as soon as possible. In lay man terms, a urethrostomy in a male cat means we are relocating and reconstructing his urethra and physically allowing him to urinate like a female cat. We discussed the very expensive costs involved and the risks. However, I made it very clear that it is Basil’s only hope of completely preventing further blockages. Unfortunately, the specialists were going to charge double if we sent him straight down because it was the weekend so they suggested I manage Basil until Monday.
I proceeded with Basil’s 3rd anaesthetic in a span of 2 days and struggled to pass a urinary catheter. The tip of his penis was abnormal and simply fibrosed. There was no urethral opening to be found.
After multiple failed attempts, I had to do the unthinkable. I had to cut the tip of his penis off.
Thankfully the sacrifice paid off and I was able to finally slot in his urinary catheter into the appropriate position.
I was pretty busy with afterhours call outs for most of the day and so I only got around to checking in on him and Gemma (my other in hospital case) around 5 that day.
When I peeped into his cage, he still looked very sleepy but my heart simply sank at what I discovered next.
Guess what? You guessed it, he pulled out his urinary catheter yet again.
At that moment of time, I was so close to strangling my handsome boy. When I looked into Basil’s big beautiful blue and very intense eyes, I forgot all that happened and was in awe of his beauty and human nature. The way he held my gaze and spoke to me simply put me under his spell. I was at his service around the clock no matter what.
Tell me you don’t think he is one stunning feline…
After I performed my huge surgery on Gemma, I got him out and knocked him out for the 4th time and passed his urinary catheter. I decided not to connect the urinary catheter to an extension set and urine collection bag. You should really have it connected in theory to prevent retrograde infection. However, I thought most likely he was getting entangled with the extension set and that was the cause of his urinary catheter failing to stay in.
I was so tempted to install a video camera to monitor his every move overnight and wished someone had created an alarm that could be set off whenever a patient was causing havoc in hospital.
I had also started him on oral Valium (diazepam) which is a smooth muscle relaxant to help counter the spasms in his urethra. I went to bed feeling on edge not knowing what to expect the next day.
Basil did not fail at giving me yet another heart attack the next morning. He was all full of himself and feeling like an over achiever. He sat there meowing at me demanding I give him attention. He felt no remorse at pulling out his urinary catheter for the 3rd time in a row. Miraculously though, he was able to urinate and had actually used his litter box overnight. I highly suspected that starting him on Valium had paid off. I decided to send him home on his oral Valium as he was booked in for the first appointment at the vet specialists the next morning.
On Monday, he went to Southpaws specialty surgery for small animals and they recommended a urethrostomy being performed.
This is a picture of Basil taken a few days after his urethrostomy was performed (not pretty!)
Basil’s recurrent urinary blockages were not due to a crystal or bladder infection. He simply has an underlying anxiety. This feline has a human complex. He thinks he is a human being and there is no way of convincing him otherwise. He will join in your conversations and contribute to the discussions. He responds to attention and simply wants his human family to wait on him hand and foot. His father is his biggest love even though his mother is his main carer.
I laughed so hard when I found out that his mother had to sleep on the couch on his first day back from the surgery while he snuggled in with his father on the king bed.
It is easy to assume that his parents should learn how to treat him like a cat. If you met ‘Basil’, you would discover the truth. He would make the biggest and most memorable impression on you. When he looks at you with that blue intensity in his eyes, you feel like he is peering into your soul.
He is currently recovering very well and I am managing his post operative care with his very dedicated owners.
Check out the intensity of his gaze below in the video below and tell me what you think!