When easy is oh so hard. . .

A blocked cat can be both my favourite emergency, and my least favourite.

What is a blocked cat? A cat that can’t pee. Usually a male, because they have long narrowed urethra. Something gets clogged up in there for some reason, and the pee can’t get out. Doesn’t take too long for the bladder to get full, and painful. Left too long, the cat will become very ill as the kidneys shut down and things go all out of whack, and then he dies. That might sound dramatic, but it is a very serious emergency. Peeing is kind of essential to life.

So why do I love blocked cats? It is one of the easiest emergencies to assess and diagnose. Unless the cat is morbidly obese, a blocked bladder is impossible to miss. It’s huge and firm. It’s also a straight forward solution: UNBLOCK. Often easier said than done, it’s true, but it is straight forward. Get a urinary catheter up the penis and into the bladder, and that cat will be feeling leagues better.

Typically, with a blocked cat, this is what happens: sedation (not many cats put up with urinary catheterization without a fight), blood work (checking kidney values, electrolyte abnormalities…), IV fluids (correct electrolyte abnormalities, and get lots of urine produced once they’re unblocked to flush things out), the actual unblocking and placing of an indwelling urinary catheter, an x-ray (check for stones, catheter placement),  urinalysis (find out what’s in the urine so you know best how to try to treat and prevent reoccurrence), and some time in hospital. Typically we leave the urinary catheter in for at least 48 hours, and then when we pull it we want to make sure the cat can pee well without it before we send them home. There may be repeated blood work, depending on how bad it was initially. There will definitely be medications. And there’s always the risk of complications – the worst case scenario being death, but short of that some cats will block again when we pull the catheter and we have to replace it and start the waiting game again. My worst case was in hospital over 7 days before he got the OK to go home.

So why do I hate them? You might imagine that all of that adds up. It does. At the hospital I work at, you’re average blocked cat will run a bill of around $1000. Unfortunately a lot of these cats come in as emergencies, so on top of all that work there are emergency fees to contend with. If the cat comes in as an appointment I may quote $750-$1500. Emergencies I quote $1000-1500. My worst case ended up at about $1800 by the time he went home.

You may be thinking “Well, Dr. Maggie, what do you care how expensive it is? How does that affect you?” and you’re right, I’m not really affected by how expensive it is (except that I have 4 male cats of my own, so I might be one day. . .). However, there are few things more frustrating in my job than euthanizing a blocked cat because the owners can’t afford to treat it. Yes, it is always frustrating to be euthanizing over financial reasons – but to be faced with a young (typical age being between 2 and 7 years old), otherwise healthy, cat with a problem you know exactly how to fix makes the “financial reasons” euthanasia that much more aggravating.

I hate having to go into an exam room, tell the owners what is wrong with their cat and how much it will cost them if things go well, and how much it could cost if it doesn’t, is one of my least favourite things to do. For some people it’s not a big deal, they understand it is what it is. For some people, it’s a hard decision to have to make but an easy one at the same time because they just do not have the money. In between I get the people who can maybe handle the low-end of the quote and are so torn about whether or not to risk a bill they may not be able to handle… and they break my heart. Sometimes we do try to do what we can, but cutting corners might not do the cat any favours… there’s a risk involved with skipping any part of the work up or procedure. Try passing a catheter without sedation; risk injury to staff members as the cat throws a fit. Skip the blood work; miss a life threatening electrolyte abnormality.  No IV fluids; stressed cat doesn’t drink in hospital and barely produces enough urine to assess if the problem is clearing up. No x-ray; miss finding out if there are any large stones in the bladder. Take the catheter out to soon and send the cat home prematurely? Then start all over again in a couple of days when the cat reblocks.

So how do you prevent this if you have male cats? The big thing is water. Feed some canned food to up the moisture content in his diet. Try running water if your cat isn’t interested in still water. A cat that drinks a lot will have dilute urine that is less likely to cause him problems. Also, pay attention to your cat. Any signs of urinary tract irritation or infection get it checked out. Exam, urinalysis, and maybe some antibiotics or prescription food and you’re looking at a bill just over $100. Ignore his frequent trips to the litter box or “accidents” around the house, and end up with a bill 10 times that. And definitely don’t ignore it if he’s going to the box and nothing is coming out – once they block they can be dead within 24 hours.

So, blocked cats: very satisfying and extremely frustrating. It’s a love hate thing.

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