The vet’s office: Recognizing and treating feline lower urinary tract disease
By Dr. Roger Krogstad, DVM
Wildwood Animal Hospital and Clinic LLC
Does your cat fit this profile: neutered male, overweight, 3-5 years old, and is being fed free choice? This describes the typical “perfect storm” for urinary crystal formation and urinary tract obstruction. This is a very painful and potentially deadly condition.
Some early-stage cats may make frequent trips to the litter box or have accidents around the house. Others squat in the litter box with no urine production at all. Some may just hide, and others roam the house with loud vocalizations, returning back to the litter box frequently to alert the owner.
With no urine outflow, the bladder is stretched painfully to capacity, and pressure up the ureters reduces kidney function. Many cats at this early stage of kidney failure may show signs of a depression in appetite and frequent vomiting. This is an emergency.
The sooner the pet gets veterinary care, the sooner the kidneys can return to normal function. A difficult decision has to be made to pursue emergency treatment or not by weighing the severity of the symptoms, cost for treatment, prognosis for the cat, and other health issues. Unfortunately, there are no guarantees, and history shows that without strict dietary management, a high percentage of these cats will reobstruct.
Treatment usually consists of general anesthesia allowing urethral catheterization to flush out the obstruction. Multiple flushings of the urinary bladder are done, and a catheter is sutured in place to allow for constant urinary outflow for 24 to 48 hours. Several days in the hospital are usually required with the patient on IV fluids, medications, and tests to monitor the kidneys’ return to full function before being discharged.
A frustration for both the veterinarian and pet owner is the small percentage of these cats that reobstruct soon after the urinary catheter is removed. The same procedure may be repeated, or another option given is a surgery called “perineal urethrostomy.” This can also be performed on cats that cannot be successfully managed on a controlled diet and therefore have a higher potential to reobstruct.
Anatomically, the urethra is shortened to a larger diameter portion and redirected to emerge higher on the back end under the anal opening. This is usually not a first-choice procedure but held in reserve because with any surgery there are risks that need to be considered. In this male cat, you are creating an opening where nature had not intended it to be.
Prevention is always a better course. Do not overfeed, provide and encourage increased water consumption, and consider special diets targeting prevention of this deadly and costly condition. Many veterinary practices have special foods and knowledgeable technicians to inform you on proper feeding.
Wildwood Animal Hospital and Clinic LLC is located at 210 Airpark Road in Marshfield and online at wildwoodanimalhospital.net.