Urine Blockage & Cat Euthanasia: When Is the Right Time?

As a veterinarian, one of my first patients in practice was a beloved 2-year-old black cat. Simba belonged to a teenage girl, and unfortunately his family was not equipped to handle the financial burden of treating an unexpected urinary blockage. They made the difficult but merciful decision to euthanize before his condition worsened. Unfortunately, this situation is not uncommon. In this article, I will discuss treatment options for urine blockage in cats, including recovery chances and when euthanasia may be necessary.

What is urinary blockage / obstruction? 

Urinary obstruction or blockage (also known as a blocked cat) is a severe and potentially life-threatening condition often resulting from Feline Lower Urinary Tract Disease (FLUTD). This obstruction is frequently caused by the formation of crystals or stones that become lodged in the urethra, blocking the passage of urine. In some cases, it can also be due to a mucus plug, inflammation, or tumor. Male cats are more prone to this condition due to their longer, narrower urethras.

Why is this an emergency? 

Urinary obstruction in cats is considered an emergency because it prevents a cat from being able to pass urine, which is a vital bodily function. 

  • One immediate concern is the physical pressure from an overfilled bladder. If not relieved, this pressure can cause the bladder to rupture, a painful and life-threatening condition that requires immediate surgery to repair.
  • Secondly, the buildup of waste products and toxins affects the functioning of other organs. The kidneys filter waste from the blood and produce urine to excrete it. When urine can’t leave the body, the toxin buildup can lead to acute kidney failure. 
  • Obstructed cats often become dehydrated and develop electrolyte imbalances, particularly a high potassium level. High potassium levels in the blood, also known as hyperkalemia, can lead to life-threatening heart rhythm abnormalities.

Given these risks, any cat showing signs of a potential urinary obstruction should be treated as an emergency and brought to a veterinarian immediately. The sooner an obstruction is treated, the better the chances for a successful outcome. Unfortunately, if left untreated, this condition will lead to a painful and distressing death. 

Cost estimate to treat a cat with urinary blockage

The cost may range from $750-$1500 for unblocking a cat. If the blockage recurs and additional care (or surgery) is needed, the price may reach up to $5000. Even after successful treatment, there is a risk of a blockage recurring in the future. If treatment is not possible for financial or other reasons, humane euthanasia is generally recommended. 

Considerations for euthanasia

Financial constraints

Owner finances can often be a deciding factor between pursuing treatment and euthanasia. It is highly recommended that pet parents get pet insurance or have an emergency fund available for such occasions. Options such as Carecredit or borrowing money from friends or family may be other ways to secure financial assistance on short notice. If this is not possible, you could discuss alternative less costly (albeit less ideal) treatment options, or even the difficult decision to surrender your pet. If all other options are exhausted, it is kinder to euthanize a blocked cat than let them continue to suffer. 

Prognosis / recovery

It can be helpful for pet parents to understand the statistics associated with this condition. Despite the emergent nature, 90% of blocked cats who receive prompt veterinary care survive and are discharged home. However, urinary obstruction may recur in 15-40% of them. Therefore, this should be considered a long-term medical condition. 

Quality of life 

If a cat is blocked and treatment is not possible, humane euthanasia is strongly recommended as soon as possible. Clinical signs will only continue to worsen and eventually lead to death. Another scenario where euthanasia may need to be considered is in cats who frequently become blocked or do not respond to treatment. Taking into account your cat’s quality of life, as well as the toll of a chronic medical condition on your mental health and wallet, are important considerations. 

How are cats with urinary blockage treated?

Your vet will perform a physical exam to palpate your cat’s bladder, which may be enlarged, hard, and painful in obstructed cats. They may also recommend urinalysis and culture (to detect infection, crystals, or other abnormalities), bloodwork (to assess kidney function and electrolyte levels), and ultrasound or x-rays (to visualize the bladder and urethra). The primary goal in treating a urinary obstruction is to re-establish urine flow as soon as possible. This is typically achieved by:

  • Catheterization: Under sedation or anesthesia, a catheter is inserted into the urethra to flush out the blockage and allow urine to flow again. Your cat will then need to be hospitalized with the catheter left in place for a few days to ensure continued urine flow and allow inflammation to subside.
  • IV Fluid Therapy: To correct dehydration and any electrolyte imbalances.
  • Pain Management: Obstructions are painful, so pain relief is a crucial part of treatment.
  • Medications and diet: Depending on the cause, medications may be used to relax the urethra, dissolve some types of stones, or treat underlying infections.
  • Surgery: In recurrent or severe cases, surgery such as a perineal urethrostomy (which creates a wider permanent opening for urine to pass) may be recommended.
  • Follow-up care: Be sure to follow your vet’s recommendations for follow-up care. Many cats, especially those with a history of FLUTD or previous urinary obstruction, are at risk for urinary blockages. Preventative measures include feeding wet cat food or a prescription urinary diet, keeping your cat active and at a healthy weight, increasing water intake, following appropriate litter box guidelines, regular vet check-ups, and stress reduction and enrichment for indoor cats. 

Are there any less costly treatment options for unblocking a cat? 

If conventional treatment is not possible due to financial constraints, it may be possible to try an alternative treatment in some cases. A protocol described in a 2010 study used pain medications and sedatives, subcutaneous fluids, cystocentesis (draining the bladder with a needle and syringe), and housing the cat in a low-stress environment, to achieve successful urination within 72 hours in 73% of cats. However, this method is less likely to be successful in cats who are extremely ill or already in kidney failure, and may still be too costly for some pet parents. 

What to expect during euthanasia 

Euthanasia, sometimes referred to as “putting down” or “putting to sleep,” is a humane and painless procedure performed by veterinarians to end the life of an animal that is suffering from an incurable condition, severe pain, or an overall poor quality of life. The term euthanasia comes from the Greek words “eu” (good) and “thanatos” (death), translating to “good death.” While each vet may have their own preferences and protocols for performing euthanasia, many of them go something like this:

A sedative may be administered first to ensure that your cat is calm and pain-free. Following this, the euthanasia solution is injected, leading to a peaceful and painless passing. Your vet may place a catheter first to aid with this injection, or simply insert a needle directly into a vein. The solution, typically a barbiturate, causes a painless and quick loss of consciousness, stopping the heart and lungs, and resulting in death. I like to prepare my clients that their pet may urinate or defecate and may have some muscle twitching or movements that look like breathing after they are gone. Their eyes also frequently stay open. Afterward, your vet will listen with a stethoscope to confirm death, and pet parents can take as much time as they need to say their final goodbyes. Aftercare options, including burial or cremation, and are typically discussed prior to the procedure. 

Coping with the loss of a pet

Coping with the loss of a pet is a deeply personal and often heartbreaking experience. The grief can sometimes be as profound as losing a human family member, as pets often hold a significant place in our lives. It’s essential to allow yourself to grieve and remember that it’s a normal and natural process. Seek support from friends, family, or pet loss support groups. Creating a memorial, sharing memories, or even adopting a new pet when ready are ways some people may choose to honor their beloved pet’s memory. 

FAQ

What are the symptoms of urine blockage?

Recognizing the symptoms of a urinary obstruction is critical for timely treatment. These may include:

  • Straining to urinate or frequent attempts with little to no urine output. This can sometimes be mistaken for constipation. 
  • Vocalizing or showing signs of discomfort or pain while urinating
  • Overgrooming or licking the genital area excessively
  • Changes in behavior, such as hiding, restlessness, or loss of appetite
  • Vomiting or abdominal pain
  • Lethargy, weakness, and collapse in severe cases

 

Author

  • Dr Liza Cahn, Veterinarian

    Dr. Cahn graduated in 2013 with a Doctorate of Veterinary Medicine (DVM) from from Michigan State University. She loves working with dogs and cats and educating owners on all aspects of veterinary medicine, especially animal behavior and dermatology. Dr. Cahn has an active veterinary license in Washington State.

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