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This morning I noticed that Twombly was straining at the litterbox and was making lots of non-productive attempts at urination, so I called my vet and they got him in this afternoon, with my partner at home to keep an eye on him in the meantime. He was clearly feeling terrible when I arrived home from work so I packed him in the car and off we went. When he arrived she palpated his bladder and immediately recognized him as having a urinary blockage. She gave me an estimate for about $500 with a few days' inpatient stay, catheterization, urinalysis, etc. Totally reasonable, particularly in the context of what I've spent on my little guy in the past year as he was also recently diagnosed with moderately aggressive mast cell cancer. According to my vet there was a 'significant blockage' that she was able to clear with the catheter, but that there is the possibility of spontaneous recurrence down the road. The vet already suggested a prescription diet which is, alarmingly, actually LESS expensive than the food he eats now, but are there other things I should be mindful of as far as managing this in the future? I'm interested to hear about other people's experiences with their blocked cats and what management looked like once the emergency care had been taken care of. We are operating under the assumption that due to his cancer diagnosis, his time with us is not indefinite and we are mostly focused on keeping him happy, comfortable, and free of pain for as long as we can without stretching our resources too far.
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Oct 14, 2014 03:55
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| # ? May 14, 2024 17:31 |
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Cats get blocked for two big reasons - either inflammation and crystal formation causes a plug to form, or there is an actual urinary stone that forms and gets lodged somewhere. Your kitty sounds like the former, which is more common as well. Originally, it was thought that the crystals themselves were the major problem - nowadays, they are generally considered more secondary to a primary inflammation. The inflammation can just come from a stressed cat - they get stressed, and their bladder decides to freak out. The inflammation of the bladder leads to formation of crystal, and then inflammatory protein and crystals mix into this gross glob that loves to get lodged in the urethra (tube that goes to the outside). In some cats, crystals play more of a role than others. The idea of the main RX diets are several fold: 1) decrease the building blocks of crystals in the urine. If the prerequisite parts aren't there, then the crytals have a harder time forming and helping form the plug. 2) Encourage water consumption - if the urine is dilute, there's not much stuff in there to form crystals, and the plug doesn't have a lot of time to form before it is peed out. Either through more salt or by being a wet food. 3) Try and modulate behavior. This is a newer one. Last I heard, Hill's was claiming that by adding certain amino acids and proteins that are associated with relaxation and calming, then they can use a diet to not only prevent crystal formation, but the inflammation too. I haven't read up on the new Hill's stuff to see if it pans out. So, in some cats, the Rx foods are necessary, otherwise they recur. Some cats can get by following two of the tenets listed above - encouraging water intake and decreasing stress. Some cats get switched to wet food only if they were dry eaters, some cats get water fountains as some cats love moving water, some people add more litter boxes in different places, or add toys, or add attention time.... there are many things that could be stressful to a cat which seem minor, and the appreciable stress might actually be pretty low. They may not actually show you they're stressed other than by having this bout.
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Oct 14, 2014 06:25
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To increase water intake you can also add water to wet food. Cats don't drink much in the first place. I usually add a couple teaspoons to their portion of pate. I don't bother with the chunkier ones with gravy because they are already pretty soupy.
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Oct 20, 2014 22:55
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http://indoorpet.osu.edu/cats/ Read up. Environmental modification is a really important part of management of cats with this type of bladder inflammation. Anecdotally, my cat had one episode of obstruction and has never reoccurred, and he never had to be placed on a prescription diet, but was transitioned to 75% canned and a lot of environmental enrichment stuff was implemented.
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Oct 23, 2014 03:55
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Thanks for all of the info. Twombly is back to being himself for now, and has, so far, not re-blocked. Part of my issue is that if this is, indeed, stress related, I am afraid that the stressors that are triggering it are not things that are easily solved because of his recent diagnosis of mast cell cancer. He takes pills multiple times a day, which he hates, and sees a veterinary oncologist who is about an hour drive from home in the car, which he also hates. We started Royal Canin S/O prescription food and he's getting about 70/30 dry/wet, supplemented every day with fluids (usually 50/50 low sodium chicken broth/water) administered by mouth with his pills (probably in the neighborhood of 40mL/day, sometimes less). Mysteriously, he fights me tooth and nail about the pills but is fine with having a syringe stuck in his mouth. He is peeing like a maniac now with the help of a smooth muscle relaxer to soothe his poor spasming bladder. The first day or so that I had him home after his hospital stay, he was peeing frequently but still in small amounts and crying at the litter box, and I was totally terrified that he had become blocked again. The vet put him on phenoxybenzamine, which I literally had to have shipped across the country, but it was totally worth it and obviously has given him a lot of relief. I guess my overarching concern is, where is the line in the sand? If he blocks again, do we go through the hospital stay again? If he was healthy otherwise, there would be no question, but he had a couple of large tumors removed this past summer and more small ones have already started to appear. All of the biopsies showed an unusually aggressive amount of cell replication in the tumors, so I guess I shouldn't be surprised that he's getting more. With that said, until one tumor became ulcerated a few months ago he had never shown any signs of illness or being particularly bothered by their existence for about two years. The veterinary oncologist has basically thrown up her hands and said "I have no idea, he could die in a month or he could be fine for years." So I guess my real question is, tell me about urinary blockages in my cat with mast cell cancer.
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Oct 24, 2014 22:56
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| # ? May 14, 2024 17:31 |
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Mast cell tumors can produce various compounds that can make animals feel crummy but we don't always see the clinical signs - histamine reactions, increased stomach secretions and ulcers... and it may be there are these subtle things occurring that are adding to the stress. If he were to block again, it would not be wrong to decide that it is the appropriate time to euthanize him. Occasionally you just can't get the stressors under control or medications administered for a variety of reasons, and reblocks happen, even in otherwise completely healthy cats. At that point, if things can't be dealt with at home, euthanasia is, in my opinion, the kinder thing to do then to risk more blocking events. With your kitty having this underlying condition, it makes the decision for euthanasia a little simpler when things come up again. Difficult, but a little simpler.
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Oct 24, 2014 23:05
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