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My cat, Sylvester, was in the veterinary hospital for several days last week because he could not urinate. They said he was blocked due to a sand plug? Anyway, he is home now and I am watching him like crazy. What did I do wrong to let this happen to him and how can I keep it from happening again? I’ve heard that cats that can’t urinate can die from renal failure.

Yes, you heard correctly. Cats that can’t urinate due to an obstruction will die after just two to three days. Unfortunately, you now know the signs to look for: urinating outside his box, vocalizing, bloody urine, licking his perineum, lethargy and anorexia. If you see any of those signs get him back to his veterinarian swiftly. Prevention is key.

There are several things you can do now, thankfully to try to keep his obstruction from happening again:

n Antibiotics. Most cats that develop a urethral obstruction don’t have a bacterial infection at that time, even though they may have bloody urine. The infection occurs after as a result of the urinary catheter placement introducing bacteria into the bladder. The urinary catheter is essential to relieve the obstruction and save his life but it does come with its own issues. A urine culture should be taken after his catheter is pulled and appropriate medicine dispensed to treat any bacterial infection that can cause complications.

n Fluids. I can’t stress this point enough in the prevention of a reoccurrence of a urethral obstruction. Remember the phrase, “dilution is the solution to pollution.” This is so true. The more liquids you can incorporate into his diet the more urine he will produce and the more he will empty his bladder of any sand and grit that accumulates there due to diet.

Water fountains, broth, Cat-Sip gravy packages daily and extra water and broth in his diet are all great ways to sneak in liquids. Canned food is a must too. Some cats are not used to a canned diet and will need the aid of an appetite stimulant to help them transition to the new diet. Some may even need subcutaneous IV fluids at home occasionally to get the extra fluids in. Whatever works best. There are also prescription diets that can encourage urine health. As your veterinarian.

n Pain management. Urethral obstructions are painful. Pain is a stressor for the cats and will contribute to his urinary dysfunction. The best pain management for cats include buprenorphine orally or gabapentin. They work well and are well tolerated by cats. Injectable Adequan also can be effective in cats who suffer from chronic bloody urine.

n Urethral relaxants. Sylvester’s urethra has been through quite a bit of trauma. From being obstructed to being unobstructed manually, to having a urinary catheter placed and left there for several days. The muscles that make up the urethra from his smooth muscles close to his body to his striated muscles at the tip of his penis, it all needs to relax so urine can flow out freely. Sedatives like acepromazine and a blood pressure lowering medicine called prazosin can both be affective in relaxing these muscles.

n MEMO. This is multi-modal environmental modification. This is almost as important as fluids in preventing re-occurrence. Decreasing stress in indoor cats keeps them and their urinary tracts happy and healthy. The Ohio State School of Veterinary Medicine has a very informative indoor cat initiative that has a check list that I will go through here. I do encourage all cat owners with urinary obstruction issues or bad habits to visit the site (indoorpet.osu.edu) and make the appropriate changes in their cats’ lives.

One aspect of MEMO is food and water. It must be in a safe and quiet place for the cat. Keep it clean and offer fresh servings daily especially if it is a canned only diet. A clean litter box is also important. Scoop daily and clean with soap weekly and use a fine-grain unscented litter. If you have more than one cat, have one litter box per cat and then add one extra to give them options.

Cats need to scratch on posts or flat pads and to climb higher than their humans to feel normal. Provide several locations throughout the house and some snuggly bedding in tucked away places that they can retreat to for rest. Lastly, they need toys to hunt and chase. Hunting prey is in their DNA. Provide opportunities for several play sessions per day.

Whew! That is a lot of work, I know. This is what we have learned over the years to keep them healthy. These treatments work. So in the short term for now focus on diet, fluids, and medicines. As he gets over his illness slowly start to change his environment to reduce the stressors in his life that have contributed to his condition. I pray that you and Sylvester never have to go through that potentially life ending condition again. Good luck.

Send questions for Dr. Allison Dascoli to “Ask the Vet,” Charleston Gazette-Mail, 1001 Virginia St. E., Charleston, WV 25301 or email them to askthevet@wvgazettemail.com. Comments or suggestions can be submitted the same way.