Blocked urethra in hangovers
How can you tell if the cat's urethra is blocked?
If you notice that your hangover is no longer urinating or can only urinate drop by drop, a blockage of the urethra is the most likely (because most common) cause. In the case of outdoor cats, however, it is often not easy to control how much urine they defecate. With these males, the problem is often only noticed very late.
The males usually try very often but unsuccessfully to pass urine and are therefore often very restless. They constantly visit the litter box or want to go outside. When trying to urinate, many males show their pain by meowing, a bristling coat and a so-called pain face (ears folded to the sides, wrinkled forehead and thus slanted eye area).
You can also notice that the cat is in severe pain by a drooping head, a hunched back and changes in behaviour (loss of appetite, withdrawal, possible aggressiveness when touching). If you feel his stomach very carefully, the bladder may be felt as a large, bulging ball.
Often, the tip of the cat's penis swells during urethral obstruction. You can easily see this if you look at the anogenital region. Many males lick the painful penis in their distress, causing it to swell even more and become even more inflamed. In the worst case, penile tip necrosis can occur because the blood supply is interrupted by the severe swelling. Then the tip of the penis becomes dark red or bluish and may have to be amputated (penis tip resection, see below).
If the urethra blockage has existed for a long time, affected cats become apathetic and can eventually die.
What should I do if my cat can no longer pass urine?
Even if you have the feeling that the cat is otherwise fine, you should immediately pick up the phone, announce to your veterinarian what it is about and take the cat to the practice or clinic as soon as possible.
Urethral obstruction is always an emergency.
The sooner your cat is treated, the better his chances of survival.
Why is it life-threatening if the cat cannot urinate?
Even if the urethra is blocked, the kidneys continue to produce urine and it accumulates in the bladder. At some point, the bladder is full and begins to overstretch, which puts a lot of strain on the bladder wall, so that the bladder can eventually even rupture or bladder paralysis can remain following the urinary stasis.
In addition, the urine backs up into the renal pelvis. Since the kidneys are located in a solid connective tissue capsule, they cannot escape the pressure and the kidney tissue is squeezed, so that kidney damage can remain even after the urinary stasis has been removed.
However, it is not only the pressure that is a problem, but also the fact that so-called urinary substances can no longer be excreted as intended. Waste products of the metabolism accumulate in the blood of males with urethral obstruction and at some point cause so-called urinary poisoning (uremia). In addition, the electrolyte balance, which the kidneys normally keep in balance, is out of joint, and this impairs heart function in particular.
The circulatory strain of prolonged urinary stasis leads to a higher risk of anesthesia and can make it very difficult to treat the problem.
How is urethral obstruction treated in hangovers?
Your veterinarian will try to fix the urethra blockage as soon as possible. Often, a sedative injection or a short anaesthetic is necessary for this so that the muscles of the bladder and urethra relax and the hangover allows the treatment at all. The circulation may also have to be stabilized by medication and an infusion.
There are several ways to remedy urinary retention:
Urethral massage
Often, small stones in the tip of the penis simply block the outflow of urine, as the urethra narrows sharply there. In the simplest case, a gentle massage of the penis and a gentle squeeze of the bladder are enough to allow urine to flow through the urethra again (which is relaxed by medication and thus dilated).
Sometimes a rectal massage of the urethra on the pelvic floor is also successful if stones are stuck where the urethra describes an arc around the pelvic bone.
Flushing back the urinary stones with the help of a bladder catheter (retropulsion)
In most cases, urinary stones can be flushed back into the urinary bladder by carefully inserting a thin urinary catheter into the urethra and at the same time pressing sterile fluid into the urethra via a syringe. Once the stones are back in the bladder, the urine can drain through the catheter.
Depending on the type of urinary stones, they can then be dissolved with the help of a special urinary stone diet (struvite stones) or must be surgically removed (calcium oxalate stones and others).
Depending on the severity of the disease, the cat may have to be admitted to the hospital and keep the bladder catheter for a few more days.
Puncturing the bladder (cystocentesis)
If the bladder is extremely full or the urethra cannot be catheterized, urine must be suctioned out with the help of a bladder puncture. This is very easy to do by puncturing the bladder directly through the abdominal wall with a cannula and then sucking it in with the syringe attached.
Penisspitzenresektion (Urethrostomie)
Bei manchen Katern muss ein künstlicher Ausgang der Harnröhre geschaffen werden, weil die Penisspitze abgestorben oder die Harnröhre so blockiert ist, dass ein Katheterisieren einfach nicht möglich ist.
Als Notfallmaßnahme ist das selten nötig, bei manchen Katern wird eine Penisspitzenresektion —— auch Penismaputation genannt —— jedoch durchgeführt, weil sie immer wieder einen lebensbedrohlichen Harnstau entwickeln.
Viele Katzenbesitzer haben verständlicherweise Angst davor, dass dem Kater der Penis amputiert werden soll. Die Tiere kommen jedoch sehr gut mit dem künstlichen Ausgang zurecht und werden auch nicht inkontinent. Wenn eine Penisspitzenresektion bei Ihrem Kater notwendig sein sollte, können Sie ihm dadurch wieder ein unbeschwertes Leben ohne Schmerzen schenken.
Bei der Operation wird die entzündete, verstopfte oder abgestorbene Penisspitze entfernt, die Harnröhre in der Dammregion eröffnet und die Harnröhrenschleimhaut dort mit der Haut vernäht. So entsteht eine Öffnung, über die der Kater kontrolliert Urin absetzen kann, ähnlich wie eine Kätzin. Manche Tierärzte beschreiben diesen neuen Ausgang auch als "künstliche Scheide".
Wie groß ist die Gefahr, dass die Harnröhre des Katers wieder verstopft?
Hat ein Kater einmal eine verstopfte Harnröhre gehabt, ist die Gefahr leider recht groß, dass das Problem nach einiger Zeit wieder auftritt. Die Harnsteine können sich wieder bilden, wenn Ihr Kater nicht ganz konsequent eine Harnsteindiät frisst.
Recurrent bladder infections (recurrent cystitis, FLUTD) promote the growth of urinary stones on the one hand and cause the mucous membrane of the urethra to swell on the other, making it more easily clogged. Therefore, in addition to feeding a diet food against urinary stones, the urine should also be checked regularly for signs of inflammation.
The more often a cat has already had a blocked urethra, the higher his risk of relapse, as the urethra can scar. Therefore, if urethral obstruction occurs repeatedly, you should consider penile amputation in your cat.
You can find more information about the diagnosis and treatment of urinary stones in cats here: