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Urinary Blockages in Cats & One Cat’s Rough Recovery

Learn about urinary blockages and how some cats have a harder time recovering than others.

Urinary blockages in cats are serious business. I’ll review signs and symptoms, as well as share a personal experience that was extremely stressful. I never want to scare anyone, but my goal is always education to help other cat owners prepare for the unexpected.

After a urinary blockage, my cat Beaker struggled to recover. I felt completely unprepared and uneducated. One of my foster cats had a super smooth recovery after a blockage, so when Beaker was struggling, I was baffled. A learned a small percentage of cats have an extremely hard time recovering. By sharing Beaker’s experience, I hope you’re better prepared than I was IF it happens to one of your cats.

Side note: I’m not in the veterinary field, so this is a very laywoman’s simplistic explanation of the condition.

What Are Urinary Blockages?

tabby cat
My foster Bobcat recovered easily from a urinary blockage.

Mucus plugs are most often the culprit of urinary blockages. They’re composed of crystals and mucus (I know, ew). They are more common in males because they have a longer urethra than females. The plug blocks the urine from passing. Since the cat can’t pee, toxins build up in their system, and if the cat doesn’t have the blockage removed, it can be fatal. Outside of plugs, other causes for urinary blockages include bladder stones or tumors. Urinary blockages can also occur from inflammation or spasming of the urethra.

What Causes the Physical Urinary Blockage to Form?

The actual cause of these issues is unknown (many theories, but no conclusions). Science seems to support some combo of genetic makeup, breed, age, diet, hydration, urine concentration, urine pH, and stress. We’ll look specifically at crystals, since they are the most common culprit. Keep in mind, the presence of crystals alone are not a problem. Issues arise when they are in high enough levels, with high (or low) urine pH. They sometimes clump together and the cat is at risk for a mucus plug or bladder stone, which causes a blockage.

The Role Players That Lead to Crystals

Cat Evolution

To understand what’s going on in a cat’s body, we have to look at their origins. Cats are obligate carnivores, eating diets that are mostly protein and fat, with very little carbohydrates. Their ancestors hunted prey in deserts. Hydration came from consuming their prey since water was scare. Because of this, cats have a low thirst drive and don’t tend to drink a ton of water. Their urine pH would also be slightly acidic in the wild, which is important for urinary health. Merck Veterinary Manual recommends a healthy cat’s urine pH to fall between 6.3-6.6, and slightly on the acidic side (with 7 balanced between acidic and alkaline).

Now, we’ve brought cats inside where they don’t have to hunt, which caused a lot of changes.

Diet & Urine pH

Cats’ diets have changed and most commercial food contains carbohydrates, which they encounter on a minimal basis in the wild. Commercial foods also affect their urine pH, putting them at a higher risk for two types of crystals:

  1. Foods with too much magnesium, ammonium, and phosphate can lead to the formation of struvite crystals and a higher, more alkaline urine pH. Studies have shown a high-protein diet may make the struvite crystals dissolve (supporting how they would successfully live in the wild without issues).
  2. More acidic magnesium-restricted diets can lead to calcium oxalate crystals and a more acidic urine pH. (A push for these diets occurred to combat struvite crystals, but now calcium oxalate crystals are more common than they were before, so it might have pushed too far in the opposite direction.)

Hydration

cat drinking from fountain
Many cats like Miss Lucy drink more water when it’s flowing from a fountain, which helps to decrease the risk of urinary blockages.

Hydration matters too. Where cats used to eat prey to get moisture, cats now eat dry food, which contains around 10% moisture, or wet food, which has around 70%. Since cats already have a low thirst drive, they aren’t drinking as much water as they should, which makes it more difficult for the kidneys to flush out bad stuff. I often recommend water fountains to help encourage cats to drink more water.

Urine Concentration

Less water leads to more concentrated urine. Since the urine is more concentrated and the cat isn’t drinking and peeing frequently, the crystals are at risk for clumping together, or at a minimum, creating inflammation in the bladder or urethra. This contributes to an increased risk in urinary blockages.

How Blocks Form

A plug can form if the struvite crystals and mucus clump together. Once the plug blocks the urethra, a cat can’t pee. The plug must be removed. For long-term treatment to prevent more urinary blockages, cats are typically fed a prescription food to treat and dissolve the struvite crystals.

Now, when calcium oxalate crystals can clump together, they form bladder stones, which need surgical removal. Long-term treatment is a prescription diet low in calcium and oxalate that also increases the urine pH.

Genetic predisposition and stress can exacerbate any type of blockage.

Cat Study: Beaker’s Urinary Blockage

cat on shelf
Meet Beaker.

Now that you have a little bit of background, I want to share what happened to my cat Beaker when he was just over four years old. Beaker had been peeing on vertical surfaces, which would typically be marking behavior, but marking involves a small amount of pee. Beaker would empty his entire bladder on vertical places.

During his annual visit, we discussed this and ran a urinalysis. It was positive for struvite crystals. The challenge was crystals probably contributed to the behavior, but there was probably a behavioral component as well. With a revolving door of fosters in my home, Beaker faced a lot of change. At the time, my super senior Vito’s health was a declining, adding even more stress to the home. I had tried some prescription urinary food, but he didn’t seem to like it and it didn’t decrease the peeing. After some rough research, I decided to give him just OTC wet food, and hopefully that would help the issue.

The Block

One day, I saw him jump into the litter box, then jump out, then jump back in. What was going on? I walked over and watched as he was straining to pee but nothing was coming out. Although I knew he had crystals, I was hopefully it was only inflammation, and it would be a quick ER visit.

The vet called, “Beaker is completely blocked. We’ll need to anesthetize him, remove the blockage and keep a catheter in him for 24-48 hours. After we remove it and he pees on his own, you can take him home.”

There wasn’t really a choice because without the procedure, toxins would build in his system and he would die, so I told them to do it. After removing the blockage, the vet informed me it was very gritty, so likely from struvite crystals. The good news was based on his bloodwork and the color of the urine, I caught the blockage immediately when it happened (otherwise his urine would have been extremely dark and his bloodwork abnormal). Because I caught it so quickly, I assumed his recovery would be smooth sailing. I was wrong.

Discharged

The vet sent Beaker home with buprenorphine for pain and prazosin, a vasodilator that helps with urethral spasms. I also received a prescription for Urinary S/O by Royal Canin, a prescription diet that would dissolve the crystals.

grey cat with big eyes
Buprenorphine is a strong painkiller. Beaker’s eyes are dilated from the drug.

The discharge instructions included a warning to keep an eye out because the next week was the most sensitive time for another blockage. He may strain to pee and go in and out of the box, almost acting like he has a UTI (urinary tract infection). As long as some pee comes out, he’s not blocked. If he gets reblocked, we’d need to consider a very invasive and expensive surgery called a perineal urethrostomy (PU), where the narrowest part of the urethra is removed and new urethra opening is created. This is sort of like turning the male’s urethra into what a female has. Not the exact same, but a similar idea. Obviously, we wanted to avoid that at all costs.

I was so happy to have him home, and decided I’d confine him to my room so I could keep an eye on his litter box habits.

Beaky is happy to be home.

Pee Here, Pee There, Pee Everywhere

It didn’t take long for the strange behavior to appear. As the vet predicted, Beaker started going in and out of the box. Then, he would just pee a few drops, so the litter box had tons of tiny little clumps in it. I mean, it was good he wasn’t blocked, I guess. Then he started meowing, growling, and hissing.

Beaker would frantically pace and cry until he would eventually lie on his side, meowing loudly while pee dripped out of his urethra. The pee would puddle on the floor and get all over the side of him that was in contact with the floor. He would also constantly lick himself, trying to either clean or just soothe his penis. This became a routine for him every few hours, and it was so, so, so hard to watch.

I called the ER again, and they told me he wasn’t blocked, so there was nothing to be done, and to make sure I kept him on the meds. Then, they suggested adding gabapentin, which I did.

The following day, these episodes continued, but this time, there was blood in his urine. Did he get a UTI from the catheter? I took him to his normal vet, where they told me the blood was from inflammation. They added Oncior, the only anti-inflammatory approved for use in cats, as well as a cone so he would stop licking himself, which was likely causing further irritation.

His episodes were still happening, and I just felt so badly for him. Although they were getting shorter, I still didn’t understand why he was having such a hard time. I caught the blockage immediately and was following all the instructions. Why was he still leaking pee everywhere?

An Explanation

Finally, I spoke to two different vets who explained a very small percentage of cats (maybe 10%) have these difficulties when recovering from a urinary blockage. Plus, the crystals were likely still dissolving, and their presence would cause more irritation and inflammation. It can take weeks for the crystals to dissolve while on a prescription diet. Plus, a high-stress environment, like one with lots of foster cats (aka my house) would make the inflammation worse.

The best course of action was to extend the Oncior, and keep him on a tight schedule of gabapentin and prazosin for at least a month. Although his episodes would continue, as long as they were getting shorter, he was healing. Our goal: Keep his stress low and him physically comfortable.

Thankfully, this solution worked.

Urinary Blockages Are Behind Us … Hopefully

Gray cat in tower
Beaker today still has some housesoiling issues, but they are very mild. He remains on Royal Canin Urinary SO Calm.

I wanted to share what happened to Beaker to prepare you that this could happen to your kitty too. Yes, a majority of cats with urinary blockages don’t have this experience. But there are some, like Beaker, who have a really hard time, and will need ongoing treatment and meds to help them feel comfortable and heal. It’s really important to tell your vet what you’re seeing and get feedback. Additionally, the entire experience is very stressful for your cat, so managing their stress will be key to their recovery.

Sources: Learn More

Barnette, Catherine. VCA Hospitals, Oxalate Bladder Stones in Cats, https://vcahospitals.com/know-your-pet/oxalate-bladder-stones-in-cats

Brooks, Wendy. Veterinary Partner, Bladder Stones (Struvite) in Cats, https://veterinarypartner.vin.com/default.aspx?pid=19239&id=5152119

Coates, Jennifer. The Spruce Pets, Cats’ Urinary pH and Their Health, https://www.thesprucepets.com/the-impact-of-cats-urinary-ph-on-their-health-4107365

Darwin’s Natural Pet Food, Urinary Crystals in Cats, https://www.darwinspet.com/health-issues/urinary-crystals-cats.html

Dowling, Patricia M. Merck Veterinary Manual, Controlling Urine pH, https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-urinary-system/controlling-urine-ph

Feinstein, Jill. Happy Tails From Husse, Urinary Crystals and Stones … What Are They? https://happytailsfromhusse.com/2015/11/18/urinary-crystals-and-stoneswhat-are-they/

Grauer, Gregory F. Today’s Veterinary Practice, Feline Struvite and Calcium Oxalate Urolithiasis, https://todaysveterinarypractice.com/feline-struvite-calcium-oxalate-urolithiasis/

Meeks, Cathy. PetMD, Wet vs. Dry Cat Food: Which Is Better, https://www.petmd.com/cat/nutrition/wet-cat-food-vs-dry-cat-food-which-better

Minnesota Urolith Center. University of Minnesota, Feline Struvite Uroliths, https://www.vetmed.umn.edu/sites/vetmed.umn.edu/files/feline_struvite_uroliths.pdf

Union Park Veterinary Hospital. A Day in the Life of Union Park Veterinary Hospital, Struvite Crystals … Pesky Buggers, http://unionparkvethospital.com/blog/2016/06/03/struvite-crystals-pesky-buggers

By LizsKittyBootCamp

Hi, I'm Liz, and I'm a cat behaviorist who provides advice and insights on cat behavior.

17 replies on “Urinary Blockages in Cats & One Cat’s Rough Recovery”

Yes, it’s not the exact same, but a similar idea. It was very hard to see him so uncomfortable and feeling helpless. His most recent urinalysis showed no crystals, so that’s good. Doesn’t mean he won’t get blocked again, but lowers the risk

How is this cat doing today? Wondering because my cat had a block and I just want to get an idea of what to expect in the future. Thanks

The prescription diet was what got rid of the crystals. Good luck with your kitty. Most cats recover very well from blockages. Beaky’s experience wasn’t common but can happen.

Thank you for the kind attention to detail. It helps so much. Vets aren’t always honest and that condescension uhmmm hum head shaking just doesn’t do the trick.

I appreciate the compliment and agree. I felt so unprepared for his recovery and would have liked more details. I hope this article helps others who experience it. Thanks for reading.

My cat is going through the exact same thing. I’ve been driving myself insane looking up why he would be having such a tough time after getting unblocked. I wake up and sit with him every night because I feel horrible that he is in pain during his recovery. I’m glad you said that it eventually got better. He’s on the same medications as your cat, and started eating the Hills Science Diet c/d prescription food. He’s been urinating but over grooming and peeing inappropriately. I’m praying for the best.

Stay positive, Taylor. I was told 10% of cats have this problem, and I wish it was talked about more. All of us pet parents just want to know if something is normal or okay because our pets can’t speak to us. I know they probably don’t want to scare people and maybe that’s why it isn’t discussed more, but I would have 100% been better if from day one they explained that some cats have a hard time recovering and that is normal and okay. I know you’re doing the best job taking care of your boy. Try to stay positive and keep loving on him as he heals.

My male cat is on day 2 of recovery, and oh my! The vet did not prepare me at all on what to do (other then the meds and keeping a close eye) they have him on the onsior (2 pills sent home) and prazosin. He’s eating great, mostly wet food, but some hard. Drinking good. But he is leaking urine bad, since he’s been more clingy to me, and stays sleepy alot, he’s been laying on me, all night he’s laying in my lap. But over grooming, I thought at first it may have been where they shaved him around that area, but I don’t believe that’s it now. I’m disabled, so this has been so hard for us all. His sister hisses and smacks at him now since he’s been home, she’s showing signs of stress, I saved these babies almost 3 years ago when my husband and son found them under our home, and found that the mother had been ran over just when they was 2 days old. He’s always been a fighter, vet said if he hadn’t been strong I would’ve already lost him. But it’s constant changing of bedding, laundry, and mopping or cleaning up urine wherever he goes. But mostly laying in bed with me, in my lap, with towels and blankets to keep me from getting soaked with his urine. How long will this last? Why is his sister/litter mate acting out? What can I do to help her, she used to be my lap cat, but now she will not even come lay or get on the bed with me. And vet couldn’t assure me that the procedure would take care of the problem, so I’m worried to death that I may loose him. I’ve cried so much, most people I’ve ever met, doesn’t understand that our kids are grown with kids and life’s of ther own. So these babies is our babies… my heart is broken. I just wish I knew how to help him, or knew if this will possibly take him away from us…. the uncertainty and stress is causing my health to be worse, and seeing him leaking, and grooming like this, I was very afraid he wasn’t getting better, but I know he is, because he is nothing like he was before he was taken to the vet. And of course with me being disabled, husband recovering from cancer and health problems his self, he works but his Dr won’t allow overtime, so we are on a tight budget. And can’t afford anything else at this time. Especially not any $2000 and up for any surgery. And I had people criticize me, and tell me I needed to either put him to sleep, or surrender him to a place that can find someone that can afford to get treatment for him. My animals eat better then I do, I always make sure they are very well taken care of. And as I said they are our babies, how could anyone just take their baby and give it away, when your are capable of taken very good care of them, just can’t afford to pay 1000’s out of pocket for emergencies as this. Vet bills are ridiculously high. But I can’t give my baby up, amd definitely don’t wanna put him to sleep when he’s always been a fighter, and is still fighting.

So sorry this is happening, Lana. The leaking pee really differs from cat to cat, but my Beaker had issues for a few weeks. Definitely keep your boy on the meds to help him get through it. Everything is still very inflamed and uncomfortable down there and the meds will provide relief.

Your other cat is experiencing pod aggression, which occurs when one cat leaves the house and comes back smelling like a different animal. The best thing you can do is try to mix the cats’ scents using blankets. I’d also get some Feliway spray and spray it around where she hangs out to hopefully calm her down.

Prayers for you. Everything you described just happened to us this past week. Even the struggles to pay. But he is our baby. I hope things got better for your family, Lana. Is he okay now? Sending you hugs.

Yes, Beaker is perfect. No crystals in his urine any more. It took him a while to heal from the blockage, but he’s okay. I hope you all are hanging in

We are in the same boat. Did not warn us and there is no information on this topic and it’s infuriating. Our cat had a sediment build up but we caught the block early. He has been leaking and in so much pain and the vet did NOT give use pain killers. Feeling useless but we can’t afford the surgery either due to a baby on the way and the expenses having a newborn. We are going to try and get pain killers first thing tomorrow.

I’m so sorry. Ask for gabapentin (for pain), buprenorphine (pain), Prazosin (vasodilator), and Oncior (antiinflammatory). Ask them to give you a detailed schedule and still to it. Goal is to manage pain while the urethra goes down (from inflammation). May take a few weeks. Keep me posted

My kitty just came home three days ago after three days in hospital with the catheter. I too feel like I caught his blockage early and immediately took him to the vet. He’s not having the issues of leaking pee like you all have described but he’s weak, still very much in recovery mode.

I have no faith in the value of the food that the vets prescribe. The ingredients don’t have any real food, just meat by products and meat flavorings and a bunch of chemical words. Purina, Science Diet, and Hills, all make their food with non human grade rendering plant products. If you don’t know what this is I suggest you research it.

Also, that pain opioid drug Buprenex that the vets prescribe is 30 times more powerful than morphine, and the side effects are difficulty urinating, and severe constipation. Upon withdrawal some cats have gran mal seizures and die. No thank you.

During the three days my cat was hospitalized he did not poop and barely ate. He came home looking and feeling much lighter. The vet did not seem to be the least bit concerned about any of this but I certainly was.

I did my research while my cat was hospitalized. I learned there is a more natural way to help my cat recover and hopefully never get sick again. I found that Primal makes a raw goat milk that has cranberry, apple cider vinegar, and inulin. These four ingredients, including the milk itself, are natural acidifiers. I have been giving my cat three tablespoons of this raw milk a day. I give it to him via an eye dropper, not a syringe. The syringe shoots the liquid out like a fire hydrant, whereas with an eye dropper I can release just a small amount at a time. The Primal raw goat milk can be bought at the specialty pet stores and comes frozen. They say it’s good for ten days but I don’t like to use it for more than seven days. It cost about $15 per bottle. I freeze in ice cube trays about two thirds of the bottle. I found ice cube trays that have a lid. I found the frozen raw milk cubes don’t release easily out of the tray, but if you let it sit on the counter for a few minutes the cubes slide right out.

I’ve also been adding to the raw goat milk Dr Mercola supplements. There’s one called Bladder Support, Liver and Kidney Support, and Vitamin B Complex. And for his pain management I’m adding CBD drops to the milk. It doesn’t seem like he has pain but just in case I’m giving him the CBD without any worry of side effects.

For food I’ve completely cut out the kibble. I’m feeding my cat a half raw and half canned food. I found a raw food brand called Small Batch that in addition to excellent whole food ingredients it also has apple cider vinegar. And another brand, also with all whole food ingredients that includes goat milk, is Quest Cat Food, from Steve’s Real Food. I’m adding filtered water to the can food if it seems a little dry.

With this approach I was able to get my cat to pee full volume three times within the first 24 hours, and poop. There’s a video on youtube from the Farm Guy where he unblocks his cat with just apple cider vinegar. Hundreds of people commented that it worked for them too. This straight ACV approach looks just brutal though and I’m happy that Primal provides for a much more gentle approach.

I sure hope my information helps someone and their beloved pet.

I wanted to add to my prior comment that I am also feeding my cat three to four times a day. And with each meal I am giving him a tablespoon of the cranberry raw goat milk. So when you think about it, to help reduce or eliminate these crystals our cats need moisture and their ph needs to be on the acidic side. With these four feedings accompanied by the tablespoon of goat milk that is a lot of moisture. The raw goat milk is also providing probiotics and prebiotics and enzymes and help reduce inflammation.

My kitty is still recovering as it is now day five after his release. But his energy is coming back, and his appetite is great, and he’s peeing large volumes about three times a day. I’m probably going to be nervous for months but so far it’s working.

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