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Unlike dogs, cats do not get bladder stones (uroliths) very often. While female cats occasionally get the uroliths, male cats most commonly get “urethral plugs” made up of mucus, protein and crystals (‘sand’). Because the size of the urethra narrows about one inch from the end of the penis, most plugs/blockages occur at this area in male cats.

The exact cause is unknown, but most urethral plugs and uroliths occur because of the individual’s reaction to the mineral composition, moisture content, and urine-alkalinizing metabolite in most feline diets. Other possible causes are heredity, infections, prolonged urine retention and formation of concentrated urine, and stress.

Early signs of trouble include irritability and restlessness, blood in urine, frequent trips to the litter box, straining while in a squatting position (owner often thinks the cat is constipated), and urinating in different locations in the house.

Once the urethra is plugged/blocked, it is an EMERGENCY. Cats may vomit or drool, refuse to eat, cry with pain, strain constantly, and have a tender and sore abdomen. Owners often believe that their cat is constipated. If the cat is not treated promptly, this disease can lead to kidney failure, ruptured bladder, cardiac (heart) arrhythmias and death.

Diagnostics that may need to be performed are CBC/Chemistry, urinalysis, FeLV/FIV test, abdominal x-rays and ultrasound.

Treatment involves hospitalization, removal of the urethral plug and placement of a urinary catheter into the bladder. Some cats will need to be sedated for this procedure. Because the urine is full of this ‘sand’, the catheter needs to be left in place for a number of days. Fluids are given, either intravenously or subcutaneously, to diurese the kidneys and flush the sand out of the bladder. Prophylactic antibiotics are also given. Sometimes pain control may need to be added to the treatment.

With early treatment, most blocked tom cats respond very well. However, there is a possibility that renal (kidney) damage can occur if the obstruction is severe or prolonged. Due to enlargement and stretching of the bladder wall, some obstructed cats may not be able to urinate on their own for a week or two following resolution of the initial obstruction.

Long term management involves feeding your cat an appropriate urinary diet that is formulated especially for this condition. YOUR CAT WILL NEED TO EAT THIS DIET FOR THE REST OF HIS LIFE. Sometimes a urinary acidifier may be added to the long-term treatment. Fresh water needs to always be made available.

The majority of cats will not re-block after appropriate treatment once they have started to eat an appropriate diet. A very small percentage of cats will re-block soon after treatment or even a few months after eating the special diet. If a cat continues to re-block, a special surgery may need to be performed to widen the urethra.