My cat can’t pee!

What do I do if my cat can’t pee? Why is my cat straining in the litter box? Why is my cat screaming in the litter box? Why is there blood in the litterbox?

If your cat cannot urinate in a 24 hour period this can be a urethral obstruction – this is an emergency situation and your cat needs to be seen by the vet immediately! Our San Antonio veterinary hospital and veterinarians are absolutely prepared to treat your cat in this emergency.

This is almost exclusively a problem of male cats, referred to as a “Blocked Tom”. Tom refers to a male feline aka “Tom Cat”.

A “Blocked Tom” refers to a subcategory of a larger disease process known as FLUTD or Feline Lower Urinary Tract Disease. We don’t discuss FLUTD as much as Cystitis (bladder inflammation) or FIC – Feline Idiopathic Cystitis (we will soon blog on the oh so common discussion of Feline Idiopathic Cystitis).

The feline lower urinary tract is the urinary bladder and the urethra; the urethra is the pipe from the bladder to the litter box. The urethra in a Tom cat is similar in size and location to that of a female cat until it narrows and curves and passes through the penis. The penile urethra is very narrow and this is where the urinary obstruction occurs. The urinary blockage usually occurs in the penis, therefore this is almost exclusively a problem with male cats – hence the term, “Blocked Tom”. This urethral blockage can simply be due to swelling of the urethra. Or it can be a combination of urethral disease with blood clots, mucus plugs, urinary crystals, and/or urinary stones.

If a cat cannot pass urine in a 24 hour period, the toxins that are normally excreted in the urine accumulate in the body and become toxic. The most concerning toxin in this situation is potassium. In normal quantities it is a valuable electrolyte; but when this builds to a toxic level, it can slow or even stop the heart – meaning the worst case scenario is death. And yes, we have seen this worst case scenario occur more than once (DOA).

Let’s jump to the chase. This describes a cat we saw earlier this month. Let’s name him “Tom”. Tom had a previous diagnosis of Cystitis that had resolved and his symptoms had resolved. However, on Thursday Tom came in dripping blood from his penis and had not urinated in 24 hours. He was also straining in the litter box. Tom was an emergency! See more details about Tom in our blog post – My cat can’t pee, now he’s at the Vet Clinic: A Case Study for Urinary Obstruction.

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