Urinary Obstruction (Urethral Obstruction)

The only helpful therapy can only be performed by a veterinarian.
It consists of timely pressure relief of the bladder and restoration of urethra patency through catheterization, if necessary initially by bladder puncture.
A bladder puncture means draining urine through a cannula inserted directly through the skin into the bladder.
The earlier these relieving measures are carried out, the sooner consequential damage can be prevented or limited in its extent.
Afterwards, your veterinarian will initially clarify the cause of the urinary outflow disorder by X-raying the urinary tract. In some cases (e.g., with tumors), further imaging examinations such as ultrasound and computed tomography are indicated.
Laboratory diagnostic tests provide information about the extent of kidney function impairment that has already occurred, the disturbance of the internal milieu, the degree of poisoning due to the backflow of urinary substances in the blood, as well as possible effects on the function of other organs.
Depending on this, the veterinarian can decide on the further recommended and medically necessary medicinal and surgical therapy.

Supplement

The treatment of a urinary tract obstruction requires a quick and systematic approach and is divided into emergency measures and subsequent causal therapy. The primary goal is to restore urinary flow and stabilize the patient.

Emergency therapy begins with catheterization of the urethra under sedation or general anesthesia. A sterile urinary catheter is carefully inserted into the urethra to overcome the obstruction and empty the bladder. In severe obstructions, a bladder puncture (cystocentesis) may initially be necessary to reduce acute pressure and obtain urine for diagnostic purposes. After successful catheterization, the bladder is flushed multiple times with sterile saline solution to remove remaining crystals, cell debris, or small stones.

Parallel to restoring urinary flow, intensive medical stabilization of the patient is carried out through intravenous fluid therapy to correct dehydration and electrolyte imbalances. Special attention is paid to normalizing potassium levels, as hyperkalemia can lead to life-threatening cardiac arrhythmias. In cases of severe pain, analgesics are administered, though non-steroidal anti-inflammatory drugs should be used with caution due to potential kidney damage.

After initial stabilization, further therapy is directed at the underlying cause:

For urinary stones, depending on the type and location, medical dissolution may be attempted or surgical removal may be necessary. Struvite stones can often be dissolved through special dietary measures and urine acidification, while calcium oxalate stones usually require surgical removal.

For Feline Idiopathic Cystitis, anti-inflammatory drugs, pain relievers, and antispasmodics are used, supplemented by stress reduction and environmental enrichment. Antispasmodic medications such as phenoxybenzamine or prazosin can promote relaxation of the urethral sphincter and improve urinary flow.

For bacterial infections, targeted antibiotic therapy is administered based on the results of the antibiogram. In cases of tumors or severe strictures, surgical intervention may be necessary. For male cats with recurrent obstructions, a perineal urethrostomy (surgical widening of the urethral opening) is often performed.

The urinary catheter typically remains in place for 24-48 hours to ensure continuous urine flow and allow the inflamed urethra to heal. After removal of the catheter, close monitoring of the patient is necessary to detect any recurrence of the obstruction early.