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Urinary tract obstruction (urethral obstruction)

Author: Dr. med. vet. Gisa Löwe | Last modified: 17.02.2026

Urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. (urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.)
A urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. is a blockage of the urethra, usually by urinary grit or stones, less often by Tumors or Inflammatory conditions. The dog cannot urinate or can only urinate drop by drop and often shows Pain and Restlessness. If left untreated, bladder RuptureA rupture is a tear or break in an organ or tissue. It can be caused by trauma, illness, or overextension, and often requires medical intervention., renal failure and life-threatening electrolyte imbalances threaten.

Urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment., medically referred to as urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment., is an acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. emergency situation in veterinary medicine (Immediate/Emergency). This involves a partial or complete blockage of the urethra, which prevents the flow of urine from the bladder. This condition affects both dogs and cats, with male animals being significantly more affected due to their anatomically longer and narrower urethra. Especially in male cats (tomcats), urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. is one of the most common urological Emergencies.

The anatomyAnatomy is the scientific study of the structure of living things. It deals with the construction and organization of organisms, including their systems, organs, and tissues. of the urinary tract plays a crucial role in the development of an obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.. In cats, the urethra narrows significantly in the area of the penis, which is a predisposing factor for obstructions. In dogs, the diameter of the urethra varies depending on the breed, with smaller breeds tending to have a narrower urethra and thus being more susceptible to obstructions.

An untreated urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. leads to life-threatening complications within 24–48 hours, as urinary substances can no longer be excreted and accumulate in the blood. This leads to metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. derailments such as hyperkalemiaHyperkalemia refers to a potassium level in the blood that is too high. Potassium is essential for normal cell function, but an excess can lead to cardiac arrhythmia and other health problems., azotemia and metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders., which can lead to the Death of the animal if left untreated. In addition, the pressure in the bladder increases continuously, which can lead to tissue damage, bladder RuptureA rupture is a tear or break in an organ or tissue. It can be caused by trauma, illness, or overextension, and often requires medical intervention. and urine drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing. into the abdominalThe term “abdominal” refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity.

Causes

As a rule, the more or less complete obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. of the urethra is caused by crystal accumulations or urinary stones. Cell accumulations also play a role.
A purely dry food diet and insufficient exercise, as well as Overweight, contribute to the increasingly frequently diagnosed urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment..
In rare cases, Tumors and other conditions such as spinal cordThe spinal cord is a long, narrow bundle of nerve tissue located in the spinal canal of the vertebral column. It is part of the central nervous system and transmits nerve impulses between the brain and body. injuries (herniated disc) and other neurogenic bladder emptying disorders can also prevent regulated urination.

Supplement

The causes of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. are varied and differ somewhat between dogs and cats. In cats, the most common cause is felineFeline refers to anything related to cats. The term is used to describe diseases, behaviors, or anatomical aspects that are specific to cats. idiopathicIdiopathic refers to a condition or disease for which the cause is unknown. It is used when no clear external cause or underlying disease can be identified as an explanation for the symptoms. cystitis (FIC), which is associated with Inflammatory conditions of the bladder wall and the formation of inflammatory products that can block the urethra. Furthermore, urinary stones play a central role, with struvite stones (magnesiumMagnesium is a vital mineral that plays a role in various bodily functions, including muscle and nerve function, blood sugar control, and blood pressure regulation. In dogs and cats, a magnesium deficiency can lead to health problems. ammonium phosphate) and calciumCalcium is a mineral that is essential for building and maintaining strong bones and teeth. It also plays a role in blood coagulation, nerve transmission, and muscle contraction. oxalate stones being the most common in cats.

In dogs, urinary stones are also a common cause of urethral obstructions, with different types of stones dominating depending on the breed. For example, Dalmatians are prone to forming urateUrate refers to salts of uric acid that are excreted in urine. In dogs and cats, high urate concentrations can lead to the formation of urate stones in the urinary tract, especially in certain breeds or dietary conditions. stones, while Schnauzers are more likely to develop cystine stones. Struvite stones occur in both animal species and are often associated with bacterial urinary tract infections.

Other possible causes of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. include:

CrystalluriaCrystalluria refers to the presence of crystals in the urine, which may indicate metabolic disorders or urinary tract diseases in dogs and cats, such as urinary stones or infections.: Accumulation of crystals in the urine that can combine to form larger conglomerates
Urethral plugs: Obstructions made up of a mixture of proteins, cells and crystals, especially common in male cats
Tumors of the urethra or surrounding tissues
Traumatic injuries with subsequent Scar tissue formation and narrowing of the urethra
Neurological disorders that can lead to a functional obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.
Prostatic hyperplasiaHyperplasia refers to an increase in the number of cells in a tissue or organ, leading to enlargement. This can be a normal reaction or a sign of a disease. or inflammation in unneutered male dogs

Predisposing factors for the development of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. are Overweight, lack of exercise, exclusive dry food feeding, insufficient water intake and chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. StressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being., especially in cats. These factors lead to concentrated urine, which promotes the formation of crystals and stones.

Symptoms

Urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. (urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.) in dogs and cats

Typical Symptoms:

Increased attempts to urinate, frequent pressing, usually only drop by drop or no urination at all
Restlessness, repeated visits to the toilet, sometimes the litter box is not used
Expressions of Pain, Vocalizations
Licking of the penis/vulva, possibly blood in the urine

Alarm signs:

No urination (especially male cats) + increasing weakness
Vomiting, apathyApathy refers to a state of indifference and reduced interest or lack of emotional involvement in activities or events that would normally arouse interest., hypothermia, bradycardiaBradycardia refers to a slower than normal heart rate, typically below 60 beats per minute in adults. It can occur in healthy individuals, especially athletes, but can also be an indication of heart disease. (hyperkalemiaHyperkalemia refers to a potassium level in the blood that is too high. Potassium is essential for normal cell function, but an excess can lead to cardiac arrhythmia and other health problems.)
Severely painful, tense bladder, collapse

Escalation/course:

6–12 h: increasing Pain/Nausea, beginning intoxication / poisoningIntoxication / poisoning refers to poisoning caused by the intake of toxic substances. This can be caused by medications, drugs, chemicals, or other poisons and often requires medical treatment.
12–24 h: life-threatening electrolyte imbalanceImbalance refers to an imbalance or disruption of normal function or composition in the body, which can lead to health problems./arrhythmias possible
After short-term improvement, renewed pressing → re-obstruction is common (days)

If the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. of the urethra is not resolved in a timely manner, consequential damage occurs to the kidneys, as well as increasing intoxication / poisoningIntoxication / poisoning refers to poisoning caused by the intake of toxic substances. This can be caused by medications, drugs, chemicals, or other poisons and often requires medical treatment. due to metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. products not excreted via the urine (uremiaUremia is a condition of blood poisoning caused by the increase of waste products, especially urea, that are normally excreted by the kidneys. It occurs when kidney function is severely impaired.).
The clinical picture worsens within hours and there is a risk of permanent damage to the kidneys. This leads to:

Disruption of general condition
Fever
Lethargy
Vomiting
Sometimes drop-by-drop blood discharge
Bladder RuptureA rupture is a tear or break in an organ or tissue. It can be caused by trauma, illness, or overextension, and often requires medical intervention.
Shock

Affected animals also show an increased frequency of urination attempts (pollakiuria) and may seek out unusual places for urination. In cats, this often manifests in them avoiding the litter box and instead trying to urinate in other places in the apartment. Another characteristic Symptom is the intensive Licking in the genital area, which indicates Pain and discomfort.

As the duration of the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. progresses, the general condition deteriorates rapidly. The animals become increasingly lethargic, refuse food and water, and may show Vomiting. The bladder is palpably full, hard and painful on PalpationPalpation is an examination method in which the condition of body tissues is assessed by feeling them with the hands. It is used to identify swelling, pain, or other abnormalities.. If the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. lasts longer, systemic Symptoms of uremiaUremia is a condition of blood poisoning caused by the increase of waste products, especially urea, that are normally excreted by the kidneys. It occurs when kidney function is severely impaired. occur with dehydrationDehydration occurs when the body loses more fluid than it takes in. This can lead to a number of problems, including headaches, Dizziness, and in extreme cases, renal failure or Cardiovascular collapse., hypothermia or Fever, tachycardiaTachycardia refers to an unusually fast heartbeat with a resting heart rate of over 100 beats per minute. It can indicate physical exertion, stress, illness, or heart problems. and finally clouding of consciousness up to Koma.

In some animals, bloody urination (hematuria) can also be observed, which indicates Inflammatory conditions or injuries to the urinary tract. In advanced cases, the high pressure in the bladder can lead to a RuptureA rupture is a tear or break in an organ or tissue. It can be caused by trauma, illness, or overextension, and often requires medical intervention., which leads to life-threatening uremiaUremia is a condition of blood poisoning caused by the increase of waste products, especially urea, that are normally excreted by the kidneys. It occurs when kidney function is severely impaired. and peritonitis.

The Symptoms of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. always represent an absolute Emergency and require immediate veterinary intervention, as Death can occur within 24–48 hours due to renal failure and metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. derailments if left untreated.

First Aid

Treatment by the pet owner is not possible. As soon as you notice the problem, take your pet to a veterinarian.

Keep your animal warm.
Do not attempt to squeeze the bladder!
Do not give diureticSee diuretics. medications or teas.

When should you see a vet sooner?

→ Red if severe weakness, collapse, slow heart rate, hypothermia, or repeated Vomiting.

Diagnosis

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. is based on a combination of medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits., clinical examination and further diagnostics. The veterinarian will first take a thorough medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits., with particular attention being paid to changes in behavior during urination, pre-existing conditions and feeding habits.

During the clinical examination, PalpationPalpation is an examination method in which the condition of body tissues is assessed by feeling them with the hands. It is used to identify swelling, pain, or other abnormalities. of the abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. is the main focus, with a full, painful bladder being a characteristic finding. In male animals, the penis and urethra are also examined for abnormalities, Swelling or palpable obstructions. The vital parameters are carefully recorded, as deviations can indicate systemic complications.

Diagnostic imagingDiagnostic imaging includes medical procedures that create images of the inside of the body to diagnose, monitor, or treat diseases and injuries. Examples include X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). plays a central role in clarifying the cause of the urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.. X-rayX-ray is an imaging technique that uses X-rays to create images of the inside of the body. It is often used to diagnose bone fractures, lung diseases, and other conditions. images of the abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. can show radiopaque urinary stones and provide information about the size of the bladder. However, not all types of stones are radiopaque, which is why an ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. examination of the urinary tract is also carried out. This enables the visualization of stones that cannot be detected radiologically, tissue changes and sediments in the bladder, as well as the assessment of the bladder wall thickness and possible kidney damage.

Laboratory tests are necessary to assess the severity of the systemic impairment:

Complete blood count and serumSerum is the liquid part of the blood that remains after coagulation. It does not contain blood cells or coagulation factors, but many other proteins, antibody and electrolytes. Serum is used in diagnostics for a variety of blood tests. biochemistry to assess kidney function (urea, creatinineCreatinine is a waste product that results from the breakdown of creatine, a chemical compound that provides energy in the muscles. The concentration of creatinine in the blood and urine is an important indicator of kidney function.) and electrolyte balanceThe electrolyte balance refers to the balance of electrolytes in the body, which is essential for many physiological processes. Disturbances in the electrolyte balance can lead to serious health problems. (especially potassiumPotassium is an essential mineral and electrolyte that is important for the function of nerves and muscles, including the heart muscle. Potassium also helps regulate fluid balance and blood pressure.)
Blood gas analysis to detect acid-base disorders
Urinalysis (if urine can be obtained) to determine the pH valueThe pH value is a measure of the acidity or alkalinity of an aqueous solution. It ranges from 0 to 14, with a pH value of 7 being considered neutral, values below 7 acidic, and values above 7 alkaline., density and to detect crystals, bacteria or inflammatory cells

In more complex cases or if tumorous changes are suspected, further diagnostic imagingDiagnostic imaging includes medical procedures that create images of the inside of the body to diagnose, monitor, or treat diseases and injuries. Examples include X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). procedures such as computed tomography or cystoscopyCystoscopy is a diagnostic procedure that uses a cystoscope, a thin tubular instrument with a camera, to directly view the bladder and urethra. It allows for the diagnosis of lower urinary tract conditions in dogs and cats, including Tumors, stones, and infections. may be indicated. If a bacterial infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease. is suspected, a urine culture with antibiogram is initiated.

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. must be made quickly, as the time until the start of therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is decisive for the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop.. A urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. always represents a life-threatening situation that requires immediate intervention.

Further veterinary measures

The only helpful therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. can only be carried out by a veterinarian.
It consists of a timely pressure relief of the bladder and the restoration of the patency of the urethra by means of catheterization, if necessary initially by a bladder puncture.
A bladder puncture means draining the urine via 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.
Your veterinarian will then clarify the cause of the urinary drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing. disorder by X-rayX-ray is an imaging technique that uses X-rays to create images of the inside of the body. It is often used to diagnose bone fractures, lung diseases, and other conditions. of the urinary tract. In some cases (e.g. in the case of Tumors), further diagnostic imagingDiagnostic imaging includes medical procedures that create images of the inside of the body to diagnose, monitor, or treat diseases and injuries. Examples include X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). such as ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. and computed tomography are also indicated.
Laboratory diagnostic tests provide information about the extent of the already occurred impairment of kidney function, the disturbance of the internal environment, the degree of intoxication / poisoningIntoxication / poisoning refers to poisoning caused by the intake of toxic substances. This can be caused by medications, drugs, chemicals, or other poisons and often requires medical treatment. 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, drug and surgical therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions..

Supplement

The treatment of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. requires a rapid and systematic approach and is divided into emergency measures and subsequent causal therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. The primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. goal is to restore urinary drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing. and stabilize the patient.

Emergency therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. begins with catheterization of the urethra under SedationSedation refers to the state of calming or suppressing the central nervous system with medication, which reduces anxiety and irritability and sometimes induces a light sleep. or general anesthesia. A sterile urinary catheter is carefully inserted into the urethra to overcome the Obstruktion and empty the bladder. In severe obstructions, a bladder puncture (cystocentesisCystocentesis is a medical procedure in which a needle is inserted through the abdominal wall into the urinary bladder to collect urine for diagnostic tests.) may be necessary initially to reduce the acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. pressure and obtain urine for diagnostic purposes. After successful catheterization, the bladder is rinsed several times with sterile saline solution to remove any remaining crystals, cell debris, or small stones.

Parallel to the restoration of urinary drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing., intensive medical stabilization of the patient is carried out by means of intravenous fluid therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. to correct dehydrationDehydration occurs when the body loses more fluid than it takes in. This can lead to a number of problems, including headaches, Dizziness, and in extreme cases, renal failure or Cardiovascular collapse. and electrolyte imbalances. Particular attention is paid to the normalization of the potassium level, as hyperkalemiaHyperkalemia refers to a potassium level in the blood that is too high. Potassium is essential for normal cell function, but an excess can lead to cardiac arrhythmia and other health problems. can lead to life-threatening Cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems.. Analgesics are administered for severe Pain, whereby non-steroidalNon-steroidal refers to medications or substances that are not steroids and often have anti-inflammatory, analgesic, or antipyretic effects. They are used in dogs and cats to treat Pain and Inflammatory conditions. anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. should be used with caution due to the potential kidney damage.

After initialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. stabilization, further therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. depends on the underlying cause:

In the case of urinary stones, a drug-based dissolution can be attempted depending on the type and location, or surgical removal may be necessary. Struvite stones can often be dissolved by special dietary measures and acidification of the urine, while calciumCalcium is a mineral that is essential for building and maintaining strong bones and teeth. It also plays a role in blood coagulation, nerve transmission, and muscle contraction. oxalate stones usually have to be removed surgically.

In felineFeline refers to anything related to cats. The term is used to describe diseases, behaviors, or anatomical aspects that are specific to cats. idiopathicIdiopathic refers to a condition or disease for which the cause is unknown. It is used when no clear external cause or underlying disease can be identified as an explanation for the symptoms. cystitis, anti-Inflammatory conditions drugs, painkillers and antispasmodics are used, supplemented by StressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. reduction and environmental enrichment. Antispasmodic drugs such as phenoxybenzamine or prazosin can promote relaxation of the urethral sphincter and improve urinary drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing..

In the case of bacterial infections, targeted antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is carried out, based on the result of the antibiogram. In the case of Tumors or high-grade stricturesStrictures are pathological narrowings of tubes or ducts in the body that impede the normal flow of fluids or other substances. In dogs and cats, strictures can occur in the urethra, esophagus, or bile ducts and require medical treatment., a surgical intervention may be necessary; in male cats with recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. obstructions, a perineal urethrostomy (surgical enlargement of the urethral opening) is frequently performed.

The urinary catheter usually remains in place for 24–48 hours to ensure continuous urinary drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing. and allow the inflamed urethra to heal. After removal of the catheter, close monitoring of the patient is necessary to detect a recurrence of the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. at an early stage.

Prognosis and aftercare

The prognosis for urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. depends largely on the time between the occurrence of the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. and the start of therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., as well as the underlying cause. With early treatment, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally good, although the recurrence / relapseA recurrence / relapse is the reappearance of a disease after a period of improvement or cure. Recurrences / relapses can occur frequently in chronic diseases or cancer. rate can be relatively high without appropriate aftercare and prophylaxisProphylaxis refers to preventive measures taken to avoid diseases or health problems. In veterinary medicine, this can include vaccinations, regular deworming, and other preventive treatments..

Animals that have already developed severe systemic complications such as renal failure, electrolyte imbalances, or cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems. have a more guarded prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop.. Studies show that approximately 15–20% of cats with urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. experience a recurrence / relapseA recurrence / relapse is the reappearance of a disease after a period of improvement or cure. Recurrences / relapses can occur frequently in chronic diseases or cancer. within six months if adequate preventive measures are not taken.

Aftercare begins immediately after discharge from inpatient treatment and includes several components:

Regular check-ups are recommended to monitor kidney function and detect early signs of re-obstruction. In the first few weeks after discharge, weekly check-ups should be carried out; later, the intervals can be extended if the course is good.

The change in diet is a central component of aftercare. Depending on the type of urinary stones, a special diet is prescribed to regulate the pH valueThe pH value is a measure of the acidity or alkalinity of an aqueous solution. It ranges from 0 to 14, with a pH value of 7 being considered neutral, values below 7 acidic, and values above 7 alkaline. of the urine and reduce the formation of crystals. In cats, a change from dry food to wet food is generally recommended to increase water intake and thus dilute the urine. Special diets such as Hill’s s/d or Royal Canin Urinary S/O may be indicated for certain types of stones.

Increasing water intake is another important aspect of aftercare. This can be achieved through drinking fountains, multipleMultiple means manifold or repeated and is used to describe conditions or events that occur in multiple instances or at different locations. In veterinary medicine, this may indicate multiple lesions, tumors, or other pathological changes. water bowls in the household, or adding water to the food. Increased water intake leads to diluted urine, which reduces the risk of crystal and stone formation.

In cats with FelineFeline refers to anything related to cats. The term is used to describe diseases, behaviors, or anatomical aspects that are specific to cats. IdiopathicIdiopathic refers to a condition or disease for which the cause is unknown. It is used when no clear external cause or underlying disease can be identified as an explanation for the symptoms. Cystitis, stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. reduction plays a crucial role. Measures such as providing sufficient opportunities for retreat, multipleMultiple means manifold or repeated and is used to describe conditions or events that occur in multiple instances or at different locations. In veterinary medicine, this may indicate multiple lesions, tumors, or other pathological changes. litter boxes, and regular play sessions can help reduce the risk of recurrence / relapseA recurrence / relapse is the reappearance of a disease after a period of improvement or cure. Recurrences / relapses can occur frequently in chronic diseases or cancer..

In some cases, long-term drug therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. may be necessary. Urine-acidifying preparations may be indicated for struvite stones, while long-term antibiotics may be considered for recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. bacterial infections. In cats with functional obstructions, antispasmodics such as phenoxybenzamine can be used long-term.

Monitoring urination behavior by the owner is an important part of aftercare. Pet owners should be trained to look for signs such as frequent visits to the litter box, expressions of Pain when urinating, or changes in the amount of urine, and to seek veterinary advice immediately if they notice any abnormalities.

Summary

Urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. (urethral obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.) is a life-threatening emergency in canineCanine refers to anything related to dogs. The term is used to describe characteristics, diseases, or specific aspects that specifically affect dogs. and cats that requires immediate veterinary action. Male animals, especially male cats, are significantly more frequently affected due to their anatomically narrower and longer urethra. The obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. can be caused by various causes such as urinary stones, crystals, inflammatory processes or tumors.

Characteristic symptoms are repeated, unsuccessful attempts to urinate, Pain when urinating, frequent Licking in the genital area, and a full, painful bladder. As the obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. progresses, systemic complications such as renal failure, electrolyte imbalances, and metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders. develop, which can lead to Death if left untreated.

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is made by clinical examination, imaging techniques such as X-ray and ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow., and laboratory tests of blood and urine. Emergency therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. includes catheterization of the urethra to restore urine flow, bladder irrigation, and stabilization of the patient with infusion therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. and Pain medication.

Long-term therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. depends on the underlying cause and may include dietary measures, drug treatments, or surgical interventions. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally good with early treatment, although there is an increased risk of recurrence / relapseA recurrence / relapse is the reappearance of a disease after a period of improvement or cure. Recurrences / relapses can occur frequently in chronic diseases or cancer. without adequate aftercare.

Aftercare includes regular check-ups, dietary changes, increased water intake, stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. reduction in cats, and, if necessary, long-term drug therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. Consistent implementation of these measures can significantly reduce the risk of renewed obstructions.

Outlook on current research

Research in the field of urinary tract obstructions in small animals is constantly evolving, with the aim of improving diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients., therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., and preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring.. Current research focuses on several promising areas.

In diagnostics, molecular biological methods are increasingly being researched to enable a more precise identification of the underlying causes. Biomarkers in the urine could in the future provide early indications of inflammatory processes or the onset of crystal formation before clinical manifestation occurs. New imaging techniques such as high-resolution micro-CT scans enable a more detailed representation of the urinary tract and can be particularly helpful in characterizing complex urinary stones.

In the field of therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., research is focused on minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. procedures for stone removal. Laser-assisted lithotripsy procedures are continuously being developed and enable the fragmentation of urinary stones without surgical intervention. Endoscopic techniques are being refined to be applicable even in smaller patients and to minimize traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries. to the urinary tract.

Another research focus is in the field of drug therapy. New substances for the targeted dissolution of various types of stones are being developed, and the effectiveness of antispasmodics and anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. is being evaluated in clinical studies. Particular attention is paid to the development of drugs with fewer side effects on the kidneys and gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract.

Research into FelineFeline refers to anything related to cats. The term is used to describe diseases, behaviors, or anatomical aspects that are specific to cats. IdiopathicIdiopathic refers to a condition or disease for which the cause is unknown. It is used when no clear external cause or underlying disease can be identified as an explanation for the symptoms. Cystitis (FIC) as a common cause of urinary tract obstructions in cats has made significant progress in recent years. Understanding the neuroendocrine mechanisms and the role of chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. in the development of this disease has led to new therapeutic approaches that go beyond pure symptom treatment. Studies on the effectiveness of pheromones, dietary supplements such as L-tryptophan and omega-3 fatty acids, and behavioral modification measures show promising results.

In the field of preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring., new dietary concepts are being researched that are specifically aimed at preventing various types of stones. The focus is on the development of animal feed with optimized mineral content, adapted pH valueThe pH value is a measure of the acidity or alkalinity of an aqueous solution. It ranges from 0 to 14, with a pH value of 7 being considered neutral, values below 7 acidic, and values above 7 alkaline., and increased palatability. In addition, probiotics are being investigated for their ability to protect the urothelium and make it more difficult for pathogenic bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. to attach.

The integration of digital technologies into the management of patients with urinary tract problems represents an innovative area of research. Smart drinking fountains with flow measurement, electronic litter boxes for monitoring urination behavior, and smartphone apps for documenting symptoms could enable early intervention in the future and improve communication between pet owners and veterinarians.

Frequently asked questions (FAQs)

Why are male cats particularly susceptible to urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
Male cats have a significantly longer and narrower urethra than female animals, especially in the area of the penis. This anatomical feature predisposes them to obstructions by crystals, stones or inflammatory material.
What role does nutrition play in the development of urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
Nutrition significantly influences the pH valueThe pH value is a measure of the acidity or alkalinity of an aqueous solution. It ranges from 0 to 14, with a pH value of 7 being considered neutral, values below 7 acidic, and values above 7 alkaline. of the urine as well as the concentration of minerals that can contribute to crystal and stone formation. Dry food leads to more concentrated urine and thus increases the risk of urethral obstructions, especially in cats.
How can I, as a pet owner, recognize urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. early?
Pay attention to frequent, unsuccessful attempts to urinate, expressions of Pain during urination, Licking in the genital area and urination in unusual places. In cats, avoiding the litter box can also be a warning sign.
Can a urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. resolve on its own without veterinary assistance?
No, a urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment. is an acute Emergency that always requires veterinary treatment. Without therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., life-threatening complications occur within 24–48 hours, eventually leading to the Death of the animal.
How can I prevent a relapse after surviving a urethral obstruction?
Preventive measures include switching to wet food, increasing water intake, regular veterinary check-ups, Stress reduction and, if necessary, special diets depending on the type of urinary stones that have occurred.
Is surgery always necessary for a urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
Not in every case. Many obstructions can be resolved by catheterization and flushing of the bladder. Surgery (perineal urethrostomy) is usually only considered for recurring obstructions or certain underlying diseases.
How long does recovery take after a urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
The acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. phase of treatment usually lasts 2–5 days. However, complete recovery, especially of kidney function, can take several weeks depending on the severity of the disease.
Can young animals also suffer from urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
Yes, although the disease is more common in middle-aged animals (4–10 years), younger animals can also be affected, especially if there are genetic predispositions or anatomical peculiarities.
Which breeds are particularly susceptible to urinary tract obstructions?
In cats, Persian cats and other long-haired breeds, as well as overweight animals, are more frequently affected. In dogs, certain breeds show predispositions for specific types of stones: Dalmatians for urateUrate refers to salts of uric acid that are excreted in urine. In dogs and cats, high urate concentrations can lead to the formation of urate stones in the urinary tract, especially in certain breeds or dietary conditions. stones, Schnauzers for cystine stones, and small breeds generally for calciumCalcium is a mineral that is essential for building and maintaining strong bones and teeth. It also plays a role in blood coagulation, nerve transmission, and muscle contraction. oxalate stones.
Can StressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. triggerA trigger is a stimulus that elicits a specific reaction or state. In veterinary medicine, this can refer to emotional responses, such as fear or aggression, or medical conditions, such as seizures in dogs and cats. a urinary tract obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.?
Yes, especially in cats, StressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. plays a significant role in the development of felineFeline refers to anything related to cats. The term is used to describe diseases, behaviors, or anatomical aspects that are specific to cats. idiopathicIdiopathic refers to a condition or disease for which the cause is unknown. It is used when no clear external cause or underlying disease can be identified as an explanation for the symptoms. cystitis, which can lead to Inflammatory conditions and eventually to obstructionobstruction refers to the blockage or narrowing of a hollow organ or canal, which hinders the normal flow of liquids or gases. In dogs and cats, an obstruction can occur in the digestive tract, airways, or urinary tract and often requires immediate medical treatment.. Relocations, new pets or changes in the household can be triggers.

Literature

https://www.thieme.de/viamedici/klinik-faecher-notfallmedizin-1539/a/harnverhalt-4185.htm
Westropp JL, Buffington CAT. Lower urinary tract disorders in cats. In: Ettinger SJ, Feldman EC, Côté E, editors. Textbook of Veterinary Internal Medicine. 8th ed. St. Louis: Elsevier; 2022. p. 2005-2016.
Berent AC, Weisse CW. Urethral obstructions: current approaches to diagnosis and treatment. Veterinary Clinics of North America: Small Animal Practice. 2021;51(4):917-936.
Kopecny L, Palm CA, Drobatz KJ, Balsa IM, Culp WTN. Risk factors for urethral obstruction recurrence in cats. Journal of the American Veterinary Medical Association. 2019;255(12):1350-1356.
Segev G, Livne H, Ranen E, Lavy E. Urethral obstruction in cats: predisposing factors, clinical, clinicopathological characteristics and prognosis. Journal of Feline Medicine and Surgery. 2020;22(2):153-159.