Male cat with sever urinary blockage and renal failure/toxicity.... survival a possibility?

The love of my life just got rushed to the hospital for sever depression and vomiting (only symptoms that he was not well). He vomited on me in the middle of the night and we got up hadn't seen anything thing else so we left for a couple hours and when we got back he was so lethargic he wouldn't move so I took him in. Immodestly he said his bladed was the size of a grapefruit, which he said was huge. He said normally the size of a hard peach or small apple. He said at that big with no urine output he is likely toxic and his kidneys have **** down and that's what caused the vomiting. The fact that he stopped vomiting for a few hours was a bad sign and that perhaps he was very late stages of renal failure.

He had no classic signs. No inappropriate use of the box. No straining. No frequent urination or drinking. Nothing. Just the vomiting, and in a matter of hours compete depression.

He's at the office for diagnostics - blood work to check kidneys, x-rays to check for large visible stones, and placing a urinary catheter and IV for fluid support. I'll know more about the damage to the kidneys in a couple hours.

My question... which such a sever blockage, and kidney failure, do they turn around? Is survival a likeliness? I'll die if he goes. I love this cat so much. I've raised him from a baby at 8 days old, lost all his siblings. He is so special to me.

Any input is highly appreciated.

Thanks.

How awful!

It's impossible to say at the point he is at now, until more info from bloodwork and the extent of damage done.

This is a VERY serious illness in males due to the blockage aspect, causing toxicity in his system like this.

It may have been caught in the nick of time, but he also may have too much damage done to turn him around.

PLEASE let us know as soon as you do how things are going and his lab results.

Sending vibes!     

They are working on him now. It's absolute agony waiting for them to call. I wasn't allowed to stay (even tho I used to work there... he said I was too emotional and would get in the way.... which I get).

Sigh. [emoji]128553[/emoji]

That's in the crate on the way to the vet. Normally he yowels and makes a fuss. Notice the head down and eyes shut? Breaks my heart.

Yes, he is very ill.

Oh I couldn't stand to be in your shoes, it's unthinkable for me to lose my girls, Krissy (avatar pic) is my love.

Got her the day she was born.

She is the reason for all of the rescues I have done, every single cat and kitten saved by me is because of her.

All the ferals I have tnr'd and cared for their entire lives, starting a cat rescue group, becoming a humane society board member to speak for the cats, turning my life into cat world!

All for the love of my special little angel who fell from the skies to bring me smiles in my unhappy life.

She is 12 now and suddenly I am dealing with something wrong too, but they aren't sure just what.

Ultrasound Thursday.

Even that anticipation is hard for me!! Just shared so you know I DO understand!

I can't imagine what you are going through now.

Hang in there, stay posting with any updates at all!

I just can't believe how fast he went from vomiting (not always a big concern but I always monitor it), to being almost unresponsive. They are such stoic creatures that he must have been in a tremendous amount of pain before showing it.

They vet said they often hide cause of the pain and he didn't. The fact that he vommittted ON me in the middle of the night means he was with me. And the fact that he tried peeing in the box every single time... such a good boy.

I wish they'd hurry up and call!!!!

Try calling them, ask if there is any news, you are beside yourself,  something like that.

There might be at least SOMETHING...

I called about 45 minutes ago and they said their phone lines went down briefly and that he was going to start making calls any moment. Shouldn't be long now.

It's taking forever!

I'm sorry to hear about your baby. Mine just went through the same thing but luckily I caught it early I just happened to see him go with nothing coming out. He also vomited after he tried to go. That was it for signs. The blood work is the key but I have heard of bad cases recovering. They always give you the worse case scenario. Mine had close to normal blood work with irritation shown of the kidneys. We are on week number 3 and he is only now back to peeing close to normal. The catheter will stay in and the key also is what happens after it is removed. Some stay unblocked some block again. Keep us posted and we will all chime in to help you navigate through this. I will tell you if you can have your baby seen by a cat specialist more of your questions can be answered by the vet. I had to do that because my regular vet mostly dogs and there were some questions he couldn't answer. Keep up hope and keep us posted.

I'm so sorry to hear of your boys problems! Yes he looks very ill in the carrier. I hope that you have managed to get him to the vet soon enough. My boy went through something similar and I was told his kidneys were possibly shutting down .We had bloodwork and it showed his kidneys are fine even though he was very ill. Fingers crossed that it's all okay and that he will recover!

So I called the clinic 5 minutes before they closed and the front desk girl told me they'd be there for a while as they still had other emergencies they were working on but the doctor would call in 15-20 minutes. I laid on the bed and basically cried myself to sleep until I woke up in a panic at 7 thinking I missed the call. Still no call. I was PO'd! I emailed the doc and told him I was so upset I didn't call before the clinic closed and that I'd now have to worry about him all night, and then at 8:30 I got a call!!

So... he had a complete obstruction (as opposed to a partial obstruction), but we kinda knew that from the size of his bladder when I brought him in). And apparently he didn't read the symptom handbook so we could catch it early. Only until he started barfing on me in the middle of the night did I even think something might be wrong. No frequent or inappropriate urination, no excessive drinking, no hiding in pain... nothing like that.

Anyway, they stayed till 8:30 getting him stable and said they'd wait a little while longer before leaving. He said he was going to stay and do paperwork as opposed to taking it home. That made me feel good. They sedated him and took blood, did an x-ray, got the IV cath in, and went to work getting the urinary cath in. He said they had a hard time doing that because he was SO plugged. And when they finally got the bladder to drain he said it was an obscene amount. He told me what a normal amount is what they got out, but I can't remembe so I'll ask again tomorrow and update cause I'd like to know too.

The x-rays were good, no visible stones (which means no surgery!), however is blood work was very poor. He's really toxic - poor kidney function, high urites (I think is the word he used for the toxins from the urine build up?), and elevated potassium. He didn't think the potassium was high enough to worry about cardiac arrest because I asked if I should either bring him home for the night or transfer to an ER clinic, and he seemed comfortable leaving him there for the night (and he's usually pretty conservative so I trust that) but he's optimistic that with the bladder draining into a closed collection system that they can push the fluids and clean him out and his kidneys will start functioning again.

He's also worried that with as much as his bladder stretched that he may have issues with it being flaccid which can cause issues when they take the cath out and they start urinating on their own, so they have him on muscle relaxants and pain meds so things can completely rest and go back to normal.

He said normally they leave the cath in for 48 hours, but with the stretching they want to aim for 3 days because he said if the bladder and muscles are stretched and fatigued and he urinates and can't contract and empty the urethra completely that it puts him at a higher risk of becoming blocked again. So 3 days with cath and one day of monitoring his own ruination puts him there for 4 days, provided his kidneys improve.

With the bladder empty and on fluids they are going to see how much urine he has produced and repeat blood work in the morning. The goal is for the fluids going in to match the fluids going out, cause that will indicate functioning kidneys. He also wants to monitor the potassium because as long as kidney function is poor it has the chance of going up and causing cardiac issues.

So with the blockage gone and no stones, now where're dealing with the toxicity issues.

I just have to say that I am SHOCKED he was so sick and that I didn't notice it earlier. I swear, he vomitted on me around 3 in the morning and by noon the following day he was lifeless. I feel terrible for not catching it sooner, and I consider myself a pretty experienced pet owner. I'm just shell shocked right now, but so glad he doesn't need surgery.

Oh, poor baby! I feel for you as my boy had a blockage a little over a year ago. He has been fine since, and I hope the outcome for your kitty will be the same! It took my guy probably a couple weeks after he got home from the hospital before he seemed back to normal. When yours gets back home, just be sure to watch him like a hawk, and if like me you don't use scoopable litter normally, get some and use it for a few months so it's easy to monitor his urine output. He won't put out much the first few days, but make sure he's at least putting out some. It should get a little more each day until it's a normal amount. Best of luck!

I have 3 cats (5 actually but the other two live in our office/shop now) and they all share boxes, so I'm going to have to separate him so I can be sure that what I'm seeing is actually his. Plus he's going to need special food for a week or two, and then different food for the indefinite future now that he's prone. That won't be an issue because I'm going to put everyone on a urinary diet to prevent this with anyone else.

Meant to add that I'm open to suggestions on food brands. He'll go home with stuff from the
Vet (can't remember the name), but for long term preventative food, I'd like to hear what everyone else has been successful with.

Thanks for all the kind words. This forum rocks!

Poor boy (and poor bladder, too)! Just goes to show how good cats are at hiding pain and discomfort. It sounds like he is in good hands and exactly where he needs to be right now.

Sending lots of vibes for a full recovery! 

As far as food suggestions go, well, I'm sure you'll get a lot of different answers. In my opinion, I think a good place to start is with an all-wet diet. The mods may wish for you to start a new thread about diet in Cat Nutrition.

I want to say WHAT A RELIEF!! 

Although he is not in the clear by no means, it sounds quite hopeful, I am feeling optimistic that he will make a fine recovery.

Stop feeling guilty, you acted as soon as you knew something was going on, it happened fast, and of course as we all know too well, they are fab at hiding issues until it's advanced. 

It's the way nature dictates, to keep themselves safe from being targeted as prey.

My thoughts are with you tonight! Please keep us posted on any/all updates

Yes, my boy is on prescription food for life since he had crystal problems twice, both times on super high quality grain free foods (canned). Hill's Prescription has two levels for feline urinary health. Their s/d food has methionine *and* extra salt (to encourage water intake), and their c/d according to my vet is the same thing but without the extra salt and is more of a maintenance food for urinary trouble kitties. Quincy was on the s/d for a month when he got out of the hospital, then switched to c/d (both canned). I've never tried Royal Canin, but I know the concept of their S/O food is similar to Hill's c/d--salt and methionine. I don't believe they have an equivalent to the c/d. I did not like the idea of prolonged high sodium, so even if my vet had offered me the choice of Hill's or Royal Canin I would've stuck with Hill's. And as much as I'd like to put him back on the nice 95% meat, grain free high end stuff, I'm not willing to risk another blockage.

They can go toxic very quickly. I lost my dog to acute kidney failure. He stopped eating but had no vomiting or any other signs. it wasn't unusual for him to skip a meal. I didn't realize how bad he was and was devastated when I had to put him down.

I rant on here a lot about pet food. Most cat foods are not balanced for urinary health. The high protein diets are not enough to prevent crystals. Putting your cat on a high protein grain free wet food diet (which everyone seems to recommend) is not always enough to prevent Crystal formation.

Methionine (the urinary acidifier) is an essential ingredient for cats. Some cat food companies do not bother to supplement additional methionine and only contain what is in the meat. The problem with this is that methionine varies by species (lamb vs chicken). It also varies depending on the meat source (thighs vs breast meat vs byproduct). So each company's cat food has different levels.

Most companies do not have enough methionine in the food which leads to alkaline urine and struvite formation. I've found the same problem with raw as there are many different recipes which all contain different amounts of methionine in the meat.

I know for my own cat with urinary issue s not even a raw diet will prevent struvite formation.
He has to have additional methionine added.

My point here is that the only way to prevent this problem is by routine urinalysis. If you change cat foods get a urinalysis done after a week on the new food. Or get ph strips and test the urine yourself. My cats urine goes up to a ph of 8 on most foods!

This problem is deadly. How many cats get put down every year for urinary problems?

A high protein wet food diet may help prevent the disease but urinary ph is important too. Once that ph gets to an 7 to 8 you are in trouble and crystals will form regardless of how much water the cat drinks or how low the food is in magnesium.

I try to tell all cat owners to get a urinalysis done routinely as it is much better than paying $600+ to try and save their sick cat.

I do not blame you, as this is the fault of the cat food companies. If my own cat had not struggled so much I would not have researched this so extensively.

Thanks for info. When I first brought him and we talked very briefly about food he said that they have one that's higher in salt to encourage drinking, and then they switch a week or two later so they don't have the high salt forever. That sounds similar to what you were talking about.

You said you add methionine additionally; is that a supplement? Where do you get it?

Also, he said he never found stones/crystals on the x-ray, nor in the urethra or penis, just that it's plugged.

He explained it like this: sometimes they can have a mild urinary tract infection or inflammation (sometimes from bacteria, or sometimes from *small* crystals) and then the body sends white blood cells to fight it, which can thicken the urine and cause a partial blockage and cause urine to back up, and then as urine backs up the body once again tries to fight it and it's a vicious cycle of the body causing a problem while trying to fix a problem.

I got the impression from talking to him that this wasn't necessarily a crystal/stone issue, but rather a snowball affect of problems. Does that make sense or even sound like a possibility?

I have so many questions. I was so flustered and upset that I forgot everything. Now that I'm calmed down and feel more optimistic I'll be in a better place to have a real conversation with him.