Urethral Blockage in males

[roses230]

Hi, I just joined today to ask for opinions on my cat's situation. I've been reading a few others' threads but it's really an individual issue. My 2 year old male cat was diagnosed with a urinary tract infection about 3 weeks ago, was given clavamox for 1 week and onsior for 5 days. He seemed completely normal and healthy after treatment until this morning, when he would hiss and cry when picked up, refused to eat at all, and would only lay in one spot with his leg slightly lifted.

I took him to the vet shortly after noticing and they said he was blocked, which is exactly what I was worried about. His bladder was described as the size of a baseball, which even I could notice when feeling his stomach. They sedated and catheterized him around 2 pm and kept him until 6:30 to keep flushing his system. As they brought him in and were going to show me how to take care of the indwelling catheter, it came out. Vet did something then, I think clipped the sutures that were supposed to hold the catheter, and sent him home with another week of clavamox and 3 days of onsior. They did not do any bloodwork, radiology, or urinalysis. I am supposed to take him back in tomorrow morning, initially for another round of flushing, but now I think just for iv fluids? The vet was rather vague and seemed like she wanted us to just go on. He has eaten since he's been home, but has yet to urinate. When we left the vet he was completely empty, it is now 11 pm. Should he have gone by now?

The vet also prescribed him RC urinary so wet food to prevent reobstruction. This stuff is ridiculously expensive, I bought him some, but does it actually help? He was being fed raw per the recipe on catinfo.org for the past few months. I am concerned that he has too much calcium which is causing the blockage, either due to this food or a switch from filtered water to regular tap (filter broke, not replaced yet).

Sorry for long winded explanation, but I really don't want this to reoccur. How quickly can stones or crystals form after a diet change, or water change? Does he have a greater chance of becoming reobstructed since his catheter was removed prematurely? Thanks in advance for any advice.

 

[denice]

The whole thing with diet is really individual to the kitty because there are a number of things that could cause this.  I am concerned about the treatment the vet gave.  Normally the catheter needs to stay  in longer and once removed the kitty stays at the clinic until they urinate on their own.  I would probably be thinking about switching vets.

 

[roses230]

This isn't our normal vet, they didn't have any appointments for over a week during his last issue, so I also used them this time as they could see him same day with the regular non emergency fees. As for the catheter, they fully meant to keep it in, but it slipped out I guess, and it was decided to keep it out and see how it went.

He did finally urinate last night while I was asleep, a 3 in clump which is good. I took him back in this morning so he could stay under observation at the vet. They basically just hooked him up to iv fluids and watched for his urination. He ate and peed on his own while he was there, and they said he's good to just keep home unless something changes. He also has a follow up next Thursday. He loves the prescription food at least, so I hope that helps prevent a reblocking.

 

[roses230]

I guess there's less users here that have had this experience than I thought :/

 

[mschauer]

The vet also prescribed him RC urinary so wet food to prevent reobstruction. This stuff is ridiculously expensive, I bought him some, but does it actually help? He was being fed raw per the recipe on catinfo.org for the past few months. I am concerned that he has too much calcium which is causing the blockage, either due to this food or a switch from filtered water to regular tap (filter broke, not replaced yet).

Sorry for long winded explanation, but I really don't want this to reoccur. How quickly can stones or crystals form after a diet change, or water change? Does he have a greater chance of becoming reobstructed since his catheter was removed prematurely? Thanks in advance for any advice.

In my opinion a diet change is absolutely essential to prevent him blocking again. The change should be to increase his moisture intake and to keep the urine pH at the proper level. Both will help to prevent urinary blocking crystals from forming. No dry food is a must.

Prescription diets are formulated to prevent crystals from forming. Some people have successfully prevented recurrence of  the crystals by switching to selected non-prescription diets. In my opinion this is a risky path to take. A given non-prescription food as formulated today may prevent crystals but the formulation of that food could change at any time and the new formulation may not prevent crystals. I believe there are non-prescription foods on the market today that claim to promote urinary health but I don't know that I would trust them.

Was he eating the raw diet exclusively or in conjunction with something else? I ask because an exclusively raw diet, made with animal parts only and no grains or vegetables should both provide enough moisture and keep the urine pH in a range to prevent crystals from forming. But, I have heard before of a cat that was on an exclusively raw, animal ingredients only diet that still developed struvite crystals. My Jeta is prone to struvite crystals and switching to an all raw diet has prevented any reoccurance for the past 7 years.

Calcium isn't a component of struvite crystals so I wouldn't a diet high in calcium would be a problem.

Knowing how painful the crystals are and how dangerous they are to a male cat, again in my opinion, there are only 2 choices: a prescription diet or a raw diet.

 

[roses230]

Thank you for all the information in your response. He and our other 2 cats were being fed exclusively raw for a few months now, after being switched from the cheapest cheap dry food. They seem to thrive on it and it's more cost effective for me because I can get the meat at a good price. I'm concerned about the raw because currently I don't have a meat grinder, and have been using bone meal as suggested for an alternative. I believe that the meat/calcium ratio is off and that purchasing a more accurate scale and checking the ratio would be the solution. Of course I'm also looking into getting the grinder because it will make all our lives easier.

I plan to keep him and our other male on the Urinary SO for at least a few months, until I'm sure he's healthy and also that the raw recipe is perfect. The vet didn't say whether it was oxalate or struvite that caused his blockage, but I have a very strong gut feeling that it is from too much bone meal/calcium in the raw. Of course I may be so wrong, which is why I'm still using the Royal canin for now.

He's doing really well today, eating like before and urinating ok. He goes to the box slightly more often but the clumps are decent sized, and he doesn't spend a lot of time there. His activity level is also back to normal. Luckily he loves the new food, so I haven't had any issues with that.

 

[mschauer]

 The vet didn't say whether it was oxalate or struvite that caused his blockage, but I have a very strong gut feeling that it is from too much bone meal/calcium in the raw. Of course I may be so wrong, which is why I'm still using the Royal canin for now.

It would have to be struvite. Oxalate crystals have to be surgically removed. Struvite crystals will dissolve in the urine as long as it is acidic enough. 

I have posted recipes that have the correct calcium amounts in the raw feeding forum:

http://www.thecatsite.com/t/272287/raw-recipe-thread

If you click on the link that is below the recipe I post you will find a directory of recipes including a complete nutritional analysis.

It's very concerning that he blocked even when on a raw diet. I've also heard of cats that blocked even when on a prescription diet. It seems some cats are prone to them regardless of diet. You might want to talk to your vet about adding an acidifying agent to his food. I don't know much about them but I know they can be tricky because they can make the urine too acidic which is when oxalate crystals form.

You might want to get some pH test strips so you can test his urine at home.  

 

[mschauer]

I just discovered something that might make your theory about the bonemeal in the raw food you fed being the culprit make sense. There is a fair amount of magnesium in bone and magnesium is a component of struvite crystals. In fact the prescription diets, in addition to the other things I mentioned, also are usually formulated to be low in magnesium. 

 

[roses230]

Well I thought it had been longer, but I just wanted to update here. I took out the bone meal entirely from their food, turns out my food processor can puree bones better than it can meat, so they have whole bone now. I blend a can of Nimm's prescription food in with it, but he seems to be doing very well since his blockage. He still has smaller clumps than the others, but he does seem to go more frequently too.