Pet Problems: Dealing with Urinary Blockage in Male Cats

My cat can't pee! Learn how to recognize this life-threatening condition that occurs in male cats.

Urinary blockage, or urethral obstruction as it is officially known, is a common emergency that see over the course of a weekend... I literally had another 3 cats being treated for this once again on Saturday and Sunday. Three little kitties with three little catheters...  

What is it?

Urinary blockage is almost exclusively a problem reserved for male cats, and occurs when the urethra becomes obstructed. The urethra is the “tube” that drains urine from the bladder out of the penis, and in males, it is very long and narrow. I usually describe to owners the difference between male and female urethras by using the example of McDonald’s straws… the female urethra is like a milkshake straw, while the male urethra is like a coffee stirrer. It gives the mental visual of just how much smaller of an opening male cats have, predisposing them to obstruction.

Obstructions are often the result of plugs of inflammatory material (such as white blood cells and mucus), as well as crystals or small bladder stones. All of this bladder “schmutz” conglomerates into a plug, lodges itself into the urethra, and blocks the exit for urine. When the urethra is completely blocked, and the cat has filled his bladder to capacity, his kidneys stop making urine as there is nowhere for it to go. With kidney “shut down” the body is no longer able to remove toxins from the blood or maintain a proper balance of fluids and electrolytes in the body, resulting in kidney failure and eventually death.

What are the clinical signs that an obstruction is occurring?

Most affected cats are 1 to 10 years of age. Initially cats may show signs of urinary tract inflammation, such as straining to urinate, frequent urination, blood in the urine, painful urination, or inappropriate urination (urinating somewhere other than the litter box). Once the cat becomes obstructed (“blocked”), they may attempt to urinate in the litter box but will produce only drops of urine or no urine at all. They may cry, move restlessly, or hide because of discomfort. Eventually they will lose their appetites, generally begin to vomit, and become lethargic. Complete obstruction can cause kidney failure in as little as 24 hours, and potentially death in as little as 48 hours. This is an easy diagnosis for your veterinarian to make because a cat with a urethral obstruction will have a very large, firm, and painful bladder that is easily felt in the back half of the belly on physical exam.

What tests are indicated?

Blood work is evaluated to check kidney function and to determine if there is any evidence of other systemic imbalances. The urinary toxins that build up can commonly cause life-threatening heart rhythm disturbances and an ECG may be needed. A urine sample is evaluated for crystals and may be sent in for culture. Radiographs of the belly are taken to see if calculi (stones) or other material are present in the kidneys or bladder.

What is the treatment?

Cats that have urinary obstruction require immediate emergency treatment and stabilization. Your veterinarian will need to anesthetize your cat to allow for placement of a urinary catheter into the urethra to flush out the plug or force the stone into the bladder. The bladder is then flushed through the catheter to remove as much urine sediment (“schmutz”) as possible. The urinary catheter is sewn in, with a urine collection system attached, and generally left in place for 48 hours to allow for inflammation in the urethra to settle down. After 48 hours, it is then removed, and the cat is monitored for an additional 24 hours to make sure that he doesn’t “re-block,” which is possible. During this 72-hour time frame, your kitty is placed on intravenous fluids so that it will urinate frequently, essentially helping to “flush out” the bladder and "clear the toxins." Medications to address pain, urethral spasms, and possible infection are generally used.

Once urine flow returns, the kidneys quickly begin to correct the metabolic disasters that have been taking place ("Ahhhhhh"). Often an extremely sick blocked cat can be snatched literally from the jaws of death by having proper fluid support and by re-establishing urine production. It is amazing how efficient the working kidneys can be in restoring the body’s balance!

Once the cat is no longer obstructed, management is the same as for any other cat with feline idiopathic cystitis that is not obstructed.

What is the prognosis?

Prognosis for recovery is often excellent if treated appropriately and in time. If sudden kidney failure does develop as a result of the obstruction, it is generally reversible and will get “back in check” with IV fluid therapy support. The biggest concern, however, is the potential to re-obstruct. For cats that have 2 or 3 recurrences of obstruction, your veterinarian will recommend a surgical correction of the problem with a PU (perineal urethrostomy) surgery. This procedure can be likened to a “sex change” in your male cat, and it involves the surgical widening of the urethra to make it more the size of a female urethra.

It is crucial to realize that the cat is at risk for re-blocking for a good week or two from the time of discharge. This is because the irritation syndrome that led to blocking in the first place is still continuing, and as long as the episode continues, blocking is a possibility.

Urethral obstruction is a true medical emergency, and any cat suspected of suffering from this condition needs to receive immediate veterinary evaluation and care.  

Questions? Comments? Topic ideas? Let me know!  

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Shane Murphrey June 01, 2013 at 01:04 AM
just wanted to say thanks a lot for this blog post! my much beloved mojo started acting funny late in the night and by 4am was a very unhappy little cat... i had suspected this was the problem, but after reading your blog i was certain... managed to find a 24hour vet here in taipei and the entire event played out exactly as you described... thanks for the great info! fingers crossed mojo doesnt need the surgery! thanks again
Marcella June 20, 2013 at 01:40 PM
My male cat had a blockage and had the PU done. He has had 5 catheters since then as they have fallen out or been ripped out because of the cone around his neck. When the vet takes out the catheter, my cat is in physical pain because he cannot urinate. I am at my wits end. Is there anything else that can be done? I feel this is being inhumane having him in a cage when the catheter is in and having him in pain when it is not. Please help.
Jason Michael Lees July 05, 2013 at 10:42 PM
I just lost my cat to this as I didn't think his symptoms could indicate ANYTHING NEARLY THIS SERIOUS!! :( He was moaning and laying around in weird places, mouth sometimes half-open. Only after reading stuff like this did I realize he was TRYING to urinate (but couldn't) on my backpack, my jacket...anywhere he could. He was squatting, but nothing was coming out, which I was unknowingly GLAD OF at the time. I went to work and talked to other cat owners about it. One said it could be "just a hairball" but all said to "keep an eye on him". When I went home later that nite, he was passed away on my floor <:'( The earliest I remember noticing symptoms was on a Wed morning, and he was deceased by Thurs evening. Unbelievable :( Miss u Sunny!!! https://www.facebook.com/jason.m.lees/media_set?set=a.10152476155571531.1073741829.645851530&type=1
Natasha Eiler August 09, 2013 at 03:44 AM
We just lost our baby boy to this this afternoon. First male cat I've ever owned. He was acting a little strange last night but didn't think anything of it. He started having seizures this afternoon and died just as they brought him through the doors at the vet.
Nicole August 11, 2013 at 12:53 PM
There is an incredibly easy solution for the urinary blockages in male cats - eliminate foods containing ash, by-products, fillers, and grains. Two of my males had PU operations and were being fed Science Diet and Royal Canin prescription foods yet they continued to develop crystals that were difficult, extremely painful, and often times impossible to pass. I switched them to a holistic diet of strictly canned foods and they have never had another blockage. If I'm out of town and they have to eat dry food, I have my pet sitter give them Methioform twice daily to acidify their urine which prevents the formation of crystals. I swear this works!!! We were spending nearly $15,000 annually on vet bills due to 4 male cats with urinary blockages and infections. Since changing their diet, none of them have been back to the vet for any sort of urinary/urethral malady. I understand that many pet owners complain that natural, holistic, grain-free foods are expensive but I believe that my babies' lives are worth it.
Farina Mir September 18, 2013 at 02:57 PM
I lost my 5 year male cat "Robbin" . His urine was blocked . He was unable to urine himself for 10 days. Vet was ejecting it manually.In 10 days he was given anthesia 3 times. First time there were white crystal in his urine. However afterwards urine was cleared. He was given medicine/injection . On death day he had dark brown vomit in morning. I gave him liquid . But in afternoon he passed away. My whole family is upset. Its really so painful.
Loueez Forrest October 24, 2013 at 10:28 AM
This has helped me understand all the wierd things Leo was getting up to! My mum just kept saying 'he will be fine' but I just knew he had to go to the vets! He's there now and the vet has said if we'd of left him any longer he would'nt of made it, just hope he pulls through this and i can get my little cherub back on track. He's only 3 and I am in no fit state to let him go any time soon!!
Laura Sheffield October 29, 2013 at 06:58 PM
My cat Noah started acting very strange. He was like a rag doll when he was usually strong and fierce. The week leading up to it, there were warning signs. He hid under the bed (he never does this), peed on an indoor plant and acted "off." It was the last straw when I woke up the next morning and he was laying on his side, panting like a dog. He vomited clear mucous and later in the afternoon, when he tried to walk, his hind legs sort of dragged. I looked up symptoms and found a vet that was opened on the weekend. They saved his life! They put in a catheter and flushed his swollen bladder. He had to be on an IV and has been back each morning for them to drain his bladder manually, because he still can't pee on his own. They put him on special food, which he loves. The vet says he may need surgery in the future, but for now he's getting better everyday. I thank the vets that saved him. I can't imagine losing him at 8 years old. I am so happy I caught it in time, because the vet said if I'd have waited til morning, he would have been in a coma. So happy to have my Noah home and healthy :D
Barbara Wilhite November 07, 2013 at 12:12 PM
I have my cat Jones at the vet now. This is the 2nd time in a little over a year that he has had a blocked urethra. The first time it took three times on catheter and now he is on his 2nd. The vet said stress and diet has a lot to to with it. It is hard to keep a cat on special diet when you have 3 other cats. One is 15 years old and is on medication for thyroid and needs to eat more. The vet mentioned penis amputation as a final resort but I don't know all the repercussions that can happen from that procedure, does anyone have any experience with that?
Richard Dwane November 19, 2013 at 02:27 PM
I've just left the vets after dropping off my 'boy' Guinness. Having emergency op overnight. Don't know what I'll do if he doesn't make it. He's seemed fine, but had one bit of blood about a week ago. Vets said he's all blocked up and very poorly. I may have left it too late. I won't sleep tonight... fingers crossed he pulls through 😞
Brad Marquez November 21, 2013 at 02:31 PM
we had this problem with our 6 year old male cat. it was really bad the second time around. we came to the decition to let him go. because we didnt want him living with that pain for the rest of his life. love ya Fritters rest in peace 11-19-2013
Barbara Wilhite November 21, 2013 at 02:55 PM
Update, After 2nd catheter I suggested Jones might be getting stressed and blocking again there at the vets hospital so I took him home, gave him his pain meds and cat prozac and now he is fine. Going to the bathroom good. I will just have to be very careful and not allow him to get stressed out. Sometimes it is best to go with your gut feelings.
T.s. Roberts December 18, 2013 at 12:28 AM
Can any of you that have been thru this tell me the vet bill amount? We believe our baby boy May May is having this problem. Emergency Vets wants 150 up front to examine him which we don't have. This is killing us because he means so much to us. Any ideas?
Barbara Wilhite December 18, 2013 at 10:36 AM
Mine was about $1,398 He was in the hospital from 11/4 to 11/9. They had to put a catheter in twice. They allowed me to put it on account and pay it monthly ($200 every 2 weeks) I suggest asking or at least applying for care credit since they allow to pay off during a promotion with no interest. It is hard paying that amount but this situation is an emergency for the cat. This is the 2nd time in a little over a year it happened. I have made some changes and will keep his stressful situations in mind and try to keep him as non stressed as possible. When I have a situation that I know will be stressful for him I have some "cat prozac" type meds to help keep him calm. Good luck, I hope everything works out. I know these pets are a part of the family and it is hard when they get sick.
Barbara Wilhite December 18, 2013 at 10:37 AM
Also I just feed him canned food, not much dry at all to speak of.
T.s. Roberts December 18, 2013 at 10:11 PM
May May had his surgery today. His dr said the she had a lil bit of a hard time getting the catheter in but was finally successful. She drained his bladder. She said he isn't out of the woods just yet. His kidney tests she said that's the highest levels she had ever seen. He is only 7 and he is a fighter. She will office opens at
T.s. Roberts December 18, 2013 at 10:11 PM
May May had his surgery today. His dr said the she had a lil bit of a hard time getting the catheter in but was finally successful. She drained his bladder. She said he isn't out of the woods just yet. His kidney tests she said that's the highest levels she had ever seen. He is only 7 and he is a fighter. She will office opens at
T.s. Roberts December 21, 2013 at 08:05 PM
We got him home today but they want us to bring him back on Monday. We have to give him pain meds four times per day and a chewable antibiotic 3 times per day. He isn't eating very much at all, nor drinking. He is however slobbering a whole bunch. Any clue as to why?
Michael Philp February 07, 2014 at 02:38 PM
My cat was put down for this reason and after hearing peoples storys and doing a little research of my own it turns out the decision they made to put my cat down was unjustified, i took my cats to the vets after like 2 days of him not being able to urinate, vets told me he was critical and needed to go to hospital but he was going to be fine... 1 hour later i recieve a call from the hospital telling me there is nothing they can do for my cat his kidneys were "failing" not failed "failING" and he needs to be put down... Whilst researching this condition i find out that yes the kidneys do start to fail but as soon as the bladder is emptied the kidneys slowly return to full working order and correct any urinal issues within the cats bladder... So my gut feeling was right they did not do enough for my cat and simply could not be bothered to do there job properly and as a result my cat was snatched from life for un-necessary reason at the age of only 2 and a half. Such a cruel world we live in.
Barbara Wilhite February 07, 2014 at 02:58 PM
So sorry for your loss.
Sherri Strikwerda February 08, 2014 at 08:11 PM
What is the expected/average time period between the removal of a urinary catheter in a male cat and a regular urination of the cat on his own?
Barbara Wilhite February 08, 2014 at 10:03 PM
He should be able to urinate on his own but it will be somewhat painful so having the cat on a strong pain medication will be necessary. My cat was also on Amitriptyline, "cat prozac" My boy stressed and reblocked at the vet so I took him home and gave him the meds and watched his urine output. Fed only can foods, UR Prescript at first and now he is doing great, knock on wood!
Barbara Wilhite February 08, 2014 at 10:04 PM
oh, It took about a week for him to get off the pain meds.
Sherri Strikwerda February 08, 2014 at 10:15 PM
My boy's catheter came out around 2pm today and he just peed on his own at around 8:30pm! Yay!! Now, I just need to keep him "flowing"! He's on the Rx diet right now and sub-Q fluids. Cross your fingers! Oh, he is also on pain meds, antibiotics and anti-spasmotics. He's feeling a bit silly and dopey right now.
Steve L. Patterson March 11, 2014 at 01:55 PM
My boy cat Tygrah, developed a blocked bladder in January of this year. Didn't know what was wrong with him at first. I knew he had passed some blood the day before. Found him lying on his side at the bottom of the stairs in my basement when the symptoms first manifested. He didn't show any outward signs of pain, just kind of curled up and not moving around. I didn't think much of it at first. I got him and since it was morning proceeded to fill his food bowl. I had always given him a combination of wet and dry food to have during the day while I was at work. I fed him and left to go to work. When I returned home from work he hadn't eaten so I chalked it up to the fact that he might not be feeling well. I had gone through a scenario like this a couple of times before and he always bounced back in a few days and all went back to normal. I laid him in his bed and went back to check on him several times during the night. Still no change and not wanting to eat or drink. He had become very lethargic and only wanted to lie down. The second morning I went down to feed him, still no change and I was becoming worried that he would be able to get past this on his own like before. I covered him with a heavy shirt from a former job. I returned to find him up but not moving around much. I knew it was time to get him some help or he would not last much longer. I called the vet's office and explained the situation to the receptionist. She consulted with the doctor and asked if I could bring him tomorrow. I informed them that he may not last through the next and then once apprised of his condition the doctor wanted me to bring him in immediately. At the vet's office Tygrah underwent preliminary examination was weighed. The vet examined his mouth and facial area and then began to feel his abdominal area. She then discovered his bladder was distended and recommended immediate surgery to correct it. During all of his discomfort my little boy only meowed once when the vet assistant took him in her arms to start the procedure. He was unblocked and brought home. He ate a small amount of food. Then he began to refuse food again and I had to try to force food into him along with his medicine. The vet told me to make sure than he ate and urinated but he was refusing to do both. I called the vet and told her of the symptoms and she asked me to bring him back. His bladder had blocked and and the procedure had to be repeated. He was catheterized and hooked back up to IV fluids. He seemed to recover and I was allowed to take him home again. I got him to eat a small amount and take his medication. He slept with me overnight on the couch. The next morning when I got ready to feed him his morning meal he ate but later began to vomit. I emailed the vet and she responded and asked me to bring him in. We had a consultation and she said if he didn't recover we might have to consider some life altering alternatives(euthanasia). I wasn't ready to give up on him yet as he had responded. One of his kidneys was doing good but the other was only partially working and instead of IV he was given a subcutaneous fluid pack and put up for observation. During his sickness, he had also lost about three pounds. Tygrah made a remarkable recovery and now this kitty is just a little bundle of energy and never seems to slow down. Hardly seems like the sick kitty the vet was considering we might have to put down.
Barbara Wilhite March 11, 2014 at 04:42 PM
whew! You had me worried there for a while! Glad he made a nice recovery. Keep feeding wet food only.
Steve L. Patterson March 11, 2014 at 08:21 PM
Thanks for your concern Barbara. I know that post was quite long. Yes I feed him a combination of wet food and leave him treats to have to snack on during the day. A typical morning meal is a can of Purina Pro Plan Urinary Tract 3.3 ounce canned cat food and a can of Friskies pate style food mixed together along with a big fresh bowl of water and a small bowl of treats. By the time I return from work all of his wet food is gone along with about half of the treats and the water bowl is half empty. His evening meal consists of another 3.3 ounce can of urinary tract cat food a can of Fancy Feast pate style and refill the water bowl with fresh water. He has been eating like this since I brought him home the last time. Vet said he needed to gain weight. He is a magical little kitty. He makes food disappear and he is not overweight.
Derrick Pizzo April 16, 2014 at 08:02 PM
My cat came home Monday from Vet..He had crystal blockage witch we could tell from strange behavior ...They put the Catheter in for 2 days and found an infection...They charged us an said all was well with some take home pain and antibiotics..The cats behavior has not changed and now that i spent $1000 already was hoping he just needs some time to recoup...I was not informed of the surgery untill after the fact then also to find out it is only about $200 more than i already spent...I wish i knew first...Any thoughts are appreciated. Thanks


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