Blocked Cat. UO. The Introduction. What Does A Blocked Cat Look Like? Part One of the Series for Feline Parents

The blocked cat. 

Beau. Blocked again, $8K in, his story is so typical,
and could have been another tragic ending.

Blocked cats are my lifelong veterinary mission. They are the place that veterinary medicine can offer the most impactful life changing care and they are also the single place we have the most alarming, dismissal statistics in actually doing it. 

The vital care needed for these cats is my passionate determined purpose. It is my hope to shed more light on this condition while inspiring others to offer more help with any, and every, degree of compromise needed so that we can relieve the suffering to save every blocked cat possible. I am proposing bold, ambitious, aggressive words of advice because of all of the many veterinary medical issues I am faced with in my day to day life there is no single other disease that has a higher prognosis to save ratio, while also escalating the cost of care so exorbitantly and unjustifiably that it has become cost prohibitive to allow most pet parents to provide it. When we allow the cost to exceed the ability to provide any degree of care the profession, the whole of the profession should be held accountable and culpable. The fact that we know most people cannot afford the ideal emergency care for this condition should be a wake up call for change. It shouldn't have to come from the outcry of the pet parents we have failed. It should come from inside the heart of our own code of ethics. With all of the miracles of modern veterinary medicine the blocked cat is both a product of our inability to educate on the appropriate care for cats before, during and after their UO, and, the profession denying every possible life saving treatment possible because we know you don't have another options to save your cat. Veterinarians, and the profession at large also knows that you cannot find affordable transparent pricing easily, if at all. We know you need us, and we know people adore their cats. We know how to take advantage of an emergency and the emotional turmoil this holds. We have profited from the intersection of emotional adoration, medical critical care, and no place for pet parents to find compassionate curative refuge. Further we have abandoned our compassion, empathy, responsibility and culpability in the process. If we are going to deny any modicum of meaningful interventional care it is time the veterinarians oath, the consequences and the challenging of what part veterinarians play in prolonging the suffering from UO's be challenged. When we offer no viable options we take responsibility for the cruelty that neglect carries.

I am here to challenge every single obstacle, empower and educate every single cat parent, and save every blocked cat I can. I am here to build a village so powerful it becomes an Army of causation for change. If the profession cannot provide affordable, transparent, compassionate care to these cats in the most dire need that is actually meaningful it is time to shift the paradigm of care based decisions back into the pet parents hands. Until the increasingly growing corporately owned monopoly releases the exorbitantly excessive costs that grip the access to pet care, and, the overseeing laws for pets being provided a higher elevation in status other than "property" are challenged there is only this, a public empowerment to permit great latitude for diversity of care based on the outcry of challenging the current Ivory Tower Gold Standard practices meant to benefit profits. The idea that we only offer what is both most profitable, albeit under the guise of ideal patient outcomes, is unrealistic and unethical. It is time to allow the conversation for ideal pet care to be shifted to an open two sided conversation. It is time to put patient options for ideal, or even viable, outcomes above all else.

This is the first part on a series of articles on this subject. This article will provide a basic overview of the condition, the clinical signs and the approach I recommend for every pet parent in the predicament of finding care for their blocked cat. The other articles will describe how to best customize your cats care to your abilities and preferences. They will also provide guidance for after care and help in addressing the likelihood of re-blocking.

Future articles will also provide a client based decision tree to help make the best decisions possible for their cat in real-time and with a team based approach to finding the best answers for you and your cat. Please follow on Pawbly.com for more help. There are also many amazing Facebook groups dedicated to this condition to help. If it takes an Army I will provide the troops and the battle plan. Never give up. Never lose hope. You are not alone and you are not helpless. Please also recognize that your voice, your pets story, these need to be heard and shared. If you find someone who won't offer options let the world know. If you find someone who will sit down with you and discuss any and every option to keep your cat alive and on the medical path to getting treatment to help them live a longer, happier life, please share this at Pawbly.com in the storylines section. It is time for all cat parents to become a part of the Army for change and care.

We are going to start here; educating, inspiring, empowering and reminding all of us that with compassion and hope anything is possible.

Urinary Obstruction, i.e. UO, or, blockage (or a "blocked cat" refers to the inability to pass urine out of your bladder, usually because the spigot is clogged. I describe it to clients as this; think of the bladder like a balloon. Think about someone tying off your balloon and then having to pee. In the beginning cats will go to the litter box frequently to try to empty the bladder. Over time the knot of the balloon gets tighter and the bladder gets larger, harder, more painful. While this is happening the toxins in the bladder become systemic to the body. The cats will often vocalize, (the loud, excruciating crying that sounds like a scream), is your cats way of saying "HELP ME!," In most cases this turns into a stupor and immobility, (lethargy that progresses to inability or unwillingness to move), because toxic doses of potassium are surging through the slowing heart, until it stops, OR, the patient dies after the bladder ruptures inside the abdomen. 

What a blocked cat looks like;

• frequent trips to the litter box
• meowing, crying, vocalizing in the litter box
• producing small amounts of urine more frequently
• licking at the area of the anus, prepuce, under the tail area
• not eating well
• not playful, happy, or calm
• agitated, not their normal self
• pawing at the litter in the box more aggressively, or frequently
• urinating outside of the box
• the urine looks bloody, or cloudy, blood spots on the tile floor, or bathtub
• angry if you touch or pet the belly area
• indoor, male, young cats are most common for UO

If your cat is doing any of these please go to the vet, or ER immediately. Waiting will worsen your cats chance of survival and make the cost of care more expensive.

Urinary blockage, (UO), happens primarily to young male cats (2-7 years old), who are indoor and being fed dry food, (usually poor quality dry food). They were previously otherwise happy, healthy, vibrant adoring cats. There is a horrific irony that the most vulnerable are often the youngest and the most beloved. The hidden joys in a home where the love of a cat who purrs you to sleep every night defines your ability to face a world outside your door that is too often unkind and unwilling to help.

Cash

It is my hope that veterinarians, and the veterinary medical community, start focusing on what we can do, regardless of cost, regardless of ideal standards of care, and let pet parents find help for a very treatable condition. It is also my hope that sharing successful stories, highlighting that these cats often have bumps in the road initially, but they can, and overwhelmingly do, go on to live long healthy lives. There is hope where there is compassion. 

Focus on this. I know that your cat is suffering from this disease, but I also know that these cats look like death when they arrive, and go back to living long healthy lives the majority of the time after they are treated. 

These patients are so young, and this is (almost always) treatable! Your cat and this issue are not uncommon. I hear about cases like yours all the time.

Here's where my Blocked Cat plan shifts the decision making, and optimal treatment options back to the pet parent for the best chances at saving these cats lives.

There is a storyline section where all of this can be added. My hope is to find a way to help everyone in your predicament. And I cannot possibly do every cat and every pu surgery.

So let’s start with the immediate. 

1. Diagnosis. Your cat needs this. A vet is needed. cost of exam $_____. This is a disease made by a physical exam, not thousands of dollars of diagnostics. Period.
2. Unblock costs this $____. You should ask for a detailed, exact list, of how this was done. It should be given to you in writing. (Insider secret; in some cases no anesthetic is needed, or given why do you have to pay for it? Keep a copy of everything you sign). 
3. Get every piece of your cats veterinary findings in real time. For example, as soon as your cat is examined you should be given, or write down all of the physical exam findings. 
4. If number 2 is not feasible, decompress by cystocentesis. Buy time by removing urine. Cost __. Get to a veterinarian who will help you affordably ASAP! You have (maybe) 12 hours.
5. Fluid therapy for 3 days. Maybe more. I treat until urine is clear and patient is acting normally again. 
6. If you cannot afford in hospital stay ask to bring your cat home with the urinary and iv catheter in place. Go to your vets office with these. They are often much more affordable than the ER, although not 24/7. If they will not keep your cat ask about having one of their technicians help you? These cats can be safely and effectively treated as an outpatient. They should wear an ecollar 24/7 to protect these catheters. Replacing the urinary catheter might cost you over $1,000.

If you cannot get these I recommend that you challenge every line item, impose upon every obstacle and call every local veterinarian, speak out on every social media platform and read the next series of my blocked cat blogs and YouTube videos. 

Your cat needs to be diagnosed, unblocked, and get i.v. fluids. Immediately! This is our most important minimum. The very bare basics. Now I have been a vet for a long time. I don't care how this happens, where it happens, or who gets paid for this. I want your cat to survive. We are talking about survival. We are talking about putting the patient above all else. 

Then your cat needs adequate time with the treatment plan for it to matter. In many cases people cannot afford the recommended number of hospital days the veterinary hospital is recommending. What happens next is almost as awful as remaining blocked, what happens next is the hospital decides length of stat based on available funds. WHAT SHOULD HAPPEN IS THE CLIENT AND HOSPITAL AGREE ON A PLAN THAT PROVIDES THE BEST CHANCE AT RESOLUTION BASED ON AVAILABLE RESOURCES. The hospital should be willing to compromise their financial gain by what the patient needs. There should be a plan that allows the adequate urinary and fluid catheters and decline the diagnostics that are advisable but not mandatory. These cats need three things more than anything else; 

1. urinary unblocking via indwelling urinary catheter

2. intravenous fluids to correct azotemia and electrolyte imbalances

3 time with both of the above..

If every person in the cats healthcare service plan was dedicated to getting these highly treatable cats the care they needed this blog, this whole movement for change wouldn't be needed. It wouldn't gain any traction, and it would be just another vet story in the mist. Instead my clinic phone rings every day with people in the most desperate place to find help. 

My point is that I don’t give up. I hope you don’t either. I will help but we have to figure this out for cats everywhere. In a profession that utilizes the tag line that "every case is unique and every treatment plan tailored" why aren't we allowing the pet parent to dictate the terms of the treatment plan so that an acceptable chance of cure is the only objective? To make this happen both parties have to agree that the only meaningful outcome is providing care to the best of all parties ability. Every cost, every line item on the invoice, and every out of the box option is acceptable and on the table. Consent for deviation of standard of care is provided and the patients life is above all else. For modern vetmed this will require stockholders to give up revenues to put the patients first. This is the war. Here is where the Army needs to be building their foundation and footing. Here is where the challenges are going to be fought. Here is where an insiders tips are lifesaving tools to keep at the ready.

If you are a cat parent please ask your vet how they manage these cases. If they tell you that they refer them to the ER ask the ER for an estimate for this before it happens to you so that you can be prepared for it. If the cost is too excessive find a general practitioner who is willing to help your cat in house. Ask what this estimate is. Be prepared before the emergency happens. Share your findings at pawbly.com, or leave a comment below. We are always looking to highlight practices, and practitioners, who offer help and don't discriminate based on financial ability.

Robert

I expect that these words, these tabs of advice, the backward driven decision tree of care to help you get your cat out alive in the minefield of highly profitable, almost absent empathy, for a young cat with their whole healthy long life ahead of them will be met with anger, accusation and venom by the colleagues of my profession who have euthanized before compromising what "ideal care looks like." Bring it on. It's time to put the patients above all else again. It's time to save every blocked cat we can.

There are other articles on this subject. Please follow along. Please utilize all of the resources I share. Please also become a part of this Army. Share your successes. Share your stories. Share the providers who cared enough to offer options outside of the first treatment plan they propose. Share the voices to build a village focused on the lives that so many of us consider our family.

I have been practicing veterinary medicine for almost 20 years. In 20 years I think I have treated hundreds of blocked cats. I have lost 2. I have never denied care based on cost. I have never recommended that euthanasia be chosen for this condition. I have learned how to do a PU surgery because I had to. I have been stressed, anxious, and afraid for my patients lives, but I have never given up on them. I will never give up on them. The profession of veterinary medicine owes these cats much more than we are providing them now. 

Krista

What can you do right now? What should your immediate take-away?

• You need to keep your cat on a good diet (I recommend a high quality canned food)
• You need to keep your cat happy, engaged, active, and think about their environment and how you can enrich it everyday
• You need to ask your vet how they would manage it if your cat blocked today? Would they refer you? What would that cost, and what would happen if you couldn't afford it? If they can't help you in a way that is meaningful to your cat getting out alive find another vet who can, and will. NOW.

See all of my blocked cat videos on my YouTube channel here;

Follow me on my veterinary clinic homepage, Jarrettsville Veterinary Center, here.

Jarrettsville Veterinary Center Facebook page here.

Ask me for help for free here; Pawbly.com

Disclaimer,, because you know this is the world we live in; I am not an internal medicine specialist, nor an emergency medicine specialist, nor a surgeon. I live, work, love, reside and chose to work in the trenches over every day general practice. I live in the place that the veterinarians before me made the most honorable yet humble profession in the world. I came here to save the lives that need me, and the rest of us, not become the wealthiest, nor the most exclusive. While I understand there are many others in this profession that will challenge my motives, and their own, I will say without hesitation that you are either here to serve your patients or get out of the way of all of the rest of us intent on just this. It is not about you, or even your perception of what "compassionate care" is.