Your Cat Is Blocked. Here Is the Night.

Nobody hands you a map on the way in. Eleven at night, a carrier on your knees, a stranger asking how long he’s been like this, everything arriving out of order like a novel with the chapters shuffled. This is the map, reassembled.

The box above is the only urgent part. The rest is for the long fluorescent hours after, in a waiting room where, as one critic said of a famous play, nothing happens, twice.

§ 1The phone call

Front desks triage by phone. Use the words: my male cat is straining and producing nothing; I think he’s blocked. Everyone there knows what that means.

Have roughly ready: last normal urine, eating or not, vomiting or not, walking normally or not, current medications. Precision not required. A photo of the litter box helps — clump size and count say more than adjectives.

“Since sometime yesterday” is everyone’s answer. A camera would have said 14:52.

§ 2Triage

A blocked cat usually skips the waiting room. Hands on the belly first: a blocked bladder is distended, firm, unmistakable. Then an IV catheter, bloodwork, and a check of the heart’s rhythm.

Potassium is the immediate threat, more than the kidneys. A cat that can’t urinate accumulates it, and high potassium destabilizes the heart. The team treats it first: heart-protective medication, fluids, sometimes insulin with dextrose to push potassium back into the cells. Often stabilized within the hour.

BUN and creatinine show how hard the kidneys were pushed. Nigel’s BUN: over 130 against a ceiling near 30, for days. Alarming — and in a blocked cat, often reversible once the plug is cleared.

§ 3Unblocking

Once he’s stable enough, he’s sedated or anesthetized — never awake for this — and a urinary catheter goes in. Sterile fluid flushes the plug back into the bladder, which is emptied. Sometimes it takes several attempts and several people.

The catheter usually stays a day or two, stitched in place with a collection bag. That lets the urethra settle, prevents an immediate re-block, and lets the team measure output exactly.

§ 4The hospital stay

Expect two to four nights. The watch is for post-obstructive diuresis: freed kidneys overshoot and pour out dilute urine, and a cat can dehydrate while apparently peeing fine. Hence measuring everything in and out, and “not yet” when you ask about home.

Pain relief is standard. Antibiotics are not automatic — most obstructions aren’t infections, and good practice is to culture first.

Each morning, skip “how is he?” Ask: what was his potassium, what was his creatinine, are they trending down?

“Comfortable” is not a number. Ask for numbers.

§ 5Money

Raise it early and directly; it’s part of the outcome and clinicians know it. Costs vary widely by country, region and clinic. In the US, emergency treatment for an obstruction typically runs to four figures, more with a longer stay or surgery.

• A written estimate, low and high.
• What an extra night adds.
• Payment plans, or third-party veterinary credit.
• Whether your regular vet can take over once he’s stable.

None of these is rude. Frightened people ask them at every front desk, every day.

§ 6Coming home

He’ll look almost normal. The instructions will feel excessive. They aren’t: the first week is when re-blocking is most likely. Expect some mix of a urinary diet, pain relief, possibly a drug to relax the urethra, and orders to watch the box.

Watching is the hard part. Pale clumping litter. Checks every few hours, not glances in passing. A written log of every clump. A cheap indoor camera does this better than a person — which is how this site began. Method: reading a litter box.

§ 7Will it happen again?

Possibly. Better to know that now than be ambushed later. Recurrence after a first obstruction is real and clusters in the following weeks and months. The underlying cystitis recurs in roughly 17 to 36 percent of cats within six months, and around half over the long run.

Prazosin was long a near-default after unblocking, on the theory that relaxing the urethra prevents re-blocks. Better-designed studies — a randomized trial and a large retrospective series — haven’t supported it, and one found higher recurrence in treated cats. If your cat is on it, ask the vet who prescribed it. Don’t stop anything on your own.

Perineal urethrostomy (PU) surgically widens and shortens the urethral opening so debris passes instead of wedging. It doesn’t treat the bladder disease, but it largely removes the risk of a fatal blockage. Usually reserved for repeat blockers or a badly damaged urethra; it has its own complications. Worth understanding before 2 a.m.

The rest of the leverage is unglamorous: more water through the cat, less for him to worry about.

§ 8Waiting rooms

Too bright. Strangers on the worst night of their year. Long stretches without news — not secrecy; the news doesn’t exist yet. You’ll read the heartworm poster twice. You’ll learn the rhythm of the door.

You may go home; many clinics prefer it once the plan is set. Eat something. Write down every number.

And when he’s home, and one evening walks out of the box leaving a large, ordinary, magnificent clump where there had been nothing — there is no word for that feeling in any language. There should be.

Works cited

1. Cornell Feline Health Center. Feline Lower Urinary Tract Disease. Cornell University College of Veterinary Medicine.
2. Hanson K.R., et al. “Effect of prazosin on feline recurrent urethral obstruction.” Journal of Feline Medicine and Surgery, 2021.
3. Conway D.S., et al. “Prazosin administration increases the rate of recurrent urethral obstruction in cats: 388 cases.” Journal of the American Veterinary Medical Association, 2022.
4. Hetrick P.F., Davidow E.B. “Initial treatment factors associated with feline urethral obstruction recurrence rate: 192 cases (2004–2010).” JAVMA, 2013.
5. Kaul E., et al. “Recurrence rate and long-term course of cats with feline lower urinary tract disease.” Journal of Feline Medicine and Surgery, 2020.