The Blocked Cat

So we started with these presenting signs…

http://twitter.com/Seh_Fid/status/459407342153760768

We all agreed to cat needed to be seen ASAP, although this could be cystitis which isn’t an emergency, a blocked cat most certainly is!

Our Case

http://twitter.com/Seh_Fid/status/459409520780128256

So first of all its really important to get a good history & undertake a complete PE, although we’re worried about the bladder & urogenital tract, need to check the cat all over!
So this was what we found

So the cat is pretty bradycardic! This is likely related to hyperkalemia

Lots of us wanted to take bloods for electrolytes now, but firstly we need to stabalise our animal

So what fluid do we use?

A bit of debate as to whether crystalloid saline or hartmanns would be a suitable choice due to the additional K, but it appears that hartmanns has no deleterious effects on the cats.

http://twitter.com/MShilleto/status/459415101490343936

In fact the attached article shows that Hartmanns/CSL/Lactated ringers are actually a BETTER fluid choice in blocked cats!

What else do we want to do with our cat?

ECG is a good idea, monitor the complexes!

http://twitter.com/Seh_Fid/status/459415721391693824

So we want analgesia that will keep our patient stable, so no alpha 2’s & avoid those NSAIDs due to kidney worries.

We wondered whether we should unblock the cat ASAP, but infact its important to get the cat stable first. So start the IVFT before anything else!

We’ve started fluids but still concerned re hyperkalaemia, what do we do?

So to reduce the hyperkalaemia, we give IV insulin & glucose, and calcium gluconate. See below for why we use these drugs.

Thoughts are that if the cat is not improved we might need to repeat the calcium gluconate after 20-40mins

However its really important you monitor BG in cats your giving insulin too- or we risk hypoglycaemic collapse!

The ECG for this cat is shown below

http://twitter.com/Seh_Fid/status/459419050855391232

So is cystocentesis a good idea to help relieve the cat?

NO! No benefits to doing it, all cons no pros.

So we have stabilised the cat, got it on fluids, treated it with insulin/glucose & calcium gluconate & placed an ECG on it to monitor the complexes. How do we unblock that bladder?

Some concern about the best way to GA/sedate the cat, but we should have stabalised it prior to unblocking so the CVS effects of the drugs should be reduced. So can use any drugs but AVOID alpha 2’s

The art of unblocking the cat

Thanks for a really great case this evening Dominic, I hope you’ve all found it useful & are ready to treat your first blocked cat in practice.
See you all next week for lameness in cows with Chris Hudson.
Also see this good link for more info on blocked cats- parts of it such as cystocentesis we have disagreed with, but some useful other stuff in there!
 http://www.cvm.umn.edu/depts/minnesotaurolithcenter/prod/groups/cvm/@pub/@cvm/@urolith/documents/asset/cvm_asset_199031.pdf