Toby, an eight-year-old male tabby, had never had any medical issues until he suddenly became blocked, or unable to urinate, one day last month.

“He was going to his litter box constantly,” said Carlos B. of the Bronx, who adopted Toby as a kitten. “Back and forth, back and forth—and his personality seemed to change.”

So Carlos and his girlfriend, Julie, brought Toby to the ASPCA Animal Hospital (AAH), where he was diagnosed with Feline Urological Syndrome (FUS), or urinary blockage, by Dr. Maren Krafchik.

Most cats affected by FUS are in the one- to eight-year range, like Toby. Common symptoms include:

• Straining to urinate
• Frequent small urinations
• Blood in the urine
• Painful urination
• Inappropriate urination (somewhere other than the litter box)
• Straining without urination (urinary obstruction) 
• Crying, restlessness, or hiding because of discomfort
• Loss of  appetite
• Vomiting
• Lethargy

“Urinary blockage is a life-threatening emergency,” says Dr. Krafchik.  “Potassium levels (as well as kidney toxins) rise in the bloodstream and can cause death in a cat.”

A urinary catheter was placed to unblock Toby’s urethra and allow urine to drain from Toby’s bladder, and he received intravenous fluids and pain medication. The urinary catheter was removed a few days later, and Toby was sent home. Unfortunately, this condition can reoccur, and Toby returned to the Hospital three weeks later with another urinary obstruction. “He went back to his old symptoms,” Carlos said. 

Given Toby’s history of chronic straining and urinary problems, ASPCA veterinarians recommended a Perineal Urethrostomy (PU). This is a surgical procedure in which the external penis/urethral tissue is incised and sutured open in order to permanently widen the urethral opening. This surgery, commonly performed at AAH, helps decrease the chance of future bladder obstruction.

“Male cats are susceptible to developing obstructions of the urethra because their urethral diameter is so small,” says Dr. Krafchik. 

As of earlier this month, AAH has performed catheterization procedures for urinary blockage on 163 cats, and 37 PU surgeries—an average of almost one procedure per day in 2015.

“Many people think their pets are misbehaving by urinating outside of the litter box,” says Dr. Krafchik.  “The reality is that there can be an underlying reason for the behavior such as bladder inflammation, crystals, stones, or less likely, infection.”

Carlos reports that since Toby’s PU procedure, he is back to his old self. “He is really happy, very friendly, and playful, which we missed so much,” Carlos says. “He's eating and his bodily functions are back to normal.”