"Justin L" wrote in message
...
Hi,

I picked up Elwood yesterday from the vet. They said he urinated on
his own, but was still straining so they prescibed him Valium to help
with the pain.
He is eating & drinking but still having a hard time in the box. He
goes in and makes a grunting sound, and very small amounts of urine
come out. I can tell it is starting to get to him, and I really don't
want him to stress himself out and get a block again.

Is this to be expected during recovery?


Two of the possible complications of a urinary tract obstruction are
urethral damage or spasms and/or damage to the bladder detrusor muscle from
overdistention. When the bladder becomes overdistended and remains
stretched for any length of time the tight junctions between the muscle
fibers loosen up and separate a little. These little gaps between the muscle
fibers interrupt the wave of motor nerve impulses across the bladder wall
that control bladder contraction. So, even though the obstruction has been
removed, the cat can't voluntarily contract his bladder and urinate.

One way to determine if the detrusor muscle has been damaged is by
expressing the bladder manually (don't do it yourself - ask your vet show
you how). If he has a good urine stream when his bladder is expressed, that
means he doesn't have any outflow obstructions and his urethra is intact
and that his problem urinating is probably the result of a damaged detrusor
muscle. If the stream is weak he could still have a partial obstruction (or
recurrence) or urethral spasms.

Unless the bladder was severely overdistended for any length of time, the
tight junctions between the muscle fibers should tighten up and return to
normal and he should be able to contract his bladder and urinate on his own
again. I don't know how long it will take before he's urinating
normally because I don't *if* or how badly the detrusor muscle has been
damaged. *If* the detrusor muscle has been damaged, you're probably going
to have to keep his bladder empty so that the tight junctions can reform-
which means either expressing his bladder manually or using a urinary
catheter. Both carry risks: catheterization can damage the urethra and/or
cause inflammation and dysuria as well as introduce bacteria into the
urinary tract. Expressing the bladder can also damage the bladder. The vet
must be sure that the bladder wall is intact before applying pressure.



Is it normal to prescribe Vlium for this?


Yes- because valium seems to help relieve urethral spasms which are fairly
common after the removal of an urethral obstruction. That might be all
that's necessary- I sure hope so- even though I don't like to use valium in
cats because it can crash a cat's liver.

If his urethra is intact and he doesn't have spasms or a partial
obstruction, and his urine stream is strong when his bladder is expressed,
you might want to speak to your vet bethanechol- it increases detrusor
muscle tone. I'm not crazy about bethanechol but it does work and its
immeasurably less stressful for the cat. Bethanechol seems to work much
better if therapy is begun after a few days of keeping the bladder empty- at
least that was my impression with our cats.


He is also on an antibiotic, and an optional appetite stimulant.

An antibiotic is a good idea since he was probably catheterized. Hang on to
the appetite stimulant because if your vet prescribes bethanechol- you're
gonna need it.

Best of luck,

Phil