The trouble veterinarians have with blocked cats is this: While we can almost always save their lives once they’re in our hands, we can’t always ensure that they’ll get to us in time for the next crisis. And there is almost always a next time.

In case you have no idea what I’m talking about, here’s a primer:

Urinary obstruction in cats is a complicated disease seen most often in neutered male cats with smaller than normal urinary passages. A trick of the digestive, metabolic and immune systems often culminates in a perfect pathologic storm that ends in complete urinary obstruction. Something is blocking the passage between the urinary bladder and the outside world (within the tubular structure we call the urethra). Crystals, stones and just plain swelling usually have a hand in effecting the obstruction. But, truth be told, we’re kinda in the dark as to what causes it. Which is partly why we call it a "syndrome" instead of a "disease."

Frustrating, right?

Right.

And even more so when a cat arrives in crisis. Here’s this week’s scenario by way of example: The cat had been missing for two days. The kid finds it under the bushes and brings its limp body inside. Handwringing ensues over finances. Then a trip to the vet. Enter Dr. K, who submits a $500 estimate for very basic, life-saving care. I mean, the cat is flat-out non-responsive and nearing the tunnel.

Before he reaches the light, I pass a catheter and relieve his obstruction. Now, the owners are free to make a decision unfettered by imminent death. So it is that when they decide against euthanasia, they have a clear idea of what’s in store: the possibility of a future obstructive event.

Surgery can be offered by way of a near-permanent solution to the dilemma. But this is an expensive and often unnecessary solution for cats with urinary diseases that can be managed via dietary changes. Still, the truth is out there: even with dietary changes, it could happen again. And again. And again.

So at what point does a veterinarian get atop her bad-news soapbox and take a stand for surgery? Gosh, it all depends. There's no easy answer. Which should give you an inkling of the stress I endure over these cases.

Wish my current patient well, willya? Because he’s not doing so hot right about now …

Dr. Patty Khuly

Pic of the day: "Otis At Vet" by brainwise