Blocked Cats

What is the most common signalment for a blocked cat

Young/ middle aged Male neutered cats, overweight

What cardiovascular things may you see w/ a blocked cat?

Arrythmisa

Weak pulse

Pale >2

Hypothermia

What does the abdomen feel like in a blocked cat?

Large turgid bladder - cant expressed (Rounded)

Painful

Cyanotic penis

What minimum database should be run for a blocked cat?

PCV/TS

Asostick

Electrolytes - Hyperkalemia

Serum lactate

Blood gas

What arrhythmias are common to see in a blocked cat?

Atrial standstill,

Ventricular fibrillation

Asystole

Tachy/ bradycardia

What is the most common presentation of a hyperkalemic ECG?

Tented T waves

Will hyperkalemic ECG waves always be present?

No

What are the steps of triaging and stabilizing a blocked cat?

IV catheter

Analgesia - pure mu opioid - reversable

Fluids

Correct hyperkalemia

What is the only true way to reduce hyperkalemia?

Unblock the cat

What fulids are recommended for correction of hyperkalemia in blocked cats?

LRS

What does Ca gluconate do for hyperkalemia?

Nothing - cardioprotectant not resolve the hyperkalemia

What does dextrose/ insulin do for hyperkalemia?

Draws k+ intracellularly - must monitor BG every 30mins for 1-2hrs if insullin

What does albuterol/ terbutaline do for hyperkalemia

Draws k+ intracellularly - lasts 3hrs

What risks for catheterization for a blocked cat?

Urethral tear

Bladder rupture

Gen anesthesia risk

What sedatives can be used for a blocked cat?

Alfaxan

Midazolam

+/- ketamine

What is a good pain control you can do for a blocked cat?

Sacrococcygeal block (caudal epideral)

Explain when to use the following urinary catheter?

Polypropylene tomcat

Rigid for unblocking

to irritating for indwelling

Explain when to use the following urinary catheter?

Slippery sam

Rigid at room temp

Soften at body temp - not labled for indwelling

Explain when to use the following urinary catheter?

Red rubber?

Too soft to unblock

Can be used for indwelling

Explain when to use the following urinary catheter?

MILA Tomcat?

Stylet for unblocking

Can be used for indwelling

What size catheter is ideal for a blocked cat?

3.5 french

What are a few catheter suture techniques?

Finger trap

Stay sutured on prepuce

Stay sutures around prepuce

What are ins and outs?

Monitoring fluids going ins and outs b/c cats can get post-obstructive diuresis

What is the main consequence of post obstructive diuresis?

severe dehydration and hypokalemia

What is the calculation for ins and outs?

(Outs - ins )/ 4 hrs = ml/hr

If outs > than ins then?

Increase fluid rates by difference

If ins > outs then?1

Assess hydration and catheter patency

What rate will tell you you have post - obstructive diuresis?

2ml/kg/hr w/in 6hrs of unblocking - lasts up to 84hrs

How should we d/c fluids on a blocked cat?

Taper by 25% every 6-12 hrs once past post obstructive diuresis

How often should we monitor labs?

Check every 24hrs if azotemic,

every hr if hyperkalemic until normal

What is the recurrence rate of Blocked catsa?

11-58% - many euthanized if recurr, some do salvage PU

When should you start urinary diet?

at home, not in hospital

When should you follow up with a blocked cat?

May not need to come in if doing well b/c stress could reblock pt